Talk:Tuberculosis/Archive 1

TB and Sexual Intercourse?
Can a person suffering from TB conduct a sex life?? It would seem from such famous sufferers as Robert Louis Stevenson, George Orwell and Therese Marten that sufferers of the lung disease often survive for quite a few years before succumbing. Can they therefore maintain a physical relationship? Aside from the severe exertion that would lead to fatigue and, potentially, coughing fits, would there be a greater risk to the sufferer's partner due to the proximity of the pair when they would be breathing against each other? I would be curious to know if sexual relationships can be maintained at all, at least in the earlier stages of the disease. 08:31, 31 October 2007 (UTC)

2003 talk
Center for Disease Control Division of Tuberculosis Elimination uses form "TB" rather than "T.B." (see link on Tuberculosis)

From the article:
 * Primary tuberculosis is a person's first exposure to T.B. Assuming the infection was not completely cleared by the immune system (which sometimes happens if the bacterial load was small enough), post primary tuberculosis can occur - this is a reactivation of T.B. following primary tuberculosis (symptomatic or asymptomatic). In 40% of patients with primary T.B., this may take more than 10 years.

The last sentence is strange and unclear. i also think it affects the liver. Certainly, in 100% of patients, this may take more than 10 years. But in what percentage does it actually take more than 10 years? Also, it is not clear what exactly this refers to. The post primary tb lasts for more than 10 years? AxelBoldt 21:06 Jan 2, 2003 (UTC)


 * It is unclear to me too. I've removed the 40% figure from the article and rephrased. I think part of the problem is the use of the term "post primary tuberculosis", (which first of all needs a hyphen), as opposed to "reactivation tuberculosis" which I think is clearer. Also added on some other missing info about staining characteristics, which remains an important diagnostic technique. Should add info about use of DNA testing of culture results, (permitting rapid, rather than 6 week cultures), too. -- Someone else 21:59 Jan 2, 2003 (UTC)

-

Few random questions that someone else (or indeed Someone else...) may have some insight into:


 * So what: "In Australia, the incidence of T.B. is currently 6 per 100,000, while for Australians born in Australia, the rate is 1.8 per 100,000."
 * Is this just giving an idea of what the infection rate in a first-world country is? Is this making a point about health factors for first-generation immigrants, and if so what?  Is there something specific to Australia?  For that matter, if anyone knows infection rates in countries in which TB is more prevalent, that'd be nice to know.
 * I've removed this statement, it does sound a bit Pauline Hanson. If they mean that TB is coming into countries with low rates from countries with high rates, then say it. Not just stats that could mean anything. (i'm not saying this was intended, but it's how it sounds). Tristanb 08:13 2 Jun 2003 (UTC)

- TB is a disease of poverty, crowding, homelessness, social neglect, and inadequate public health systems. Persons inclined to blame immigrants and immigration for TB can find statistics to support their views: the Journal of the American Medical Association (JAMA) a rag, not a journalclaimed, in 1994, that the foreign-born living in the United States were responsible for sixty percent of the total increase in cases from 1985 to 1992. The New York City Task Force of TB's simultaneous analysis showed that increased TB rates were mainly attributable to HIV infection, homelessness, and inadequate health care, which affected immigrants disproportionately. The remedy proposed (on the one hand, to keep immigrants out, and on the other hand to assure them appropriate living conditions and health care on their arrival) depends more on the proposer's political views than on science. -- Someone else 08:27 2 Jun 2003 (UTC)


 * "The cause of tuberculosis, Mycobacterium tuberculosis is a Gram-positive aerobic bacterium that divides every 16-20 hours."
 * Is this in the human body, or is this in the lab. I know that TB takes a long time to grow in the lab (like 2-3 weeks to get a visible colony), but I thought this is because people don't know the optimal conditions in the lab -- and that it grows faster in its natural environment, i.e. humans.  Seems to me that E. coli divides in about 20 minutes, and takes I'd say ~ 8 hours to form colonies.  TB's division time is thus 60x longer, and 60*8 hours = 480 hours = 20 days = ~ 2-3 weeks.  I'd suspect that the division time is different in human vs. in lab, but I don't know the #s.  Anyone?


 * "For example, T.B. cases in Britain, numbering around 50,000 in 1955, had fallen to around 5,500 in 1987, but for 2001 there were over 7,000 confirmed cases."
 * This statistic is meaningless without knowing what the change in population in the UK was from 1987 to 2001. Anyone know cases per 100,000 in 1987 and 2001 (or other nearby dates)?


 * Speak the name of the devil, and he will drop by to italicize species names. . Seriously, all good questions, especially the one on division rate (which varies (obviously) with the virulence of the various specific strains, and depends not only on in vitro vs in vivo, but also is higher in lungs in vivo than in other tissues in vivo, presumably as a function of oxygen tension, and one suspects therefore on a great many other variables), but sadly, no answers here. -- Someone else 00:44 Mar 27, 2003 (UTC)

P.S. FWIW: Infect Immun 1999 Jan;67(1):74-9	 "Mycobacterium tuberculosis catalase and peroxidase activities and resistance to oxidative killing in human monocytes in vitro". Manca C, Paul S, Barry CE 3rd, Freedman VH, Kaplan G.  found doubling times of about 27-32 hrs intracellularly (in monocytes) and 16-22 hrs extracellularly (acellular culture medium). -- Someone else 00:58 Mar 27, 2003 (UTC)

Most common?
The first sentence of the article says that tuberculosis is "the most common infectious disease in the world today". Really? More common than the Common cold? That sounds astounding and counterintuitive. Some explanation, please! -- Wondering simply, Infrogmation 06:05, 22 Aug 2004 (UTC)


 * explanation and clarification - could have stated: most common major infectious disease (ID) in the world, (the top 3 ID killers are HIV/AIDS (3 Million), TB (2 Million), malaria (1 Million)),  mostly in developing countries).  Stats from WHO, one-third of world has infection (>90% latent TB infection LTBI), about 9 million new cases active disease annually (mostly reactivation from LTBI - 10% lifetime, if HIV 10% annually) with 2 million deaths.  Since the common cold is actually caused by several different classes of viruses Virus classification and one-third of the world has been infected by only one species Mycobacterium tuberculosis, TB could still be called the most common infectious disease by a single organism.  The adjective "major" has been added to the article.  Petersam 09:08, 22 Aug 2004 (UTC)

I dunno how true this is... Check the WHO stats; I've found numbers attributing 8 million deaths per year to TB, which would coincide with the description (as per the WHO) of TB as the greatest killer worldwide..
 * The latest stats 2003 from WHO are 8.8 million new cases (incidence 140/100,000) with 1.7 million deaths (mortality 28/100,000).  2 billion worldwide are infected with TB, but only about 10% will die as there is treatment for TB (50% will die if not treated).  http://www.who.int/tb/publications/global_report/2005/summary/en/index.html    In 2003, AIDS/HIV has almost 5 million new cases with almost 3 million deaths, most will die within a few years because the expensive treatment is not available or accessible.   http://www.unaids.org/bangkok2004/GAR2004_html/ExecSummary_en/ExecSumm_en_01.htm#P52_5995   TB has recently been surpassed by AIDS/HIV as the infectious disease killer.  Also see Infectious disease for 2002 and 1993 data and trends. Petersam 00:16, 26 Apr 2005 (UTC)

X-rays (GNU FDL ?)
For a collection of interesting chest X-rays see pl:Gru&. They are probably GNU FDL unless employer can claim copyright on them. Kpjas 22:33, 22 Aug 2004 (UTC)

nominated for FA removal
See Featured article removal candidates. --mav 06:58, 26 Aug 2004 (UTC)
 * working on this to address concerns Petersam 10:09, 26 Aug 2004 (UTC)


 * The 2 concerns raised have been addressed. Lead section is now 3 paragraphs.  TOC is now down to 15 headings/subheadings.  Tried to substitute HTML header markers H2, H3, etc for the various headings to preserve font size and boldness which reduced the size of TOC, but that interfered with section editing - when editing was clicked, a different section was selected.  So now used wiki 3 aposthophes for bolding Petersam 09:03, 28 Aug 2004 (UTC)

Need more photos?
On Polish Wikipedia: http://pl.wikipedia.org/wiki/Gru%C5%BAlica You can find some big, good photos, which can be good ilustrations of this article. There are PD or GNU FDL, so You can just upload it to en: server. 17:43, 19 Sep 2004 (UTC)
 * There are a couple that are, but the one thats currently being used is almost certainly not in the PD. This one  is, this one  isnt. I was going to swap them around unless anyone has some objections or an even better photo. Agnte 11:02, 13 November 2005 (UTC)

Reworded lead section paragraph for clarity
Originally the parts I changed were: "There is a 10 percent lifetime chance that it may progress to active TB disease in which, if left untreated, more than 50 percent of people will die. It is one of the top three infectious disease killers in the world..."


 * As it was, it implied that 90% of the time it is impossible to progress and 10% of the time it might. It should state that 90% it won't progress and 10% it will.  As such "There is a 10 percent lifetime chance that LTBI will progress..." is more appropriate.
 * "more than 50 percent of people will die" edited due to passive voice.
 * TB is not a disease killer, it is a killing disease.

I'm no expert on TB, so I document these changes here in case I made anything inaccurate. 15:14, 26 Nov 2004 (UTC)

Morbus Hungaricus
The TB was known as "morbus hungaricus" throughout Europe in the medieval ages and baroque, because of its extreme prevalence among the magyar people. It continued to hit Hungary very hard until the early 1950's.

After the big WWII destruction the communist dictatorship immediately started a very ambitious anti-TBC programme and spent a lot on radiology equipment, x-ray buses and antibiotics. Mandatory chest x-ray for every adult every year and if a TB patitent failed to take the medicaton, police would throw him/her into prison hospital until totally cured.

It worked, by 1960 there were only two to three dozen deaths per year, instead of ten of thousands (pre-WWII) and the measures were maintained for 25 more years. Since communism fell in 1990 the regulations are no longer vigorously enforced and only 50% of people take the x-ray regularly. The streets are full of homeless TB-people in cities and more average citizens contact TB. There were about 130 TB deaths per year in Hungary in the mid-1990's.

Looks like TBC prefers democracy and that's a disturbing idea.

BTW, I heard russian prisons have the worst TB statistics in the world. Almost all cases are drug-resistant there.

TB may have killed off leprosy
Found this interesting "There is a theory that having one of these diseases protects a person against contracting the other one, which is called cross immunity. Some say this theory explains the rise of TB and fall of leprosy - more people caught TB and were therefore protected against leprosy." The article is however about a research in progress, so such information wouldn't be acceptable in the front page, but may not hurt to note it here gathima 05:36, 10 Feb 2005 (UTC)

TB vs Malaria
This article claims that Malaria kills only one million people a year, but most of the sources I've seen (including the wikipedia article on it) give two million or more - is it worth looking into further?
 * See WHO data at Infectious disease. It was 2 million in 1993; down to 1.3 million in 2002 Petersam 05:35, 2 Jun 2005 (UTC)
 * The malaria article has been updated with the WHO Malaria Report 2005 with over 1 million deaths now; see the malaria talk page for references. Petersam 06:20, 2 Jun 2005 (UTC)

TB - Abbreviation for what?
One of our Health Worker training teachers told us that TB stands for Tubercle Bacillus. But Wikipedia says that TB is for tuberculosis. Which is right? 61.0.164.148 06:08, 20 Jun 2005 (UTC)
 * Both are right, depends on the context. Clinically, it refers to the disease; in microbiology it refers to the tubercle bacillus.  Merriam-Webster Online for TB] - Etymology: TB (abbreviation for tubercle bacillus), Definition : TUBERCULOSIS Petersam 21:41, 20 Jun 2005 (UTC)
 * Thanks! In that case please insert the first abbreviation also. 61.0.164.186 00:54, 21 Jun 2005 (UTC)
 * Be Bold, you can do it yourself. Petersam 07:24, 21 Jun 2005 (UTC)
 * Done. 61.0.164.194 16:39, 21 Jun 2005 (UTC)
 * I think both information should be inserted into the article. Troop350 10:52, 9 September 2007 (UTC)

The article starts using 'TB' before it is explained what TB is. I don't like it. -- CraigKeogh 08:25, 4 January 2006 (UTC)

Change made to measurement guidelines for tb skin test
I changed the measurement guideline for tb skin test to reflect the actual figures healthcare officials have to go by, i had a tb skin test performed yesterday and talked about the different ways the results are handled. Since i work in the medical field i thought i could help clarify some of the information, also i did not remove the other facts from this section but modified there position and context. 68.153.29.23 - 07:54, 2 July 2005
 * The complete CDC guidelines for "classification of tuberculin reaction" are listed in the Tuberculosis diagnosis sub-article which was created because the main TB article was getting too large. The changes you added do not apply in the section dealing with "Prevention - BCG vaccine and tuberculin skin test", so I will revert to previous edit. Your edit does point out that the section on "Diagnosis" needs to be expanded a little more so readers know that there is a measurement guideline in the TB diagnosis sub-article.  Petersam 3 July 2005 06:16 (UTC)
 * I moved the "BCG vaccine and tuberculin skin test" subsection out of the Prevention section to Tuberculosis diagnosis.  The subsection deals mostly with TB diagnosis and not Prevention.  Petersam 3 July 2005 06:59 (UTC)

national arrogance

 * It was first used on humans on July 18, 1921 in France, although national arrogance prevented its widespread use in either the USA, Great Britain, or Germany until after World War II.

