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Tuberculosis' hidden threat

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Tuberculosis' hidden threat PostMon Dec 03, 2007 11:07 pm  Reply with quote  

Why is our government suddenly so concerned with TB?

Here IMHO is what they are really worried about:

--Pulmonary tuberculosis, combined with pulmonary AIDS, would be highly lethal because both the microbes would be coughed into the air, and both remain infec­tious for more than a week at room temperature .... Journal Royal Social Medicine '86 pp 122
--Dr. BIaser of the Vete­rans Administration Medical Center in Denver has found that "the earliest manifestation of AIDS in persons native to developing countries is frequently tuberculosis." Journal American Medical Association , '86 p 255: 463-464
--The Wall Street Journal, in 1986, presented a report, "Tuberculosis Rise among AIDS Patients Raises Con­cern about Wider TB Infection", stating:
Public health officials are keeping a worried watch on a new epidemic: the appearance of tuberculosis in the same groups of people that are at high risk of developing AIDS.
a pattern was also emerging of young, white American-born TB victims, she says. The common element among the victims was the presence of AIDS, she adds ....

In the past two years, cases of TB, known as the white plague in the 19th century, have been diagnosed among drug addicts in New York City, among young, white male AIDS patients in San Francisco and among Haitians in Miami. ...
TB in Miami
In Miami, TB cases grew by 38% last year, with the largest increases among men in the 25 to 44 age group, says Janice Burr, a Dade County health official. The department had earlier noted ocurrences of TB among Haitians with AIDS, but
Increase in San Francisco
1 ... "We're finding that the incidence of TB in AIDS patients is five times that of the regular population of San Francisco", says Gisella Schecter, tuberculosis controller for the city's health departmerlt. San Francisco reported a 10% gain in TB cases in 1985 ....
In about half of the San Francisco cases, TB was diag­nosed before AIDS. But the city doesn't know to what extent tuberculosis is occurring among carriers of the AIDS virus who don't have the disease, she says, because California law restricts the use of the AIDS test. ... 49
A textbook for medical students, The Pathogenesis of Infectious Disease, by Cedric A. Mims, states:
Respiratory Tract
In infections transmitted by the respiratory route, shedding depends on the production of air-borne parti­cles (aerosols) containing microorganisms. These are produced to some extent in the larynx, mouth and throat during speech and normal breathing ... more patho­genic streptococci, meningococci and other microorga­nisms are also spread in this way, especially when people are crowded together inside buildings or vehicles. There is particularly good aerosol formation during singing and it is always dangerous to sing in a choir with patients suffering from pulmonary tuberculosis. Microorganisms in the mouth, throat, larynx and lungs are expelled to the exterior with much greater efficiency during coughing,

shedding to. the. exterior is assured when there are increased mucus secretions and the cough reflex is induced. Tubercle bacilli in the lungs that are carried up to the back of the throat are mostly swallowed and can be detected in stomach washings, but a cough will project bacteria into the air.
Efficient shedding from the nasal cavity depends on an increase in nasal secretions and on the induction of sneezing. In a sneeze up to 20,000 droplets are pro­duced and during the common cold, for instance, many of them will contain virus particles. The largest droplets (I mm diameter) fall to the ground after travelling IS feet or so and the smaller ones evaporate rapidly, depending on their velocity, water content and on the relative humidity. Many have disappeared within a few feet and the rest, including those containing micro­organisms, then settle according to size. The smallest, although they fall theoretically at 1-3 feet per hour, in fact stay suspended indefinitely because air is never quite still. Particles of this size are likely to pass the turbinate baffles and reach the lower respiratory tract. If the microorganisms are hardy, as in the case of the tubercle bacillus and smallpox virus, people coming into the room later on can be infectedSO [emphasis added].

Lancet, the Journal of the American Medical Associa­tion commented in the Medical News section:
A recent report from the Pasteur Institute in Paris by the investigators who originally isolated the lymphadenopathy virus suggests that the AIDS virus might be pretty tough. The French study finds that virus survives ten days at room temperature even when dried out in a petri dish,27
Six months after the Pasteur Institute study was
reported, researchers from the laboratory of Tumor Cell Biology, National Institutes of Health and else­where reported findings on the stability of concentrated amounts of the AIDS virus:
In view of the serious consequence of HTLV-II1/LAV infection, its stability under clinical and laboratory condi­tions and its inactivation by commonly utilized inactivat­ing agents and disinfectants are of tremendous importance

