Table Of ContentT
UBERCULOSIS
S
AND UPERBUGS
EXAMINING TB AND
BACTERIAL INFECTIONS
DISEASES,
DISORDERS,
SYMPTOMS
Evelyn B. Kelly, PhD, Ian Willkkeerr,,
and
Marylou Ambrose
Copyright © 2015 by Enslow Publishers, Inc.
Jasmine Health, an imprint of Enslow Publishers, Inc.
Originally published as Investigating Tuberculosis and Superbugs: Real Facts for Real Lives in 2011.
All rights reserved.
No part of this book may be reproduced by any means
without the written permission of the publisher.
Library of Congress Cataloging-in-Publication Data
Kelly, Evelyn B., author.
Tuberculosis and superbugs : examining TB and bacterial infections / Evelyn B. Kelly, PhD,
Ian Wilker, and Marylou Ambrose.
pages cm. — (Diseases, disorders, symptoms)
Summary: “Discusses tuberculosis and other drug-resistant diseases, including risk factors,
causes, symptoms, history, prevention, diagnosis, treatment, and coping.” — Provided by
publisher.
Includes bibliographical references and index.
ISBN 978-1-62293-085-2
1. Tuberculosis—Juvenile literature. 2. Drug resistance in microorganisms—Juvenile literature.
3. Multidrug-resistant tuberculosis—Juvenile literature. I. Wilker, Ian, author. II. Ambrose,
Marylou, author. III. Title.
RC311.K45 2015
616.9’041—dc23
2014019142
Future editions:
Paperback ISBN: 978-1-62293-086-9
EPUB ISBN: 978-1-62293-087-6
Single-User PDF ISBN: 978-1-62293-088-3
Multi-User PDF ISBN: 978-1-62293-089-0
This is the PDF version 1.0.
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Illustration Credits: Photographee.eu/Shutterstock.com, p. 4; stockdevil/iStock/©Thinkstock
(pulmonary tuberculosis).
Cover Illustration: stockdevil/iStock/©Thinkstock (pulmonary tuberculosis); Stefanina Hill/
Shutterstock.com (Rod of Asclepius on spine).
C
ONTENTS
What Are Tuberculosis and Other
Superbugs? ............................................................ 5
Introduction ........................................................ 7
1 Understanding Tuberculosis ..................... 8
2 Understanding Other Superbugs ...........18
3 The History of TB and Other
Superbugs .............................................................27
4 Preventing TB and Other Superbugs ..40
5 Testing and Treatment.................................51
6 Outlook for the Future ...............................64
7 Living With TB and Other
Superbugs .............................................................76
Chapter Notes ...........................................................84
Glossary .....................................................................91
For More Information .............................................93
Index ..........................................................................94
Searching for a cure, a scientist examines a specimen.
W A
HAT RE
T
UBERCULOSIS AND
O S ?
THER UPERBUGS
WHAT IS TUBERCULOSIS?
Tuberculosis is an infectious, potentially fatal disease that is caused by
bacteria and usually affects the lungs. It is commonly referred to as TB.
HOW DO YOU GET IT?
TB is generally difficult to catch. It is contracted by inhaling air that
contains droplets contaminated with TB bacteria.
WHAT ARE THE SYMPTOMS?
Symptoms of tuberculosis include fatigue, fever, loss of appetite, weight
loss, night sweats, persistent cough, chest pain, and blood in sputum.
HOW IS IT PREVENTED?
Tuberculosis may be prevented by avoiding close contact with people
who have active TB, and by staying healthy so the body can fight off
infection. A vaccination called BCG helps prevent TB in many parts of
the world, but it is not widely effective and not commonly used in the
United States.
• 5 •
TUBERCULOSIS and SUPERBUGS
HOW IS IT TREATED?
TB is treated with drugs called antibiotics, taken over a period of several
months to two years. The drugs must be taken exactly as prescribed for
the amount of time the doctor orders or drug- resistant strains of TB can
arise.
WHAT IS DRUG RESISTANCE?
Some disease-causing organisms mutate so that they are no longer killed
by drugs, most often antibiotics. They are referred to as drug-resistant
organisms, or superbugs.
HOW MANY OTHER DRUGRESISTANT DISEASES, OR
SUPERBUGS, ARE THERE?
There are dozens of superbugs. Besides TB, infections caused by other
bacteria, parasites, and viruses can also become drug resistant.
• 6 •
I
NTRODUCTION
Ask Americans what public health threats they fear, and they
might name AIDS, flu, mad-cow disease, or even bioterrorism.
Chances are, they will not mention tuberculosis (TB). Most
people think of TB as something from history textbooks, like smallpox
or polio. After all, we have antibiotics now, and we can prevent or cure
TB, right?