Is "national arrogance" really Neutral point of view? Perhaps a brief description of the relationships among the countries is in order, or just remove the phrase entirely "although it did not have widespread use in the USA, Great Britain, or Germany until after World War II." Podkayne 00:20, 19 January 2006 (UTC)

An article entitled "Hypervirulent mutant of Mycobacterium tuberculosis resulting from disruption of the mce1 operon" appears to corroborate this claim. However, I'm not a doctor!



genetically modified TB
"In 2003, by disabling a set of genes, researchers accidentally created a more lethal and rapidly reproducing strain of tuberculosis bacteria."

This single sentence paragraph appears with no citation whatsoever. What are the implications? Consequences? Did this really happen? Was it just in a lab?

It is a rather suspect claim, I think.

Trivia overload
The section "Tuberculosis in art, literature, history and film" is getting severely overloaded with trivia, e.g. minor characters in books of marginal notability. Can we arrive at consensus as to what should be included? My rule of thumb is that if an appearance in popular culture has made a lasting contribution (even if erroneous) to the public perception of a condition, it is includable. JFW | T@lk  19:24, 7 February 2006 (UTC)


 * No apologies for the slashing that is about to take place. JFW | T@lk  02:33, 15 March 2006 (UTC)


 * I have split the section in "historical people" and "portrayals". In each I have grouped the items by subject area. This will make it easier to judge the relative prominence of each item. Could others have a look and decide what the parameters for notability should be? JFW | T@lk  02:50, 15 March 2006 (UTC)

Isolation
Isolation of TB Patients, Sanatorium therapy and avulsion of the phrenic nerve of the individual to immobilise the diaphragm and give rest to lungs (as it was thought that rest heals the lungs) were the treatment of the past. The present concept is domicillary therapy and active lungs. Hence I am of the opinion that the following line may be edited as it gives a wrong concept to non medical people. The chain of transmission can be stopped by isolating patients with active disease and starting effective anti-tuberculous therapy. Nowadays Isolation is NOT practised as a rule

Infection rate
I'm not a doctor so maybe I'm missing something here, but this sentence:

"(typically 22% infection rate but everything is possible, even up to 100%)"

Doesn't seem to make sense to me - what does it mean, "everything is possible, even up to 100%"? I assume what is meant is the probability that contact with an infected person will result in you being infected too - so isn't that just one straight probability figure?...


 * I agree; that statement sticks out like a sore thumbsmollock. I'm going to be bold and remove it, and hope that it'll only go back in if someone can provide a reference supporting that 100% statistic. dfg 16:43, 8 March 2006 (UTC)

I'm not a mathematician, but the maths don't seem to add up here.

"infecting two billion people or one-third of the world's population. Nine million new cases of disease, resulting in two million deaths, occur annually"

At a rate of only nine million a year, even if everyone with TB lived to be a hundred, there'd be only 900 million cases.


 * My knowledge of TB is a little rusty, but I believe that many people infected with the TB bacterium do not develop the disease. Thus, 1/3 of the world could be infected with only a much smaller number actually becoming sick.

Symptoms
Shouldn't there be a section outlining the symptoms of TB? And is it really trut aht 1/3 of the people on the earth have this disease??? Arundhati bakshi 16:33, 27 March 2006 (UTC)
 * Symptoms are in the section The disease / Progression - 5th paragraph; Also in Tuberculosis diagnosis.  1 out of 3 people worldwide have the infection (Latent TB Infection), not the disease; 10% of those infected will develop the disease later in their life (see 3rd paragraph in lead section) .  See article for differences.  Petersam 19:40, 27 March 2006 (UTC)
 * Source WHO TB web site http://www.who.int/mediacentre/factsheets/fs104/en/ Petersam 20:36, 27 March 2006 (UTC)

If a person is coughing blood a little and not always then is he/she effected by TB disease??? 6:30, 20 October 2010 (IST).

Historical causes of epidemic TB
TB has been with us since antiguity, but some researchers suggest that it only took on epidemic proportions when hygiene increased, since children no longer were exposed to the bacteria, and could therefore not develop any immunity resistance towards it. Does anyone know more about this?DanielDemaret 06:39, 31 March 2006 (UTC)

Peptidoglycan
As both gram-positive and gram-negative bacteria exhibit peptidoglycan in their cell walls, I'm going to remove the reference to it "being related to the gram-positive bacteria".John Sheu 17:17, 31 March 2006 (UTC)

Symptoms
Why aren't there any symptoms in this article? 209.7.119.196 16:41, 10 April 2006 (UTC)


 * Agree. JFW | T@lk  16:57, 10 April 2006 (UTC)


 * Symptoms are listed in the paragraph under The Disease - Progression. I added a subsection heading 'Symptoms' to locate this topic. Petersam 18:55, 24 April 2006 (UTC)

socioeconomic factors in TB
I was disappointed to see almost no attention to such critical factors as housing, poverty, substance abuse and AIDS that affect the incidence of TB. TB rates dropped wherever overcrowding was reduced and standards of living increased. See for example http://knews.knet.ca/modules.php?op=modload&name=News&file=article&sid=1942

Vronsky

History Question
Out of curiosity, why isn't there any mention of Selman Waksman in the history, or for that matter, anywhere else in the article? It strikes me as a rather grievous omission to neglect mention of a man so instrumental in the treatment of Tuberculosis. I'd add something but it's already been well established that I'm biased on matters relating to Selman Waksman or Albert Schatz (who should probably also be mentioned). --gwax UN (say hi) 03:19, 10 May 2006 (UTC)

Self-contradiction
"TB infects, as of 2004, around 14.6 million people in the world... TB infects approximately a third of the world's population. Approximately 14.6 million people died from TB in 2004."

Taken together, these imply a roughly 100% mortality rate, and that the total population of the world is about 45 million. --Calair 23:29, 21 May 2006 (UTC)


 * From the first citation, in 2004 there were 14.6M infections and 1.7M deaths. The bad numbers appear in the second and third paragraphs of the introduction and under Epidemiology. -=Blurble 15:01, 24 May 2006 (UTC)


 * Fixed. 147.188.244.139 16:43, 24 May 2006 (UTC)

Infection vs. Disease --- Incidence vs. Prevalence vs. Mortality
The correct numbers are 2 billion people have TB infection with 14.6 million active TB disease; in 2004, 8.9 million new cases with 14.6 existing cases and 1.7 million deaths. Recent edits have shown that there is some confusion between latent TB infection (LTBI) and active TB disease. According to WHO, one-third of the world's population (2 billion people) is currently infected with the TB bacillus. ... However, people infected with TB bacilli will not necessarily become sick with the (active) disease. The immune system "walls off" the TB bacilli which, protected by a thick waxy coat, can lie dormant for years. When someone's immune system is weakened, the chances of becoming sick are greater. 5-10% of people who are infected with TB bacilli (but who are not infected with HIV) become sick or infectious at some time during their life. People with HIV and TB infection are much more likely to develop TB. For 2004 WHO reports 8.9 million new cases of active TB (Incidence (epidemiology)) with 14.6 million existing cases of active TB (prevalence) and 1.7 million deaths due to active TB (mortality). Petersam 08:05, 25 May 2006 (UTC)

History or Relevant, for disambiguity and ranked searching or search ranking?
TB abbreviation TT

TB and peritonitis

1966 Webster's Third New International Dictionary lists abreviation TT Page 2,458 TT 1.. 2.. 6 tuberculin tested

1966 Webster's Third New International Dictionary lists TB a cause of 2 diseases Page 2,459 tuberculous 1 : .. 2 a : constituting or affected with tuberculosis ... b : caused by or resulting from the prescence or products of the tubercle bacillus <~ peritonitis> <~ meningtis> — tuberculously adv

John Zdralek my mom can slice thinner than your mom (joke) 06:13, 27 May 2006 (UTC)

question - who posts to the talk and does a person talk then is selected by the editor to be talk what is talk?

hmmm... obviously there is a difficulty uploading a verified image of the dictionary to a talk page ... let then try else this



Charles Bukowski
Added Charles Bukowski to the Literature and Poetry section. I think this is particularly interesting since he contracted TB in 1988. I think this is particularly interesting since this is much later than any of the others in the section. He is also considered a major American author and deserves to be noted. Liontamarin 10:22, 30 May 2006 (UTC)

Red Death is not TB
Poe's The Masque of the Red Death described "Red Death" as "sharp pains, and sudden dizziness, and then profuse bleeding at the pores" and death within half an hour. This is not TB; see article for symptoms. TB does not kill that fast, but can take longer, up to several years, to finally kill its victims. TB did affect Poe's life in claiming the lives of those he loved. This story describes his perception of how TB affected him, but does not describe any real disease. I have not seen any reference to Red Death describing any actual disease. Therefore, I removed Red Death from the Other names for the disease section. Petersam 09:23, 1 August 2006 (UTC)

"Nine million new cases"
This sentence is from the second paragraph of the intro:

"As of 2004, 14.6 million people have active TB disease with nine million new cases of the disease and nearly two million deaths, [1] mostly in developing countries."

It talks about "nine million new cases of the disease and nearly two million deaths". Does this mean anually, there are these many new cases/deaths? If so, it should state so! Reading it is fairly confusing. T. S. Rice 03:27, 5 August 2006 (UTC)
 * Added the terms prevalence, incidence, and mortality to clarify the numbers. See section above Infection vs. Disease --- Incidence vs. Prevalence vs. Mortality Petersam 07:09, 5 August 2006 (UTC)

Confusing statement
The article says "While only 10% of TB infection progresses to TB disease, if untreated the death rate is 51%." Does this mean 51% of everyone infected will die, or that of the 10% that get the disease, 51% of them will die? Vicarious 07:44, 14 September 2006 (UTC)
 * Changed to: Most of those infected (90%) have asymptomatic latent TB infection (LTBI). There is a 10% lifetime chance that LTBI will progress to TB disease. If untreated, the death rate for active TB disease is more than 50%. Petersam 08:24, 14 September 2006 (UTC)
 * Thanks Vicarious 02:45, 15 September 2006 (UTC)

US guidance
Will people please STOP chopping and pasting bits wholesale from the CDC website and pretending that they apply to the whole world? CDC recommendations are specific to the US and are NOT relevant to other countries: in fact, many CDC recommendations directly contradict the recommendations of other countries and international health organisations (including the WHO). If you ARE going to put CDC guidance into this article, PLEASE mark it as US specific, or at the VERY least be polite enough to reference statements as coming from CDC guidance. --Gak 18:09, 17 September 2006 (UTC)

Overcrowding
Could someone please write something about overcrowding.

Improved TB vaccine developed
This is an improvement, especially given that drug resistant TB has been on the increase.

