Tuberculosis

Over the next few online lessons you will be

taking a detailed look at some specific pathogens
and the diseases they cause, starting with …

Tuberculosis!
Textbook pages:
Textbook pages:
 What is TB?
TB is an infectious disease that can affect any part
of the body although it is usually found in the
lungs.
• Mycobacterium tuberculosis
– Between humans
– Droplet infection
• Mycobacterium bovis
– Between humans and cattle
– Milk (unpasteurised)
& droplet infection
Human TB in sputum
The 22 countries with the highest burden of tuberculosis, which
account for 80% cases worldwide—are labelled.
Chest X-ray of a
person with
advanced
tuberculosis.
Infection in
both lungs is
marked by
white arrow-
heads, and the
formation of a
cavity is
marked by
black arrows.
 Symptoms
• Fever
• Night-time sweating
• Loss of weight
• Persistent cough
• Constant tiredness
• Loss of appetite
• Coughing up blood
 How is it caught?
• aerosol infection.
• 22% of those in close or prolonged contact
with a person carrying the disease become
infected.
Is associated with AIDS and / or people with
immune-suppression. (Why do you think this is
the case?)
How is it caught?
 Course of Infection
1. Primary infection.
• Can last for several months and give no symptoms.
• The person infected deals with the infection by their
macrophages engulfing the bacteria that have
invaded the lung.
• However tissue masses form containing dead
bacteria and macrophages in the centre.
• These tissues are called tubercules.
• After 3-8 weeks if the infection is controlled and the
lung heals. White spots are
tubercules. These are
• Most primary infections happen in childhood.
in rabbit’s lungs.
 2. Second phase - Active TB:
• Happens when a previous infection is no longer controlled or if the
body is overwhelmed by a high dose of bacteria.

• What things might trigger a reactivation of TB?

• Bacteria multiply rapidly and break down tissue in the lungs causing
spaces where alveoli should be.

• How will this affect gas exchange?

• The bacteria target T-cells and therefore reduce the production of

antibodies.

• Which T-cells will help antibody production?

• Eventually TB causes death.

• How?
 How TB evades the Immune system.
Bacteria have a thick waxy
outer layer which protects
them from attack by
macrophage enzymes.
They lie dormant in the
tubercules until the person
has a weakened immune
system.
What selection mechanism is
happening here?
TB can disable two of the
mechanisms a macrophage uses
against bacteria.
First it disrupts the production
of cytokines.
Second it stops the apoptosis of
the macrophage – which
normally will happen after
invasion.
 Vaccination
• Western Countries - The Bacillus Calmette-Guerin
(BCG) vaccine
• Attenuated version of M. bovis
• What does “attentuated “ mean?

• Drugs – must be taken for 6-9 months

• Drug-resistant strains now exist

Explain this graph
The Evolutionary Race.
In the book, “Alice Thorough the
Looking Glass” Alice complains that
she is exhausted from running, only
to find she is still right where she
started from. The Red Queen’s
reply: “Now, here, you see, it takes
all the running you can do to keep
in the same place. If you want to get
somewhere else, you must run at
least twice as fast as that.” As Van
Valen (evolutionary biologist),
described it, the best a species can
do to survive, he said, is to respond
to an adversary’s adaptations,
quickly and without pause.
 Application of Knowledge Question:
• How does the possession of the evasion
mechanisms of TB support the concept of an
“evolutionary race” between the pathogens
and their hosts?

• ( 4 marks).