Not necessarily. Even with antibiotics, TB remains a formidable foe,
circulating among one-third of the world’s population.1 It is highly
infectious, difficult to detect, and often hard to kill. It may lurk in the
body for decades before suddenly activating. Although uncomplicated
TB can be defeated with antibiotics, it takes six to nine months of treat-
ment with powerful drugs that often have unpleasant side effects.
If a person stops taking medication too soon or skips doses, a much
scarier disease can result: drug-resistant TB. If the patient gets sick again,
he or she may face a much more difficult road to r ecovery, and may also
pass drug-resistant strains of the disease on to other people. This is one
reason new varieties of TB are now loose in the world and resistant to
multiple antibiotics.
Other infectious organisms are also becoming drug resistant. They
are aptly named “superbugs.” Malaria, caused by a parasite, has been
around since ancient times, but it still kills over one million people
across the globe every year.2 Methicillin- resistant Staphylococcus aureus
(MRSA) is a new version of an old bacterial infection that was once eas-
ily cured by antibiotics. It gets its name from the fact that the drug
methicillin is now powerless against it. Drug- resistant varieties of pneu-
monia and other infections have arisen as well.
This book covers TB and other superbugs—what they are, how they
affect the body, how they are diagnosed and treated, and how drug
resistance has affected their course. Stories of children and adults with
TB and other infectious diseases show how real people deal with these
stubborn and sometimes devastating illnesses.
• 7 •
1
Chapter
U
NDERSTANDING
T
UBERCULOSIS
In January 2007, Andrew Speaker, a thirty-one-year-old lawyer from
Atlanta, fell and landed on his rib cage. He went to the doctor for an
X-ray, which revealed an abnormality, but not from the fall. After
several other tests, Andrew was finally diagnosed in March with tuber-
culosis (TB). He began taking antibiotics. Two months later, his doctors
informed him that he actually had multidrug-resistant TB (MDR-TB), a
much more serious type that is resistant to most drugs. According to
Andrew, he felt fine and had no symptoms. He said the doctors told him
he was not contagious, and although they said they would prefer if he did
not travel, they never ordered him not to.
So Andrew traveled. He was scheduled to get married, and on May
12, he flew to Paris and then to Greece for his wedding. He was honey-
mooning in Europe when the Centers for Disease Control and Prevention
(CDC), a United States government agency, called him to say that his
original diagnosis had been wrong. What he actually had was exten-
sively drug- resistant TB (XDR-TB), a rare, much more serious, sometimes
incurable disease. They told him to either check into a European hospital
or hire a p rivate plane to take him back to the United States so he would
not expose other passengers. Unable to afford a private plane and wor-
ried that he would not get good care in Europe, Andrew flew on a
commercial flight to Montreal, Canada. Then he rented a car, drove
across the border into the United States, and checked himself into a New
• 8 •
Understanding Tuberculosis
York City hospital. Even though they had been alerted, the Canadian
border patrol failed to detain Andrew because he did not look sick.
When CDC officials found out that Andrew had boarded a com-
mercial flight, they held a press conference and warned the public that
an American passenger with XDR-TB was traveling from Europe to
Canada. They even announced Andrew’s name. The news caused an
international uproar.
After staying in the New York hospital for a few days, Andrew was
transported in a medevac plane to CDC headquarters in Atlanta. He was
then taken to National Jewish Hospital in Denver, Colorado, which spe-
cializes in treating TB and other lung conditions. Andrew was the first
American to be quarantined by the federal government since 1963. At
the hospital, he was isolated from other patients and given potent anti-
biotics. Then on July 4, the hospital announced that Andrew did not
have XDR-TB after all. The diagnosis of MDR-TB, a still serious but
more treatable form, was correct. The fact is, MDR-TB and XDR-TB are
not any more contagious than regular TB; they are just harder to treat.
But no matter what type of TB Andrew had, everyone around him had
been exposed.
In July, Andrew had surgery to remove a diseased part of his lung.
He remained in the hospital for eight weeks, taking powerful antibiotics,
which he would have to continue taking for the next two years. Because
he was young and otherwise healthy, the doctors expected him to make
a full recovery. But even though Andrew was getting better, his life was
falling apart. He got hate mail and death threats. His legal practice fell
apart. His marriage came to an end when it had barely begun. Several
people who had been sitting near him on the plane sued him (although
in the end, none actually caught TB from him). In 2009, Andrew himself
sued the CDC for invading his privacy, destroying his reputation, and
causing his marriage to end.
This incident was called the TB Scare of 2007, and it brought
attention to the growing problem of drug-resistant infections.1
WHAT IS TB?
Tuberculosis is an infectious disease caused by a type of bacterium called
Mycobacterium tuberculosis, or M. tuberculosis for short. The TB bacteria
mainly attack and damage the lungs, but they can also get into the blood-
stream and invade other parts of the body, such as the kidneys, spine,
and brain. If not treated properly, TB can be fatal. In the early 1900s,
• 9 •