TB is Gram Positive
"phylogenically it IS gram positive. Running the actual gram stain however can yield poor results because of the waxy outer well wall composed of LAM and Mannophosphinositide" Supporting Information can be found on http://www.mansfield.ohio-state.edu/~sabedon/biol4045.htm#mycobacterium_tuberculosis --darkphase 13:23, 16 November 2006 (UTC)


 * Thanks for spotting this error. It has been corrected. TimVickers 16:48, 16 November 2006 (UTC)

Treatment
Should we keep this and reformat it, or is it too specific? TimVickers 18:10, 17 November 2006 (UTC)
 * Chemoprophylaxis, AND Izoniazid, AS WELL AS rifampin, pyrazinamide AND ethambutol COULD BE USED TO TREAT TUBERCULOSIS, OVER A SIX MONTH COURSE. ANY PREGNANT MOTHERS SUSPECTED TO HAVE TUBERCULOSIS, MUST IMMEDIATELY BE TREATED, BECAUSE THERE IS A HIGH RISK OF THE BABIES AND THE MOTHER BEING VERY HEAVILY AFFECTED. ethambutol IS RECCOMENDED FOR CHILDEN, WILE THE OTHERS COULD BE TRATED WITH ALL THESE DRUGS. IT IS STRONGLY RECOMENDED THAT PATIENTS CONTINUE THEIR REGIMENTS UNTIL THEIR ANTIBIOTICS RUN OUT. Chemoprophylaxis, Izoniazid, Rifampin, AND Pyrazinamide SHOULD BE USED OVER THE ENTIRE REGIMENT. Ethambutol SHOULD BE CUT BACK, OR ELIMINATED ALTOGETHER AFTER THREE MONTHS.
 * I see very little there that is salvageable or encyclopedic. Sandy (Talk) 19:20, 17 November 2006 (UTC)
 * I agree. TimVickers 19:36, 17 November 2006 (UTC)

World Map
That map does not even have some countries on! It should be either fixed or removed because it's highly inaccurate. Suane
 * Which countries are missing? TimVickers 16:08, 22 November 2006 (UTC)
 * A lot. It's obviously deeply outdated (Socialist era). I found Slovakia, Slovenia, Croatia, Bosnia & Herzegovina, Serbia & Montenegro, Macedonia, Albania, Ukraine, Belarus, Latvia, Lithuania, Estonia, Kazachstan, Uzbekistan, Turkmenistan, Kyrgistan, Tajikistan missing. I might be not so exact about that, since the map is quite small. New base map should be used, and colored according to the newest WHO data. Suane 21:06, 27 November 2006
 * Haha, yes that is a VERY old map. Disco 12:10, 19 December 2006 (UTC)

TB vaccines
The para on the main tuberculosis page under vaccines:

"Several new vaccines to prevent TB infection are being developed. The first recombinant tuberculosis vaccine entered clinical trials in the United States in 2004, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID).[32] A 2005 study showed that a DNA TB vaccine given with conventional chemotherapy can accelerate the disappearance of bacteria as well as protect against re-infection in mice; it may take four to five years to be available in humans.[33] The only TB vaccine currently in phase III trials is MVA85A, which is being trialed in South Africa by a group led by Oxford University,[34] and is based on a genetically modified vaccinia virus. Because of the limitations of current vaccines, researchers and policymakers are promoting new economic models of vaccine development including prizes, tax incentives and advance market commitments.[35][36]"

is inaccurate in the sense that MVA85A is not yet in phase 3 trials - these are still at least 2 years away. The vaccine is in phase one and two trials in the UK (Oxford), South Africa (Cape Town) and The Gambia.

I cannot make the changes as the page is restricted - maybe someone else can.

There are also a number of other new TB vaccines which are in phase 1 trials, produced by Glaxo Smith Kline (GSK), Statum serum Instituut (SSI) and the Aeras Global TB Vaccine Foundation (www.aeras.org) which should be added to the list.

Tony Hawkridge University of Cape Town tony@rmh.uct.ac.za —The preceding unsigned comment was added by 41.241.91.81 (talk) 04:56, 10 December 2006 (UTC).

High number for infected correct?
"Over one-third of the world's population now has the TB bacterium in their bodies ... one in ten latent infections will progress to active TB disease which, if left untreated, will kill more than half of its victims." -- 1 in 30 persons in the world today is expected to develop active tuberculosis disease? (220 million persons). Is this right? -- 201.50.251.197 15:37, 26 February 2007 (UTC)
 * Indeed, it is described more fully in the WHO factsheet reference. TimVickers 16:27, 26 February 2007 (UTC)


 * Thanks for the info. One more thing to lose sleep over. :-( -- 201.50.251.197 01:48, 28 February 2007 (UTC)

Cell damage help
I'm doing a grade 8 science project about tuberculosis and I've looked all over the internet but i cant find the following information: How does TB affect certain types of cells (how does it affect muscle cells, blood cells etc...), what happens to the tissues of the cells, and how does the infection prevent the cells from doing their job (therefore, how does it affect the body). If anyone could please help me find any of hat info it would be greatly appreciated. -Demonskyline7


 * There is a bit in this article, see the pathogenesis section. TimVickers 22:54, 4 March 2007 (UTC)

Yeah I read that over 100 times, but I can't really understand all these scientific terms... or find the information I need

In non-technical terms, TB grow within the white blood cells (immune cells) called macrophages. The multiplication of the bacteria kills the macrophages and bursts them open. In tissues, the dying macrophages attract other immune cells that damage the tissue in their efforts to kill the bacteria. The most common cause of death is destruction of lung tissue and slow suffocation. this is a much more technical description of this process. TimVickers 03:12, 5 March 2007 (UTC)

Thanks, that helped. ;) -Demonskylne7

I cant understand a lot of it... can you copy-paste the section where it mainly explains how it damages cells? because I need to write one page on how it damages cells and how this damage distrupts cells from their usual activities, and how this damages the body.


 * You can copy and use anything in Wikipedia without any restriction, as its content is in the public domain. However, you will need to cite Wikipedia as the source if you simply copy the section and use it without making any major modifications. TimVickers 22:18, 26 March 2007 (UTC)


 * I meant if YOU can find me the main paragraph here which explains how TB damages cells and the rest of things I need for my essay and copy-paste it here or somewhere... because i need a one-page explanation of what i said earlier by tomorrow... Thanks for your effort to help :) -Demonskyline7 —The preceding unsigned comment was added by 74.103.176.163 (talk) 23:02, 26 March 2007 (UTC).

Famous deaths
I don't see the need for this section. In the Medical Manual of Style it says this isn't usually a good idea to do this for common conditions. TimVickers 03:22, 15 March 2007 (UTC)

The world map
The world map on that page, when I click on it, the country Taiwan seems to be colored white. Since this page is an FA article, I did not want to ruin it. So, if someone can verify the color. Thanks, CarpD 3/23/07.
 * I'm afraid Taiwan isn't covered in the WHO data from which the map was generated, I don't know why not. TimVickers 15:40, 24 March 2007 (UTC)

what is tuberculosis
what is tuberculosis may i ask why does it hurt so many people in our everyday life?♥ —The preceding unsigned comment was added by 170.211.123.123 (talk) 15:15, 30 March 2007 (UTC).
 * I hope if you read the article it will answer that question. TimVickers 15:26, 30 March 2007 (UTC)

Intro sort of misleading
The intro states that "Tuberculosis (abbreviated as TB for Tubercle Bacillus) is a common and deadly infectious disease caused by the mycobacterium Mycobacterium tuberculosis or Mycobacterium bovis."

However, the article later goes on to state two more species that cause tuberculosis - M. africanum and M. microti. This exclusion is unjustified. I think we should reword the intro to include these two species. Agree/Disagree? KBi 00:15, 11 April 2007 (UTC)

Infection/Transmission?
Is TB Contagious?
 * Yes, read the article. TimVickers 18:31, 15 May 2007 (UTC)

I thought the TB bacterium needs to enter the respiratory system in order to infect a person. But the article says it can be transmitted through kissing, spitting and using unsterilized eating utensils. Does this mean, TB can be transmitted through contacting the body fluids of a person with active TB? How long can TB bacteria survive in the air?

Need to include some of the nineteenth century folklore
The folklore information is one sided. I would like to add some things about how TB was romanticized. The Spes phthisica, how many aesthetes did their creative work while suffering from it, and it's reputation for increasing sex drive and feelings of euphoria. Here is what I would add to the folklore section: editprotected TB was romanticized in the nineteenth century. Since TB sometimes produces feelings of euphoria referred to as "Spes phthisica" or "hope of the consumptive", some TB sufferers were said to have bursts of creativity as the disease progressed. For instance, Frederic Chopin complained that he could not compose unless he was coughing blood. It was also believed that TB sufferers acquired a final burst of energy just before they died which made women more beautiful and men more creative.

Vincentsharma 02:21, 19 May 2007 (UTC)Vincent
 * Template:editprotected is for specific edits to a particular page. If you have text to insert into the article that is uncontroversial and follows consensus, please feel free to re-enable the editprotected tag. Cheers. --MZMcBride 02:30, 19 May 2007 (UTC)

Okay, perhaps I should do a better job of making it clear that this was the belief of the time. That's why I want it added to the folklore section and not the history or medical sections. Also, I removed the quote from Chopin since I can't cite it (I read it on in an article that didn't cite it). How about this: editprotected TB was romanticized in the nineteenth century. Many at the time believed TB produced feelings of euphoria referred to as "Spes phthisica" or "hope of the consumptive". It was believed that TB sufferers who were artists had bursts of creativity as the disease progressed. It was also believed that TB sufferers acquired a final burst of energy just before they died which made women more beautiful and men more creative.


 * We can either add this directly, or as the page is only semi-protected, in 4 days you will be able to edit it yourself (semi-protection only blocks newly-registered users). TimVickers 12:19, 19 May 2007 (UTC)
 * I've disabled the editprotected tag. Almost any editor can add the text should they want to. Cheers. --MZMcBride 03:19, 21 May 2007 (UTC)


 * I added it.Vincentsharma 00:18, 24 May 2007 (UTC)

Tubercluosis affecting Brain
Dear Friends,

I am looking for much literature on the Tubercluosis in the Brain. If U have any important inputs on this topic. Pls discuss with me.

Rgds, JayantJayant94026 16:30, 26 May 2007 (UTC)


 * Try the reference desk. There's tuberculous meningitis, cerebral TB (e.g. in AIDS)... Prognosis not great. JFW | T@lk  21:41, 5 July 2007 (UTC)

Bovine tuberculosis
Does this deserve its own article? I got redirected here but there isn't much information on the subject. Richard001 01:00, 19 June 2007 (UTC)
 * Changed redirect to Mycobacterium bovis. TimVickers 15:13, 19 June 2007 (UTC)

Genomics
genomics in TB diagnosis and treatment. JFW | T@lk  21:42, 5 July 2007 (UTC)

Possible improvements?
In this part of a sentence in the 4th paragraph—"data show that, from 2000 to 2004, 20% of TB cases were resistant to standard treatments and 2% were also resistant to second-line drugs"—are the 2% of cases part of the 20%, or are they a separate category?

Also, under "Transmission", I think it would be good to define or clarify the meaning of "congregate settings" in "residents and employees of high-risk congregate settings".

I've made a few additions, most of them minor and just for the sake of clarification, but the one I'm most worried about is the reference to "histological techniques" under "Bacterial species" since, although I've studied histology, my knowledge is still only rudimentary. Thanks, everyone! Scrawlspacer 14:59, 12 July 2007 (UTC)

Evolution vs. mutation
I noticed there was a disagreement about whether to use evolution or mutation in a sentence under Bacterial species:
 * During its evolution, M. tuberculosis has lost numerous coding and non-coding regions in its genome, losses that can be used to distinguish between strains of the bacterium.