to health care workers and laboratory personnel. Here, the results of testing the stability of HTLV-Ill/LAV under various experimentalconditions are reported ....
To test the effect of some frequently encountered clinical and laboratory conditions on the infectivity of the HTLV-III (TM), virus diluted in media supplemented with 50% human plasma was dried..and incubated at 23 to 27 degrees Centigrade, or incubated in an aqueous state at one of several different temperatures: room temperature (23 to 27 degrees Centigrade), 36 to 37 degrees Centigrade, and 54 to 56 degrees Centigrade for various periods of time. In a dried state, complete inactivation of virus required between three and seven days ....
Exposing virus to different temperatures resulted in a reduction of infectious virus corresponding to increas­ing times of incubation and increasing temperatures. Complete inactivation ... of infectious virus was seen between I I and I5 days of exposure at 36 to 37 degrees Centigrade. Infectious virus was still detected after 15 days at room temperature ....
Infectious cell-free virus could be recovered from dried material after up to three days at room temperature, and in an aqueous environment (e.g., water), infectious virus survived longer than IS days at room temperature. Even under the more rigorous heating conditions com­monly used to inactivate complement (54 to 56 degrees Centigrade [133 degrees Fahrenheit]), infectious virus was detected three hours after exposure .... The stabil­ity of HTLV-III at 54 to 56 degrees Centigrade suggests that the inactivation of virus in blood products (e.g., antihemophilia factors) could require more extensive treatment, as has been suggested.28
The lack of accurate news coverage regarding this critical information is highly discomfiting. More disturb­ing still are the recommendations by the French researchers for guarding against AIDS transmission. They give specific safety precautions for. medical and dental personnel which clearly intimate that oral transmission of AIDS through saliva is a danger to be reckoned with. They also advise that hygiene should be increased in the general population. The question of who should disinfect whom, how, what and where are left unan­swered. For example, when an AIDS virus carrier coughs or sneezes infected secretions into a punch bowl or salad bar, the AIDS virus could remain infectious for quite some time. When a cook or waiter contaminates food with infected saliva or other body fluids-i.e., coughs, sheds infected tears while slicing onions or sustains a cut and contaminates the food with blood - what should be done? Should one spray or wash the contaminated foodstuffs with chemical disinfectant? Or should the hapless patron simply swallow hard and hope for the best?
In any case, it does appear that a lentivirus which remains infectious for ten days or longer in dry form may be not quite as delicate and innocuous outside the body as has been widely rumored.

Lentivirus Transmission in Sheep
The most telling indication of the potential for casual transmission Of AIDS is the nature of the AIDS agent itself. The AIDS virus is a highly potent lentivirus. Maedi-visna,the form of lentivirus infection appearing in sheep kills the animals through a deadly form of pneumonia or through gradual but progressive brain disease. Dr. Slaff of the National Institutes of Health affirms that the visna virus is the animal virus closest to the AIDS virus.43
Lentivirus infection in sheep involves a means of spread consonant with casual transmission in man. In the 1976 treatise Slow Virus Diseases of Animals and Man, P. A. Palsson described the transmissibility of maedi lentivirus among sheep:
maedi was successfully transmitted to healthy sheep by direct contact between healthy and diseased animals, by contaminating their drinking water with faeces from diseased animals and by injecting material from typi­cally affected lungs and lymph nodes intranasally [into nasal passages] ... and intravenously ....
In advanced stages of maedi the presence of the viral agent can be demonstrated regularly in various organs. Occasionally maedi virus has also been demonstrated in nasal swabs from such sheep. During the clinical course of [maedi infection] fits of dry coughing are occasionally seen, and thick mucous is often seen in the larger bronchi.
Transmission of maedi by the respiratory route as a droplet spread of the infectious agent while animals are in close contact is considered from field experience to be the most likely way the disease is spread naturally 44

Simply put, the lentivirus which causes lethal pneumo­nia in sheep is spread by coughing. Dr. BIaser of the Vete­rans Administration Medical Center in Denver has found that "the earliest manifestation of AIDS in persons native to developing countries is frequently tuberculosis." 45
Dr. John Seale comments:

Pulmonary tuberculosis is often the initial clinical manifes­tation of infection with LAV (the AIDS virus) in Haiti and Central Africa. Indeed, it was suggested last month in the Lancet, that infection with M tuberculosis hominis should be included as a manifestation of lesser AIDS or ARC. CDC remains silent on this absolutely fundamental issue.
Pulmonary infection with M tuberculosis hominis is characteristically transmitted via respiratory aerosols. If open, cavitating, pulmonary tuberculosis coexists with chronic lymphoid interstitial pneumonitis caused by LAY, it is inevitable that large numbers of infectious LAY virons, as well as tubercle bacilli, will be expelled in aerosols during coughing. LAY spread by the respiratory route would affect men and women equally; spouses and children of index cases would be particularly at risk, as has already been observed in Africa.46
An illustration of the phenomenon described by Dr. Seale was reported in the July 18, 1985, issue of Lancet. Researchers from France, including two from the Pasteur Institute, reported:
We recently examined a Haitian woman with the AIDS­related complex in whom LAY [the AIDS virus) was isolated simultaneously from blood and bronchoalveolar lavage fluid. LAY has previously been isolated from peripheral-blood lymphocytes, saliva, semen, lymph nodes, and brain, but in this case it was isolated from pulmonary secretions [lung fluid].

The woman, Who had no history of blood transfusion, drug abuse or sexual promiscuity, was diagnosed as having AIDS virus~induced lymphoid interstitial pneumonitis.47
Regardingthe less-well-known ability of the AIDS virus to Infect cells in the lungs, Dr. Seale wrote recently in the Journal ol the Royal Society of Medicine:
... Chronic lymphoid interstitial pneumonitis (CLIP) is such a characteristic feature of paediatric AIDS that CDC, when it redefined AIDS on 28 June 1985, decided to include CLIP. Serological tests for HTLV-III/LAV antibodies had to be positive, but no evidence of oppor­tunistic infections was required for the diagnosis, pro­vided that it occurred in children under the age of thirteen. Evidence now emerging from Central Africa shows that in the later stages of the AIDS epidemic, large numbers of adults as well as children develop CLIP, often in association with pulmonary tuberculosis.
Pulmonary tuberculosis, combined with pulmonary AIDS, would be highly lethal because both the microbes would be coughed into the air, and both remain infec­tious for more than a week at room temperature .... 48
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