If this question comes up again, I'd like to support the use of evolution. After all, mutation is not the only evolutionary mechanism, and one might even want to specify the kind of mutation taking place (e.g., hereditary, environmentally caused through radiation or something similar, etc.). Mutation also gives the impression that the change happens over a shorter time than evolution does, since evolution refers to the entirety of an organism's existence on the planet, from first appearance to extinction. Be well, all! Scrawlspacer 08:52, 13 July 2007 (UTC)

Transmission reference re: 40.000 droplets.
Although the reference cited is quite interesting as well as informative, it does not contain the specific information (the number of aerosol droplets contained in a sneeze) which it supposedly confirms. Guille 21:45, 28 August 2007 (UTC)


 * On page 455, line 10 the article states "A sneeze can generate as many as 40,000 droplets, which can evaporate to particles in the 0.5 to 12 μm range." I've reworded the article to say "A single sneeze, for instance, can release up to 40,000 droplets" from the original that stated "about 40,000 droplets". Tim Vickers 22:07, 28 August 2007 (UTC)

Page 455? line 10? The site referenced has 17 lines of text in a single paragraph. Perhaps you should link to the actual citation rather than the synopsis of the article? Guille 16:42, 30 August 2007 (UTC)


 * That is the abstract of the paper. Click on the link saying "Full text article" at middle right of that page. If you do not have access to a library that subscribes to this journal, please e-mail me from my userpage and I can attach the Pdf in my reply. All the best Tim Vickers 16:50, 30 August 2007 (UTC)

Sorry I fucked up while creating a new redirect
Please repair it. I don't know how to. The whole history of this article is moved. --Koreanjason 06:55, 4 September 2007 (UTC)


 * Done. Please don't do that again. Where did you want Colin Flooks to redirect to? I've left the redirect blank for now. Tim Vickers 17:08, 4 September 2007 (UTC)
 * Fixed redirect. Nothing to see here people, move along now. Tim Vickers 19:43, 4 September 2007 (UTC)

Appetite loss
According to the article, appetite loss is a symptom. But, I've heard that an increased appetite is also a symptom. I was wondering if both are true, and it goes in a cycle, or if the increase is wrong. Lascoden 03:22, 10 September 2007 (UTC)

California ban on Gerbils
Can someone check the reference? The text implies that Gerbils are banned from California due to passing on TB, whereas from what I have read it seems that they are banned for fear of crop damage. —Preceding unsigned comment added by 69.107.141.221 (talk) 22:03, 28 September 2007 (UTC)


 * Good question. They are termed "detrimental animals" in the regulations (link) but the reason is not given. Tim Vickers 02:52, 29 September 2007 (UTC)

Map of incidence
I corrected a map of incidence per for the European Union. It really needs hard proofcheck because map as I found it there is not based on real data.  ≈Tulkolahten≈ ≈talk≈ 20:44, 10 December 2007 (UTC)

Consumption article?
What is the connection between this article and the consumption article? The consumption article is a poor version of this one, although perhaps it should direct to history of TB? Not sure, but consumption needs help. --Zachbe (talk) 23:14, 3 January 2008 (UTC)


 * Consumption is a disambiguation page that should only give redirects to articles. So I've removed the TB text that was added by 59.92.164.141 from Consumption.  Since none of the text was cited, it didn't make sense to merge the text into the tuberculosis article.  (Cross-posted to Talk:Consumption)  –panda (talk) 23:39, 3 January 2008 (UTC)

Ranke's Complex
I couldn't find a reference here to Ranke's complex (calcified TB lesion located in lung parenchyma and hilar lymph nodes) - is this something worth adding or is there a better place for it or is it even worth the mention? Thanks! BruceD270 (talk) 15:42, 21 January 2008 (UTC)


 * There's an article under the alternative name of Ghon's complex, we don't have anything about the stages of TB infection here, if you could write a paragraph that would be great. Tim Vickers (talk) 18:43, 21 January 2008 (UTC)

Is the bacteria cleared from the granuloma by the immune system?
I think this is an important consideration. The article stated that the bacteria was cleared but the reference cited indicated the opposite. I would expect resolution to be documented. does anyone have a good source either way? Shaedo (talk) 16:20, 22 May 2011 (UTC)

Cure in a dry climate
In movies about the past, a recent example is "3:10 to Yuma", people talk of moving to a dry climate to treat tuberculosis. Is such a climate helpful? Or is this just a myth? --206.63.95.15 (talk) 18:53, 17 February 2008 (UTC). Another example is the movie "Tombstone" which features the O.K. Corral shootout. In the movie a character by the name of Doc. Holliday is dying of TB. (Edited May,6,2008).

Interferon
The T-cell stimulation tests for latent TB are rather good: http://www.annals.org/cgi/content/abstract/0000605-200808050-00241v1?papetocJFW | T@lk  22:52, 3 July 2008 (UTC)

People certainly did move to "better climates" - if they could afford to. In many places "better climates" meant warm dry weather. In other places (Switzerland for example) it meant cold weather - patients were stuck outside even during winter (well clothed against the cold) so they could inhale "clean air". Sanitoria were established in these places for TB patients.

However, it doesn't help :) Sanitoria, where people often went (or were sent) on the other hand, did help. Often people got better food and better care than they would otherwise have received. In the worst case, by sending patients to sanitoria, they were unable to infect other people!

Plsmmr (talk) 14:19, 28 January 2009 (UTC) y8uyuyuguy tguguc7tgui —Preceding unsigned comment added by69.235.26.41 (talk) 01:37, 2 March 2009 (UTC)

Contradiction?
Are these sentences contradictory? "South Africa, the country with the highest prevalence of TB"... "India has the largest number of infections, with over 1.8 million cases." What's the difference between 'prevalence' and 'infections'? delldot  talk  22:47, 5 July 2008 (UTC)


 * They are not contradictory, the terms have different meanings. If a country had ten inhabitants, and all of these inhabitants had TB, then this country would have a very high prevalence (cases per unit of population), but would only have a very small number of cases in total.Webster's is the dictionary I usually use for these things. Tim Vickers(talk) 06:39, 6 July 2008 (UTC)


 * Ah, that makes sense, sorry.  delldot   talk  15:06, 6 July 2008 (UTC)


 * No problem, your question showed me that I need to wikilink that technical term so other people don't have the same problem.Tim Vickers (talk) 15:33, 6 July 2008 (UTC)

Does South Africa have the highest prevalence of TB? The most recent UN statistics show a number of African nations as having a higher prevalence (per 100,000 inhabitants): http://mdgs.un.org/unsd/mdg/SeriesDetail.aspx?srid=617&crid= Dsi2104 (talk) 02:00, 27 March 2010 (UTC)


 * maybe regarding the historical average (1990-2007) south africa has the highest prevalence? --Homer Landskirty(talk) 07:51, 27 March 2010 (UTC)

Two sentences contradict each other
"One third of the world's current population has been infected by TB,.."

I"n 2005, the country with the highest estimated incidence of TB was Swaziland, with 1262 cases per 100,000 people"

These two sentences contradict each other… How can one sentence claim one third of the world’s current population is infected with TB, and the other that the country with the highest TB incidence is 1262/100,000?

Henkvdm (talk) 03:35, 13 July 2008 (UTC)


 * I'll check the sources, but I'd think this is probably a difference between one source referring to people with latent TB infections, and the other to people with active TB disease. Tim Vickers (talk) 04:19, 13 July 2008 (UTC)

Correct: the vast majority of people who are infected will never develop full-blown TB, but may remain infected for the rest of their life. This is called latent infection.. Unfortunately, a few percent of them *will* develop TB over their lifetime. Hence you often see statements like "One third of the world's population are infected ..." and so on, which are referring to latent infections, not actual disease. —Preceding unsigned comment added by Plsmmr (talk • contribs) 13:52, 28 January 2009 (UTC)

Incorrect:Somebody clearly was confused when they read the sentence: "The World Health Organization (WHO) estimates that the largest number of new TB cases in 2005 occurred in the South-East Asia Region, which accounted for 34% of incident cases globally."

What this means is that, of all the new cases in 2005, 34% of them came from SE Asia. If you look at the table, it defines prevalence as "the number of cases which exist in the population at a given period of time." Thus, the Global row is the total number of cases in the entire world, which the table lists as 14,052,000. For a world population of 6.7 billion, this means 0.2% of the world is infected with TB.


 * This source states "Overall, one-third of the world's population is currently infected with the TB bacillus." This is confirmed by, which gives a global prevalence of MTB infection of 30%. You need to make a distinction between infection with MTB, which is common, and actual TB disease, which is much rarer. Tim Vickers (talk) 19:57, 21 September 2009 (UTC)

Chances of Survival When Left Untreated
What is an estimated life expectancy for someone who has contracted TB and leaves it untreated? —Precedingunsigned comment added by M d'avout (talk • contribs) 06:15, 21 August 2008 (UTC)

Given that approx 90% are asymptomatic, then effect on life span in approx 90% of cases is negligible (or unknown). Shaedo(talk) 15:57, 22 May 2011 (UTC)

Epidemiologic Risk-Factors
The last paragraph in the section on epidemiology talks about risk-factors of tuberculosis. I noticed that no social factors are mentioned, for example I would argue that not co-infection with HIV is the most important risk-factor but simply poverty (see e.g. Paul Farmer, "Infections and Inequalities." UC Press). I believe a discussion on social factors should be included in this section.


 * That's a good point. Could you suggest some sources that cover this? Tim Vickers (talk) 15:51, 10 September 2008 (UTC)


 * Check out: Spence, D P et al. “Tuberculosis and poverty.” British Medical Journal 307.6907 (1993): 759–761. It is available at PubMedhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1696420. —Preceding unsigned comment added by92.193.25.182 (talk) 18:22, 10 September 2008 (UTC)


 * Added to the epidemiology section. Tim Vickers (talk) 17:55, 7 November 2008 (UTC)

I think one of the issues with this is that the epidemiology section is getting a bit convoluted. I'm going to draft some changes to the section to split up the prevalence statistics from the risk factors in order to organize the information more clearly. I'll also include results from a systematic review that identified both health and social risk factors found in the literature published between 2000 and 2005. Please let me know if you have any ideas, suggestions or contributions that you'd like to add or that you think I should keep in mind.User:Flaucirica (talk) —Precedingundated comment added 14:52, 22 June 2011 (UTC).

Tuberculin testing results are deceptive
The statement that "80% of the population in many Asian and African countries testing positive in tuberculin tests, while only 5-10% of the US population testing positive" is very deceptive. Many, if not most, third world countries vaccinate against TB, and anyone who has been vaccinated will test positive for Tuberculin. The US does not vaccinate. —Precedingunsigned comment added by 65.31.4.200 (talk) 14:50, 10 October 2008 (UTC)
 * Tuberculin skin testing is not diagnostic of TB. I vote for this statement to be removed.--Gak (talk) 01:27, 18 October 2008 (UTC)

if the above is indeed true - that being vaccinated causes a positive on the tuberculin tests, then that sentence is very misleading and I vote it should be removed or re-worded. The implication is that testing positive means one has a latent or active infection, it should be explicitly stated otherwise if that implication is not the case. —Precedingunsigned comment added by 66.51.248.91 (talk) 11:25, 23 February 2010 (UTC) yes that is right, also in third world countries testing is extra common, teating in the Us, however, are extremely hard to find. Mostly, the people who find someone to test them do not have TB —Preceding unsigned comment added by Frog1734 (talk • contribs) 03:57, 12 June 2010 (UTC)

Suggested Links
I am not sure what section of the links this would fall under but, I stumbled across James Nachtwey an individual who is attempting to spread the word about drug resistant TB. Here are the two links for consideration:


 * James Nachtwey
 * James Nachtwey on Youtube

--Shane Birley 16:11, 10 October 2008 (UTC)


 * I don't think these links are appropriate: see WP:ELNO. --Steven Fruitsmaak (Reply) 18:13, 10 October 2008 (UTC)
 * I agree. Neither of these links is appropriate for this article. It may possibly be appropriate to create an article on James Nachtweylinking back to tuberculosis.--Gak (talk) 01:29, 18 October 2008 (UTC)

I would like to suggest another external link to add as part of the database links: The publication on the homepage of the website will officially be released on February 10, 2009.
 * Tuberculosis Drug Resistance Mutation Database

--Brian Weiner 17:29, 05 February 2009 (EST) —Preceding unsigned comment added byBriankweiner (talk • contribs)

Incidence and carrier rates
I've reverted thesetwo edits by Yeerkkiller1 as factually incorrect per the cited WHO source. -- MarcoTolo(talk) 03:04, 11 October 2008 (UTC)

Vegetarian "Protein deficiency" causing TB?
Yesterday, I've edited a statement that said vegetarians have a 8.5 fold increased risk of being infected with TB because of "protein deficiency". The term "protein deficiency" itself is actually misleading, as the human body digests proteins and does not use them directly. Accordingly, the correct term would "essential amino acid deficiency", which is very unlikely in a vegetarian diet based on legumes and rice, as it is provided with Indian food.http://en.wikipedia.org/wiki/Vegetarian#Protein

The reason I post this here is that the page was edited again within 24 hours with two new references added.

However, none of the cited articles indicate any relation between protein intake and TB.

IMHO, in order to state that a vegetarian diet causes "protein deficiency" we would need to provide better evidence and cite references that really support this theory.

Furthermore I think, if support existed, it should be included on http://en.wikipedia.org/wiki/Vegetarian as well. —Preceding unsigned comment added by There-is-life-on-mars (talk • contribs) 04:51, 7 November 2008 (UTC)


 * Good point. I've rewritten and expanded the discussion of diet in the section on epidemiology, adding some references that discuss malnutrition as an important global risk factor. The PLoS Medicine article discusses protein malnutrition as a risk factor, but this is in reference to severe malnutrition in the developing world, not alternative dietary choices in affluent countries. Tim Vickers (talk) 16:18, 7 November 2008 (UTC)

It seems that the problem we are scratching on is not directly a matter of what kind of "flavour" your diet is but nutrient deficiencies that affect the immune system in general. The fact that vegetarian Indians in London have a higher risk of getting TB is interesting but not very significant as the study does not cover vegetarian Indians in India. This means the increased TB risk cannot be linked to a traditional Indian diet directly as immigrants naturally change some of their habits and consume food from sources that are different from those in their home countries. (I recall stories of vegetarian immigrants to the US who developed vitamin B-12 deficiency because they changed their traditional way of treating food. The life-style they adopted was simply too clean, as they removed all vitamin-B12-containing bacteria from the vegetables by washing them too well.)

I think if it is worth to keep this part in the article, the following is necessary:

1. provide references that show evidence of the relation between TB and each deficiency

2. link risk groups and deficiencies (e.g. urban vegetarians and vitamin D, vegans and vitamin B12, etc.)

3. emphasise the relation between TB and the human immune system

There-is-life-on-mars (talk) 18:44, 7 November 2008 (UTC)


 * Let's work on redrafting this paragraph then, please add more references if you find some that would be useful. Tim Vickers (talk) 19:20, 7 November 2008 (UTC)


 * This is the current text, please edit this draft:


 * I've made a start by attributing the idea of "micronutrient deficiency" directly to Strachan et. al. Tim Vickers(talk) 19:22, 7 November 2008 (UTC)

LOCATING THE SOURCE?
wIs it true that when diagnosed with TB, doctors and / or tests can pin point when it was caught and what part of the Country / orld you were in at the time?

Chris.


 * Read the article. JFW | T@lk  06:36, 11 March 2009 (UTC)

Updating vaccines info:please update the sentence "Many other strategies are also being used to develop novel vaccines" to the folowing.
Many other strategies are also being used to develop novel vaccines, including bothsubunit vaccines(fusion molecules comprised of two recombinant proteins delivered in an adjuvant) such as Hybrid-1,Hyvac4 or M72and recombinant adenoviruses such as Ad35. Some of these vaccines can be effectively administered without needles, making them preferable for areas where HIV is very common. All of these vaccines have been successfully tested in humans and are now in extended testing in TB-endemic regions.

MarkD100 (talk) 13:59, 27 February 2009 (UTC)
 * Yes check.svg Done. I've reworked the external links into formatted references as well. haz (talk) 13:58, 1 March 2009 (UTC)

PCR
http://jama.ama-assn.org/cgi/content/full/301/10/1014 - CDC guidelines on the use of PCR.JFW | T@lk  06:36, 11 March 2009 (UTC)

Pathogenesis section edit
Hi, am just a passer by, not sure how to work this whole edit thing, just letting you know this "Within the granuloma, T lymphocytes (CD8+) secrete cytokines such as interferon gamma, which activates macrophages to destroy the bacteria with which they are infected.[31] T lymphocytes (CD4+) can also directly kill infected cells." sentence within the pathogenesis section has a minor but important error, the roles of CD4+ and CD8+ should be swapped with each other.


 * Reworded. Tim Vickers (talk) 16:15, 11 August 2009 (UTC)

See also section
The see also section needs to be combined into the article. Have started.-- Doc James (talk · contribs · email) 16:38, 15 June 2009 (UTC)

Gold-dust treatment?
In Kathryn Hulme's largely fact-based novel The Nun's Story and the film based on it, Sister Luke is cured of tuberculosis by being injected with gold dust. Was this a real treatment? Kostaki mou (talk) 23:55, 3 July 2009 (UTC)
 * I don't know of any historical treatments such as that, but today we do use gold (albeit not dust) as a treatment for Rheumatoid arthritis. Thus gold should be an immunosuppressant - a very bad idea for someone with TB, it would likely kill them.  So perhaps someone did try it, but I very much doubt it would be a good idea. |→ Spaully τ 09:24, 4 July 2009 (GMT)

Current:

The Bill and Melinda Gates Foundation has been a strong supporter of new TB vaccine development. Most recently, they announced a $200 million grant to the Aeras Global TB Vaccine Foundation for clinical trials on up to six different TB vaccine candidates currently in the pipeline.

Suggested:

The Bill and Melinda Gates Foundation has been a strong supporter of new TB vaccine development. Most recently, it announced a $200 million grant to the Aeras Global TB Vaccine Foundation for clinical trials on up to six different TB vaccine candidates currently in the pipeline.

Change:

Change "Most recently, they . . ." to "Most recently, it . . " as this refers to the foundation mentioned in the previous sentence. —Preceding unsigned comment added by Sayakurt (talk • contribs) 12:45, 21 July 2009 (UTC)

reference to "cottage country"
I think it might be prudent if someone took another look at the use of the reference to the word "cottage country" in this article. I can corroborate that the phrase "cottage country" is commonly used in Canada, it means many different areas depending on where the person lives, such that it means very different geographic areas depending on whether you live in Montreal, Ottawa, Toronto, Vancouver, Winnepeg etc. This article suggests that Tuberculosis is more common in cottage country, but the reference article refers to only one specific area, i.e. that of one area of rural Manitoba. I think the inference is wrong and should be changed or removed, there is no proof that the incidence of TB is higher in several or all of Canada's cottage countries, as there could possibly be if there was a legitimate confounding factor, such as 'deer are carriers and live in all of Canada's cottage countries'. The paper cited here refers to one area with a high population density of Native Canadians, who also have a higher than normal incidence of TB. Can this reference be corrected or made a bit more specific?

Thanks

Jamaas (talk) 13:20, 11 August 2009 (UTC)


 * I've removed the phrase, I don't think it added anything. As to making this more detailed, I don't think localised areas of high TB in Canada are particularly important from a global perspective on this disease, so this mention is sufficient. Tim Vickers(talk) 16:08, 11 August 2009 (UTC)

Rifampicin and Pyrazinamide for latent TB
Removed the following paragraph because it falsely gives the impression that RMP and RZA are the main treatments for latent TB and are unsafe. The issues are actually much more complicated and cannot be adequately dealt with in two sentences, but are dealt with in detail in the TB treatment article, which the reader is already referred to at the beginning of the section.
 * However, treatment using Rifampicin and Pyrazinamide is not risk-free. The Centers for Disease Control and Prevention (CDC) notified healthcare professionals of revised recommendations against the use of rifampin plus pyrazinamide for treatment of latent tuberculosis infection, due to high rates of hospitalization and death from liver injury associated with the combined use of these drugs.

--Gak (talk) 11:27, 3 September 2009 (UTC)

FYI - Quotation
Portions of this article's lead section were quoted by Mr Alistair Coe MLA in the Legislative Assembly of the Australian Capital Territory on 11 November 2009. Just by way of warm (or otherwise) fuzzy to the article's substantial contributors. -DustFormsWords (talk) 06:01, 11 November 2009 (UTC)

M. canetti
... is also part of the TB complex. —Preceding unsignedcomment added by 66.159.214.137 (talk) 17:05, 6 December 2009 (UTC)


 * Added, thank you. Tim Vickers (talk) 18:38, 6 December 2009 (UTC)

Infectious dose
"the inhalation of just a single bacterium can cause a new infection". Surely that's technically (but misleadingly) true of almost anything, and it's the ID50 that really matters? Casual googling suggests the ID50 of TB is 10 organisms. (The page for Coxiella burnetii says that has an ID50 of 1 and is therefore the most infectious organism known to man. This triumph presumably isn't a draw with TB.)81.131.46.77 (talk) 12:28, 9 December 2009 (UTC)


 * Yes, says "infectious dose is less than ten", as does  "the infectious dose is <10 bacilli". So I'll change this to reflect these more specific sources. I haven't see any IC50 data for people though. Where did you see this? Tim Vickers (talk) 17:50, 9 December 2009 (UTC)

leaving things out
the author forgot that TB is also refered to as the "beautiful deaseas" or "love sickness" by the japeneese who saw the wives' of soldiers who were always get sick.

Also, in the syntoms thre should be extreame pailness, redened cheeks, thin blood (or brusing or cutting easily), and passing out/ --Frog1734 (talk) 04:03, 12 June 2010 (UTC)

Consumption
Could there be some mention in the header of the older and other terms used to name this disease??--Oracleofottawa(talk) 04:26, 18 July 2010 (UTC)

Consumption is a name used for a bunch of diseases, including diabetes. It's more like a symptom.216.249.60.170 (talk) 14:32, 27 October 2010 (UTC)

Misuse of sources
This article has been edited by a user who is known to have misused sources to unduly promote certain views (see WP:Jagged 85 cleanup). Examination of the sources used by this editor often reveals that the sources have been selectively interpreted or blatantly misrepresented, going beyond any reasonable interpretation of the authors' intent.

Please help by viewing the entry for this article shown at the cleanup page, and check the edits to ensure that any claims are valid, and that any references do in fact verify what is claimed. Tobby72 (talk) 22:24, 26 August 2010 (UTC)

"Invitation to edit" trial
It has been proposed at Wikipedia talk:Invitation to edit that, because of the relatively high number of IP editors attracted toTuberculosis, it form part of a one month trial of a strategy aimed at improving the quality of new editors' contributions to health-related articles. It would involve placing this:"You can edit this page. Click here to find out how."at the top of the article, linking tothis mini-tutorial about MEDRS sourcing, citing and content, as well as basic procedures, and links to help pages. Your comments regarding the strategy are invited at the project talk page, and comments here, regarding the appropriateness of trialling it on this article, would be appreciated. The trial is due to start 15 September. Trialling here would necessitate lifting Pending changes protection, if it is still in place, for 30 days. Anthony (talk) 12:03, 31 August 2010 (UTC)
 * The list of articles for the trial is being reconsidered, in light of feedback from editors, and should be ready in a day or two. If you have any thoughts about the Invitation to edit proposal, they would be very welcome at the projecttalk page. Anthony (talk) 14:44, 2 September 2010 (UTC)

New species
Exciting news, new species just discovered in a type of mongoose.News article,journal article. Don't know where exactly to put the info, so feel free to shift it around. 216.249.60.170 (talk) 14:37, 27 October 2010 (UTC)

Work needed
Hello everyone! This article currently appears near the top of the cleanup listing for featured articles, with several cleanup tags. Cleanup work needs to be completed on this article, or a featured article review may be in order. Please contact me on my talk page if you have any questions. Thank you! Dana boomer (talk) 16:23, 31 December 2010 (UTC)

Gross ommission in rx section
Isoniazid and rifampin are discussed but streptomycin is treated as though no longer used after its initial discovery. It was brought back in the 1990's for MDR-TB. I don't have time to cite this. so I am leaving it off mainspace.Brothercanyouspareadime (talk) 01:52, 10 February 2011 (UTC)

WHO reference page does not contain symptoms mentioned
"When the disease becomes active, 75% of the cases are pulmonary TB, that is, TB in the lungs. Symptoms include chest pain, coughing up blood, and a productive, prolonged cough for more than three weeks. Systemic symptoms include fever, chills, night sweats, appetite loss, weight loss, pallor, and fatigue.[5]"

The fifth reference page does not contain information on TB symptoms. — Preceding unsigned comment added by William Rolfson(talk • contribs) 10:43, 9 March 2011 (UTC)


 * Thanks, I have replaced the reference. Graham Colm (talk) 09:38, 17 April 2011 (UTC)

T cell vaccine target
Responses Against Major Tuberculosis Cell Wall Lipid Hint at Vaccination Strategy may be worth mentioning. - Rod57(talk) 11:20, 18 May 2011 (UTC)

Review by Axl


This picture (right) is in the "Signs and symptoms" section. I wonder if it too complicated. It took me a short while to understand it&mdash;and I already know what the symptoms of the different forms of TB are. The diagram also implies that the "Return of dormant tuberculosis" is specifically associated with coughing up blood and separate from "(Established) pulmonary tuberculosis". Despite the caption's caveats, in my opinion, the article would be better without this picture. Axl ¤  [Talk]  10:31, 6 June 2011 (UTC)

From "Causes", paragraph 2: "The most common acid-fast staining technique, the Ziehl-Neelsen stain, dyes AFBs a bright red that stands out clearly against a blue background. Other ways to visualize AFBs include an auramine-rhodamine stain and fluorescent microscopy." Is the ZN stain still the most commonly used technique? In the UK, I think that auramine-rhodamine is more common now. Axl ¤  [Talk]  10:49, 6 June 2011 (UTC)



This picture (left) is confusing. I don't understand it. It is particularly odd that it is in the "Signs and symptoms" section. Axl ¤  [Talk]  17:43, 6 June 2011 (UTC)

In "Risk factors", silicosis is given undue prominence. Perhaps fifty years ago it was the most important risk factor. Now, HIV is far more important, followed by the haematological malignancies. Axl ¤  [Talk]  17:54, 6 June 2011 (UTC)

The whole section "Risk factors" needs to be re-written for balance and tone. Axl ¤  [Talk]  18:05, 6 June 2011 (UTC)

In "Mechanism", subsection "Transmission", there is repetition of risk factor information. Axl ¤  [Talk]  18:27, 6 June 2011 (UTC)

From "Mechanism", subsection "Transmission", paragraph 2: "People with prolonged, frequent, or intense contact are at particularly high risk of becoming infected, with an estimated 22% infection rate." Surely the infection rate is dependent on the degree of exposure? This is supposedly referenced to WHO Tuberculosis. However there is no mention of this infection rate in the reference. Axl ¤  [Talk]  18:15, 13 June 2011 (UTC)

The "Diagnosis" section contains information about the IGRAs, including their "use" in the diagnosis of TB infection. However I believe that these assays are licensed for the diagnosis of latent TB, not active infection. Axl ¤  [Talk]  17:13, 29 June 2011 (UTC)

Lethality is a matter of factual incidence not a matter of "potentiality"
Per edit comment: (MTB=lethality incidence=x. It is not a matter of a "potential{ity"; the lethality phenom. is bona fide and does occur. "Potentially" is the wrong word. Please take it to talk thanks.


 * It is potential in an indiv. patient; it is not "potential" in a population it is a fact with a percentile incidence.


 * Thus edit in lede.


 * This should be non-controversial but since (a) it is a high profile (b) technical and (c) lede edit I am inviting discussion here rather than wheel warring. Please advise.

 Geo Bard  Rap 21:11, 24 June 2011 (UTC)

Closing sentence in introduction is neither vital nor true and linked source fails to support assertion
Last sentence of third paragraph of intro notes: "More people in the developing world contract tuberculosis because of a poor immune system, largely due to high rates of HIV infection and the corresponding development of AIDS.[9]" This is clearly not vital to any discussion of tuberculosis the case as AIDS incidence rate is much lower than the incidence rate of tuberculosis. Clicking on the source shows a misreading of the relevant information - the source indicates that tuberculosis is on the rise in developed nations, primarily due to AIDS and other diseases compromising the immune system. As developing nations and developed nations are practically opposites, this information needs to be fixed, and due to its minor importance to the disease at hand, should be excised entirely from the introduction. — Preceding unsigned comment added by 98.199.75.215 (talk) 05:24, 10 February 2015 (UTC)

First skim of the page "look"
Layout looks a little scatter shot and some of the images seem poor as well. Has a big effect on someone seeing page for first time.

Image on top needs an explanation of the white and black marks on X-ray. More debatable, but perhaps w-linking x-ray not needed in this day and age and for an article not on imaging itself. The other thing is it's actually a hard image to quickly look at and grok the disease for general public. I'm a smart guy, but don't know what to look for. Think putting it lower in article and then explaining it (under diagnosis or whatever) would be better. The picture of the evil looking B&W bacterium would work well as an iconic lead image, that does not need a lot of clunky caption analytical explanation.

The list of external links seems clunky in it;s blueness and letter-number inexplicabillity, for a general reader. Would be better in a table towards the end or just in External links, formally. Doing that, would also allow junking the info box and just having a lead image.

Symptoms is way to small. Would display it centered and larger. Also seems a little confusing. That said, it is kind of cool looking visually and the method of using a body to point out various symptom areas is helpful visual summary.

I can't understand the genus organization. (are there X-Y axes? Is it some sort of PCA representation of differentness?). That and it's also very blurry and should be drawn in SVG (image help desk is great at Wiki). But maybe just a basic branching tree would work well. Would this fit better in the article on the bacterium?

The red and yellow photo is pretty. Would like to add a scale though. And probably a little more in caption or section text to get a "so what". Is it just an optical version of the SEM picture?

High burden map should be bigger. Could use it centered to start the section, but no push.

Age standardized death is painful with how 80% of the image space is for the KEY. There are ways to clean that up with a coloured bar or other tricks. Would up size it a bit too.

Do we need a prevalance AND death map? They roughly correlate. Plus given the map before we have 3 similar maps now. And if it is important to show this, we should use the SAME colour scale as the map before (yellow is good on one and bad on the other). If you have same rough scale, at least then we can see where the two aspect are not correlated. If this compare and contrast is really important, maybe a side by side would be good also (will also help with the text wrapping issues because you're not going down the gutter as much then).

I like the X-Y line graph for diversity of a visual. And it is simple clear content. But is too small to read the fonts of the axes, needs a redraw or an up size. Also, this content seems similar to the high burden--time dimension as opposed to geo dimension of new cases--should they be near each other?

Mummy, public health and Kochs pictures look great and are nice variety.

Haven't looked at the article text itself to think about what aspects need illustration. FWIW, may be some other helpful images easily available (just on Commons, not doing Flickr or donations or any of that):

Haven't looked at licencing.

TCO (talk) 05:38, 6 July 2011 (UTC)


 * As with many frequently edited articles, editors chunk in random unnecessary images over time. Here is the version that passed FAR.  Sandy Georgia  (Talk) 13:53, 6 July 2011 (UTC)

World Health Organization Recommends Ban on TB Blood Test
It is reported today on the BBC that the TB blood test commonly used in much of the world should be banned entirely, on the grounds that it fails to provide the correct diagnosis 50% of the time (in both directions), and that it is unethically marketed to the Third World, as this error is known to be the case.

The test kits are manufactured by eighteen companies in Europe and North America.

I am not sufficiently skilled to make edits to Wikipedia articles, so I leave the information here for those more capable. http://www.bbc.co.uk/news/health-14234575 James K. 71.50.19.103 (talk) 23:44, 21 July 2011 (UTC) 71.50.19.103 (talk) 23:46, 21 July 2011 (UTC)

Still working?
Are editors still working on this article in response to the comments at the featured article review? If so, could you please place an update there? There have been several comments on the review page regarding comprehensiveness, organizations, contradictory material, sourcing, etc., that as far as I can tell have not been addressed. This article is in danger of being delisted from featured status unless interested editors reappear and more work is completed in the near future. Dana boomer (talk) 15:02, 24 August 2011 (UTC)


 * Update : Article de-listed 9/26/11. Discussion here: F.A.R/archive -Anon98 98.92.184.116 (talk) 07:18, 11 November 2011 (UTC)

Vampires
I am removing the following text:

"Furthermore, people who had TB exhibited symptoms similar to what people considered to be vampire traits. People with TB often have symptoms such as red, swollen eyes (which also creates a sensitivity to bright light), pale skin and coughing blood, suggesting the idea that the only way for the afflicted to replenish this loss of blood was by sucking blood."

This is not supported by the reference it is attached to and also seems to be describing the modern vampire with its pale skin and aversion to sunlight.

The folkloric vampire is the exact opposite of someone with tuberculosis.

"These vampires were corpses, who went out of their graves at night to suck the blood of the living, either at their throats or stomachs, after which they returned to their cemeteries. The persons so sucked waned, grew pale, and fell into consumption; while the sucking corpses grew fat, got rosy, and enjoyed an excellent appetite. It was in Poland, Hungary, Silesia, Moravia, Austria, and Lorraine, that the dead made this good cheer." - Voltaire http://en.wikipedia.org/wiki/Vampire#Medieval_and_later_European_folklore

--69.169.137.62 (talk) 06:16, 27 January 2012 (UTC)

PVN Acharya's and Dexter Goldman's TB Article on Chemical COmposition of the cell wall.
I would like to re -add this article form 1970

It is from a respectable, reliable journal. Although it is more than 3-5 years old, there are numerous articles on this page far older than that. Further, I put this article on here years ago and have only recently encountered this opposition. (RaghuVAcharya (talk) 19:00, 7 February 2012 (UTC))
 * The citation is unnecessary (WP:CITEKILL), is old (against WP:MEDRS) and per your own statements here and on other pages, is being used to promote your family member's research. This is not appropriate for Wikipedia. Yobol (talk) 18:13, 8 February 2012 (UTC)
 * I agree with Yobol. Graham Colm (talk) 18:38, 8 February 2012 (UTC)

Ok. This article in particular has been cited so many times anyway that the world probably knows about it. Thanks and have a jolly good show. (RaghuVAcharya (talk) 18:17, 9 February 2012 (UTC))

I have noticed that Reference 81 is a one page article by Schoenlein, about impetiginous lesions, but does not mention Tuberculosis. The information about him being the first to name the disease can be found in  PaullTas (talk) 04:23, 2 March 2012 (UTC)

precaution
which precaution should be take by patient after cure?Bhavinkundaliya (talk) 17:46, 28 March 2012 (UTC)

Fix
That such an important article has fallen into disarray is unfortunate. Will see if I can fix it.-- Doc James (talk · contribs · email) 12:23, 29 December 2011 (UTC)
 * We have a great 2011 Lancet review here


 * Doc James (talk · contribs · email) 04:53, 5 January 2012 (UTC)
 * Doc James (talk · contribs · email) 04:53, 5 January 2012 (UTC)

2011 US data
Doc James (talk · contribs · email) 16:40, 23 March 2012 (UTC)

Seminar
The Lancet have a seminar in print (10.1016/S0140-6736(10)62173-3) that might be useful for updating the article.JFW &#124; T@lk  07:31, 27 June 2011 (UTC)
 * And here is the 2011 WHO report -- Doc James (talk · contribs · email) 22:16, 31 March 2012 (UTC)


 * 1) - Doc James (talk · contribs · email) 11:15, 1 April 2012 (UTC)
 * 1) - Doc James (talk · contribs · email) 11:15, 1 April 2012 (UTC)
 * 1) - Doc James (talk · contribs · email) 11:15, 1 April 2012 (UTC)
 * 1) - Doc James (talk · contribs · email) 11:15, 1 April 2012 (UTC)

The White Death
I've heard that TB was called 'The White Death' at some point in the past. I can find no mention of the term in the article. Isn't it worthy of a mention? Perhaps in the history section? VenomousConcept (talk) 10:39, 16 May 2012 (UTC)
 * It is mentioned in "History of tuberculosis". Axl  ¤  [Talk]  21:04, 16 May 2012 (UTC)

Post-GA improvement
"" Not really room for a table [of regional incidence values]. ""

- Doc James

What do you mean "Not really room"? Space is not an issue in Wikipedia articles. Adding a table isn't going to make the article impractically large.
 * While we have two images in that section on epidemiology right now. Adding a table will make formatting worse. Doc James (talk · contribs · email) 23:05, 26 May 2012 (UTC)

"" Added balancing details [about aboriginals]. ""

- Doc James

I'm still not convinced that this focus on aboriginal peoples is appropriate for this general article. Anyway, I am prepared to ignore it for the time being. The FAC reviewers will consider it when the time comes and we can get a consensus.

"" Will consider putting [thoracoplasty and plombage] in the sub article of history. ""

- Doc James

These used to be important and common treatments for TB. This article should at least mention them in the "History" section. I could add this.

"" Do you know if there is a bot that can do this [standardize references]? ""

- Doc James

I don't know. I can go through the reference list and fix these issues.

Axl ¤  [Talk]  10:24, 26 May 2012 (UTC)

The bacteria in granulomas are not dormant. The granuloma is helpful to the host, but dow not prevent dissemination of the disease. See articles by L. Ramakrishnan at U. Washington in the journal,Cell. — Preceding unsigned comment added by Chemtr (talk • contribs) 09:05, 14 October 2012 (UTC)

2013 review in the NEJM
Doc James (talk · contribs · email) (if I write on your page reply on mine) 02:57, 28 February 2013 (UTC)

Pending needed edit.
The very second citation does not support the assertion that TB spreads through"saliva". How do you know it does not spread through mucous, or free baccilli suspended in air. This is wrong, and needs to be changed promptly: It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit their saliva through the air.[2]Go scan the citation - it has nothing whatsoever to do with the issue of transmission, it is an article about diagnostics. I can't perform this edit from this account and won't, from my primary account, due to WP-policy compliant reasons of my own.Agent128 (talk) 01:02, 7 March 2013 (UTC)
 * Yes "The infection is transmitted by respirable droplets generated during forceful expiratory manoeuvres such as coughing." Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:04, 7 March 2013 (UTC)
 * But we know that is not a comprehensive description in that the infection can in some cases be transmitted by events other than "expiratory manoeuvres". In any case I am glad you supported my edit as it is not "saliva" but rather the baccilli which transmit, via pulmonary and perhaps other material originating in the sinuses, the oral mucosa. I don't know that the baccillus has been isolated from saliva, or from sinoidal fluid, or from mucous, but I imagine that a late stage patient does indeed have swarms of MTD everywhere. Agent128 (talk) 01:45, 7 March 2013 (UTC)

Vaccine
I was just going to add that the vaccine is "no longer" used routinely in the UK, because it was up until like 2006. I think i may have been in the last year to get it. Just saying it's not routinely given suggests that it never was, when there a good couple of generations of people with the scars to prove otherwise! — Preceding unsigned comment added by 129.215.149.97 (talk) 22:13, 8 April 2013 (UTC)
 * Yes good point. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 00:09, 19 May 2013 (UTC)

Reduction of cost for test to detect drug-resistant strain(s)
Public-Private Partnership Announces Immediate 40 Percent Cost Reduction for Rapid TB Test, press release reprinted by WHO, Aug. 6, 2012.

"PEPFAR, USAID, UNITAID and Bill & Melinda Gates Foundation have finalized an agreement to expand access to GeneXpert®, a molecular diagnostic system that provides a two-hour rapid diagnosis of TB, TB/HIV co-infection and drug-resistant TB. .  .  "

" .  .  .  can detect TB disease in patients co-infected with HIV and resistance to the antibiotic rifampicin – a widely accepted indicator of the presence of multi-drug resistant TB  .  .  .  "

The Stop TB Partnership, which operates through a secretariat hosted by the World Health Organization (WHO) in Geneva, Switzerland, with WHO also as a leading partner. Published evidence and commentary on the Xpert MTB/RIF assay, a PDF file containing 11 pages of published studies and commentary, updated April 5, 2013.


 * I added these two references to our Diagnosis . . . Active tuberculosis subsection. I AM NOT A DOCTOR.  However, I am interested in issues of public health, and am willing to do the work (time permitting of course) of getting good references.  Cool Nerd (talk) 22:27, 17 May 2013 (UTC)
 * Have moved to were this discussion already was in the society and culture section. Refs need further formatting. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:45, 18 May 2013 (UTC)
 * Hi Doc James, good to here from you! :>) In the Extrapulmonary subsection our article states "In those with HIV, this occurs in more than 50% of cases."  And I'm assuming that's why microscopic examination of morning sputum is less helpful . . . but I'd still ask if the patient co-infected with HIV might tend to have extrapulmonary in addition to pulmonary?  Now, on the question of drug resistance, I'm surprised there's not the best bet approach used, say like what a seasoned poker player might do.  I mean, if a certain type of resistance is present in 30% of TB strains in a region, why don't doctors treat all cases in that region as if such resistance is present?  I know WHO has gone from DOTS to DOTSPlus and I think two further levels as well.  And I know there's been a debate, with some people saying, Hey, DOTS has saved a whole bunch of lives over the years, and other people saying, Yes, and we can do better.


 * On the issue of formatting the references, I'm against it! I mean, just straight up.  Please remember, I'm one of the people who think we pay dearly for the (over-) formality of wikipedia, often at the expense of the accuracy of the information itself, and certainly at the expense of breadth of coverage.  To me, the formatted reference is more complicated to do and more complicated to correct and improve.  For example, we might loss the part from above "a PDF file containing 11 pages of published studies and commentary," which is what it is and is useful information to share with our readers.  Cool Nerd (talk) 18:16, 18 May 2013 (UTC)
 * "In those with HIV, this occurs in more than 50% of cases" simply refers to extrapulmonary Tb and yes they likely also have pulmonary Tb. With respect to "I mean, if a certain type of resistance is present in 30% of TB strains in a region, why don't doctors treat all cases in that region as if such resistance is present?". They might be I am not sure. Every other ref in this article is formatted in a certain fashion. I have formatted these two. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 23:53, 18 May 2013 (UTC)

Familial disseminated atypical mycobacterial infection
Or Mendelian Susceptibility to Mycobacterial Disease can expand on this? Jpogi (talk) 07:23, 16 May 2013 (UTC)

Evidence
Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:45, 18 May 2013 (UTC)

History, first sanatorium
In the article, it is written

Hermann Brehmer opened the first TB sanatorium in 1859 in Sokołowsko, Poland.[104]

I read from this sentence, that the sanatorium was opened in Poland. This is not true. In 1859, this town was called Görbersdorf and it was part of the Lower Silecian Province in Prussia. — Preceding unsigned comment added by 139.20.118.102 (talk) 08:09, 21 May 2013 (UTC)

Inaccurate information
From the article,"One third of the world's population is thought to have been infected with M. tuberculosis,[3] with new infections occurring at a rate of about one per second." I went to the source http://www.who.int/mediacentre/factsheets/fs104/en/index.html and found that "At least one-third of the 34 million people living with HIV worldwide are infected with TB bacteria, although not yet ill with active TB. " was the only mention of the 1/3 statistics and this clearly represents a skewed class in which the people infected with HIV is non-representative of the global population. Secondly, through their information of ~9 million people falling ill per year--> this leads to only 0.3 per sec not 1 per second. I request either removable or change unless someone can find sources on this sentence. Andy Jiang (talk) 00:44, 22 May 2013 (UTC)
 * What do you think about this line "About one-third of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with disease and cannot transmit the disease." Doc James  (talk · contribs · email) (if I write on your page reply on mine) 04:04, 22 May 2013 (UTC)
 * As far as I can tell, the original source does not indicate that the one-third of the world's population has TB but rather one-third of the HIV population "About one-third of the world's HIV population has latent TB." would be more appropriate. Also, the second half of the one case per second is false.Andy Jiang (talk) 05:07, 22 May 2013 (UTC)
 * That however is not what the WHO site states. Have you tried writing to the WHO to ask them to correct / clarify this? There site very clearly states "one-third of the world's population" Do you have a counter ref saying this is incorrect? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:43, 22 May 2013 (UTC)
 * And if WHO is wrong so are dozens of review articles such as this one and  plus many textbooks.  Doc James  (talk · contribs · email) (if I write on your page reply on mine) 05:47, 22 May 2013 (UTC)
 * I agree with James. Flyer22 (talk) 08:29, 22 May 2013 (UTC)
 * Can you point to me which line in the WHO site has that information of 1/3 of the world? Also that would imply ~2.3 billion people which is much more than 10 times of 8.7 million. I simply wish to see an estimate of the total that is approximately 1/3 of the world's population.Andy Jiang (talk) 14:17, 22 May 2013 (UTC)
 * Linked above twice and two additional links provided. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 15:45, 22 May 2013 (UTC)
 * I apologize,I just found it in the article. It should be kept. It just seemed a little out of proportions. The one per second statistics I assume is also based on the total cases--latent and active? I think it should be made more clear that this is the case.Andy Jiang (talk) 00:46, 23 May 2013 (UTC)
 * They are in the same sentence so I felt that would be enough. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 07:52, 23 May 2013 (UTC)
 * The WHO article now reads: "About one-quarter of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease." So at the very least I would think the Wikipedia page should be updated to read "one-quarter" instead of "one-third" (and perhaps it should specify that these are latent TB cases).--Fivehundredmillionsprings (talk) 23:01, 27 November 2017 (UTC)

specter of TDR in India
Now, this is independent media (I think) or in any case, a source I'm not familiar with. All the same, the author does include a lot of references.

Tuberculosis – Still A Scourge, News Laundry, posted by Anand Ranganathan, May 24, 2013.

' .  .  .  The government, however, refused to believe Dr Udwadia. They said it wasn’t TDR but rather XXDR. In a Madam Speakeresque fashion they asked everyone to “calm down, calm down”, traumatised as they were by that one word: Totally. . .  '

' .  .  .  “We have thrown every possible salvage drug in a desperate attempt to treat each patient”, says Udwadia. “We have come a full circle, back to the sanatoria days, and are operating on large numbers, too. The new drugs, Bedaquiline and Delamanid offer hope. One of our TDR patients was the first Indian patient to start on Bedaquiline and I was delighted he sputum-converted [i.e. responded to treatment]. But a single new drug is doomed to failure and we need new regimens, which are a decade away.”. . .  '


 * posted by Cool Nerd (talk) 16:15, 17 June 2013 (UTC)

---

Killer TB theory 'premature': Govt, The Times of India, Jan 19, 2012.

' .  .  .  The seven were subjected to the basic TB test called sputum microscopy in various municipal labs in the city. And the medicines that appear to be working for them are special drugs that are outside the defined purview of TB treatment. "These patients are under salvage treatment using drugs that are meant for other conditions," said Dr R K Jindal, one of the experts in the central team. Some of these salvage drugs are usually used to treat conditions such as leprosy or staph infections. . .  '

Prevention
I was told by a biology teacher some 50 years ago that TB could not live in oxygen, and that by filling your lungs once a day would ensure you're not being affected. 1. Is this true? 2. If it is (or any variation on it) is that information not worthwhile in a prominent position? My logic is that in places were it is a major threat people can take simple action to ward off infection. PeterM88 (talk) 07:26, 23 August 2013 (UTC)
 * Does O2 prevent TB? Not that I am aware of. Would need ref. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 07:41, 23 August 2013 (UTC)
 * No, it is not true. Indeed one suggested reason for TB's predilection for the upper lobes is due to a higher V/Q ratio, leading to a higher oxygen content there than in other parts of the lung. Axl  ¤  [Talk]  09:23, 23 August 2013 (UTC)

Lungs?
Is there any reason we can't say lungs in place of respiratory organs in "the infection spreads outside the respiratory organs"? Thanks. Biosthmors (talk) 09:23, 9 September 2013 (UTC)
 * No good reason. I have changed the text. Axl  ¤  [Talk]  21:49, 9 September 2013 (UTC)

Semi-protected edit request on 13 February 2014
Hi -- I request correction of a grammatical error: "After determining the disease was contagious in the 1880s, TB was put on a notifiable disease list..."

Obviously, TB didn't determine that the disease was contagious. Please change, to something like "After TB was determined to be contagious in the 1880s, it was put on a notifiable disease list..."

thanks, Richard Sedlock

71.215.179.54 (talk) 05:31, 13 February 2014 (UTC)

✅ - Thanks for pointing that out - Arjayay (talk) 10:47, 13 February 2014 (UTC)

Semi-protected edit request on 5 March 2014
Under the transmission section it is stated: Each one of these droplets may transmit the disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection).[41] However in the reference, that specific journal article cites additional sources for the infectious dose being only 1 M. tuberculosis organism. It explicitly states that the reader is directed for discussion of the inferred infectious dose; specifically 3 articles, Wells (1955), Ratcliffe (1952), and Nyka (1962). The article does not itself address the number of bacteria needed to establish infection, but discusses the bacterial vehicle for transmission. Mainly the respiratory droplets and their change in size during a cough or sneeze of typical healthy patients from 4 previous studies. The Poisson equation for risk depends on whether infection can be established with just one organism and can significantly change if not just 1. Request that the infectious dose and reference to it should be further clarified.

Coveted Intelligence (talk) 01:25, 5 March 2014 (UTC)
 * What do you want it changed to? Doc James  (talk · contribs · email) (if I write on your page reply on mine) 01:31, 5 March 2014 (UTC)
 * Red question icon with gradient background.svg Not done: it's not clear what changes you want made. Please mention the specific changes in a "change X to Y" format. — &#123;&#123;U&#124;Technical 13&#125;&#125; (t • e • c) 11:59, 5 March 2014 (UTC)

TUBERCULOMA
Hi, I noticed that in ALL the project the voice Tuberculoma MISSING! I wrote it but I can not put it because of the blockade. Here there are other sources http://it.wikipedia.org/wiki/Tubercoloma Seeing her SERIOUSLY LACK hope you can write it AS SOON AS POSSIBLE!

The 'tuberculoma' is a clinical manifestation of the tuberculosis which happens to conglomerate tubercles and radiologically simulating a cancer. Since these are evolutions of primary complex, the tuberculomas may contain within caseum or calcifications. With the passage of time, in fact, for degeneration,  Mycobacterium tuberculosis (also called Bacillus Koch) is transformed into crystals of calcium. Can affect every organ such as the brain  or intestine.
 * Sure lets work on adding something. First of all can you just use secondary sources from the last 5 years as references. These include review articles. I will than help you with the text and add the content. Also WP:MEDHOW gives an overview of a better way to reference. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:34, 8 March 2014 (UTC)
 * I don't see the "edit" link ... How can I add it? — Preceding unsigned comment added by 79.41.26.4 (talk) 22:22, 10 March 2014 (UTC)

Masquerading as Tuberculosis
A science magazine had a medical diagnostician story about patient who died after initially dismissing Tuberculosis but found to have "mycobacterium avium paratuberculosis". Exposure can be inhaled and sourced by dust from dried pigeon droppings. Shjacks45 (talk) 09:47, 13 March 2014 (UTC)
 * Yes MAC. Not that uncommon. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 09:54, 13 March 2014 (UTC)

Lack Of Clarity, & Some Ludicrous "Facts"
This wiki article makes absolutely no clarification in whether or not the treatments of TB cure people with TB if it's not antibiotic-resistant, or whether it just prolongs their lives, or makes it go back to dormancy. All it does is discuss treatments, and not at all how much it does, or does not help. (And, if it does cure it, doesn't it mean that one can overcome it naturally?) There's also almost nothing in here about ordinary TB versus antibiotic-resistant TB, or about the latter originally coming... If I recall, from Russian prisons. And, someone has the article saying a third of the world has TB. I call BS on that. That would mean dormant TB is widely spread all over the planet, even here in the United States, where almost no one has so much as dormant TB, let alone active. It would also be so huge everyone would hear/read a lot of news regarding it, which isn't the case. A very huge portion of the global population lives in countries that do not have TB problems, or where their TB problems are only in places like prisons. And, TB clearly isn't a giant problem in many third world countries either, with malaria, and AIDS being much bigger issues. So, how could a third of the world possibly be infected with TB? I mean, by that claim, I'd be likely to have it, at least dormantly, by now; or, else, some-to-many third world countries would have to all be infected (and, I mean as in just about every single citizen). So, this 1/3 of the world has TB claim is ridiculous. It gets better. That paragraph goes onto say more outragious, and unbelievable statistics, as well as it's alleged factual statistics being quite old while pretended like they're recent enough to represent current statistics, despite the same paragraph says TB is going down in it's prevalence. The entire paragraph is just weird, and inaccurate. I'm sorry, I just don't believe that I could possibly have TB, or catch it courtesy of my diabetes in my lifetime without going to a country with a TB problem. I also can't believe that the rest of you would be likely to have it, or to catch it in your lifetimes if not having it already. (Yes, it implies likewise of you guys, not just me. Though, I probably have lower immunities than the rest of you from Type 1 Diabetes.)--97.117.177.103 (talk) 12:53, 21 May 2014 (UTC)
 * Read the references would be a good start. The 1/3 statement is from WHO. You could write to them. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 15:51, 21 May 2014 (UTC)
 * 1. Perhaps it would be better to write that 1/3 of the population has at one point in their lives been infected. That's enough to get a positive reaction in tests, but it does NOT mean you'll develop the illness. I know that my parents and both sets of grandparents had a positive test result (obligatory, because they were all teachers), most probably from drinking infected milk in their childhood, but their immune systems eliminated the bacillus.
 * 2. Multiresistent TB obviously developed in hospitals, not in Russian prisons.
 * 3. I think you underestimate the dangers of TB and you clearly have no idea about the condition of the health care system for the poorer part of the US-American citizens. Some third-world-countries have higher standards!--79.194.228.29 (talk) 22:44, 14 July 2014 (UTC)

Quantiferon Gold test
This article is missing the Dx test of Quantiferon Gold! 129.180.159.8 (talk) 12:52, 8 June 2014 (UTC)
 * Here's a link QuantiFERON 129.180.159.8 (talk) 12:52, 8 June 2014 (UTC)
 * IGRAs are mentioned in the article. The main article "Tuberculosis diagnosis" gives more details. Axl  ¤  [Talk]  13:16, 8 June 2014 (UTC)

Semi-protected edit request on 9 June 2014
PLEASE

Jman23424 (talk) 19:17, 9 June 2014 (UTC)


 * Er, are you requesting an edit? Axl  ¤  [Talk]  20:07, 9 June 2014 (UTC)
 * Red question icon with gradient background.svg Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. — &#123;&#123;U&#124;Technical 13&#125;&#125; (e • t • c) 22:26, 9 June 2014 (UTC)

Semi-protected edit request on July 14th, 2014
History, first sanatorium

In the article, it is written

Hermann Brehmer opened the first TB sanatorium in 1859 in Sokołowsko, Poland.[104]

I read from this sentence, that the sanatorium was opened in Poland. This is not true. In 1859, this town was called Görbersdorf and it was part of the Lower Silesian Province in Prussia. — Preceding unsigned comment added by 139.20.118.102 (talk) 08:09, 21 May 2013 (UTC)


 * Yes check.svg Done. I've clarified the location. —Mr. Granger (talk · contribs) 23:52, 14 July 2014 (UTC)

Merge notice
Gilded Snail (talk) 02:28, 1 August 2014 (UTC)

DOTS & STOP TB & Tuberculosis in relation to HIV

 * This article needs some mention of DOTS and STOP TB - WHO's treatment guidelines. I suggest some merging of content from Tuberculosis management


 * There should be some mention of the article Tuberculosis in relation to HIV

-- CFCF  🍌 (email) 07:50, 4 August 2014 (UTC)

Decreas or increase?
It seems to me that the text and the graph of new cases disagree (unless the text is referring per capita incidence, in which case MAYBE the two can be reconciled). Am I missing some=thing, or is this an error: "decrease" vs. rising dots on graph.Kdammers (talk) 06:13, 22 August 2014 (UTC)

This is the offending graph:-



I have deleted the graph from the article and moved it here. (The formatting used in the article's editing page made it difficult to find.) The reference provided is unhelpful for verifiability.

This document by the WHO indicates falling incidence, prevalence & mortality (page 15, or page 28 of the pdf). The only way that I could resolve this is to assume a disconnect between estimated incidence and "reported" cases, but that is pure speculation on my part. In the meantime, the graph should not be in the article. Axl ¤  [Talk]  10:10, 22 August 2014 (UTC)

Popular press
I have trimmed some popular press that was added. It is based on a recent primary source We need to wait for proper secondary sources per WP:MEDRS. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:43, 23 August 2014 (UTC)


 * What about the original article by the study team in "Nature"? Isn't this an RS?Parkwells (talk) 15:51, 23 August 2014 (UTC)
 * It is a primary source. We should be using secondary sources generally per WP:MEDRS. Doc James  (talk · contribs · email) (if I write on your page reply on mine) 21:13, 23 August 2014 (UTC)

Semi-protected edit request on 11 November 2014
add 'vinegar kill mycobacteria' to somewhere in https://en.wikipedia.org/wiki/Tuberculosis#Mycobacteria

Arnon81 (talk) 20:07, 11 November 2014 (UTC)
 * Red information icon with gradient background.svg Not done: No WP:MEDRS. Cannolis (talk) 20:50, 11 November 2014 (UTC)

Semi-protected edit request on 14 February 2015
The description of the cause of hemoptysis (coughing up blood) is incorrect. Coughing up bloody sputum is mostly caused by destruction of alveolar lung tissue and creation of cavities. This is my expert opinion, and may be omitted. Erosion into a pulmonary artery is a rare cause. This is described as the main (only) cause of massive (>500 ml in a 24 hr period) hemoptysis. The main cause of massive hemoptysis in tb, and the reason that it is remembered vividly as a cultural memory (most doctors can think of only this single cause of massive hemoptysis) is BRONCHIAL artery rupture. This is a feature of the disease process bronchiectasis which is a near ubiquitous part of active pulmonary tuberculosis. Here is a reference as to successful treatment of a majority of cases of massive hemoptysis due to tb: http://www.ncbi.nlm.nih.gov/pubmed/8756916

71.229.159.242 (talk) 06:01, 14 February 2015 (UTC)
 * Just to be clear, are you suggesting that the reference to Rasmussen's aneurysm be removed and replaced with something about bronchial artery rupture? If so, I think there may be something to this - the only source on the article for Rasmussen's aneurysm is this, which states "However, the hemoptysis resolved only after subsequent embolization of the bronchial artery." However, I am far from an expert and will leave this to one of the expert editors Cannolis (talk) 08:24, 14 February 2015 (UTC)

Yes agree just one cause. We have a review here which states "Because of bronchial artery or a branch of pulmonary artery erosion due to cavitary infiltration, bronchiectasis, fungus ball, broncholithiasis or destroyed lung, the bleeding can some" Will adjust Doc James  (talk · contribs · email) 12:34, 14 February 2015 (UTC)

Notable people who died from TB
There doesn't seem to be any refererence or link to the 884 wiki-notable people who have died from TB, as listed at Category:Deaths from tuberculosis. Perhaps the link could go in a 'See also' section, along with Tuberculosis in relation to HIV and Tuberculosis in India, which don't appear to be linked in the text. >MinorProphet (talk) 20:09, 27 February 2015 (UTC)
 * There is no see also section. There is already but it needs refs and is linked in the navbox  Doc James  (talk · contribs · email) 01:57, 28 February 2015 (UTC)

Semi-protected edit request on 3 March 2015
27.49.64.138 (talk) 15:34, 3 March 2015 (UTC)
 * Red question icon with gradient background.svg Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format. —  16:13, 3 March 2015 (UTC)

Semi-protected edit request on 7 October 2015
Please delete or put into context the use of the term "high-risk ethnic minorities" as written in the Wikipedia entry on Tuberculosis. This term has no meaning without relevant context. e.g. Africans are not an ethnic minorities in Africa where tuberculosis rates are high. But in the context of tuberculosis rates in the U.S., African immigrants are ethnic minorities, and would be part of a high risk group. Here is the relevant paragraph: Tuberculosis is closely linked to both overcrowding and malnutrition, making it one of the principal diseases of poverty.[9] Those at high risk thus include: people who inject illicit drugs, inhabitants and employees of locales where vulnerable people gather (e.g. prisons and homeless shelters), medically underprivileged and resource-poor communities, high-risk ethnic minorities, children in close contact with high-risk category patients, and health-care providers serving these patients.[38]

2605:E000:5B01:FB00:E025:192C:FD59:8049 (talk) 09:00, 7 October 2015 (UTC)
 * This is many aboriginal populations in many areas of the world. It is also some immigrant groups. What wording do you wish to see used? Doc James  (talk · contribs · email) 11:30, 11 October 2015 (UTC)
 * I am changing the answered parameter to yes as this request has been pending the response to Doc James's question for a few days now. OP is more than welcome to reactive this request if/when they respond. --Stabila711 (talk) 01:43, 16 October 2015 (UTC)

Lancet
Seminar 10.1016/S0140-6736(15)00151-8 JFW &#124; T@lk  23:55, 19 March 2016 (UTC)


 * And this in the Lancet Infectious Diseases in the same week. 10.1016/S1473-3099(16)00070-0 JFW &#124; T@lk  07:41, 23 March 2016 (UTC)

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sentence "However, existing data suggest that patients taking bedaquiline in addition to standard TB therapy are five times more likely to die than those without the new drug,"
The sentence "However, existing data suggest that patients taking bedaquiline in addition to standard TB therapy are five times more likely to die than those without the new drug," is so badly organized that one readily reads the exact opposite of what it is trying to convey. This sentence should be put out of its misery. Please take it out the back and shoot it. Then rewrite it. — Preceding unsigned comment added by Redreinard (talk • contribs) 23:12, 10 May 2016 (UTC)

Semi-protected edit request on 27 May 2016
In the first sentence:"Tuberculosis (TB) is an infectious disease usually caused by the bacterium Mycobacterium tuberculosis (MTB)."the word "usually" shouldn't be there. Even in the given reference it states clearly that Mycobacterium tuberculosis is the agent causing the disease, not one of many.

MateiHermina (talk) 16:12, 27 May 2016 (UTC)
 * Yes check.svg Done Sir Joseph (talk) 16:20, 27 May 2016 (UTC)

Each fact in the article is well referenced and the references seem to be reliable. Some of the data is dated and could be updated to portray numbers effected today and the problems the disease imposes on our present day world and future. Mablythe (talk) 18:35, 6 September 2016 (UTC)mablythe

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