Tuberculosis
Tuberculosis is caused by infection by the microbe mycobacterium tuberculosis. While this is a condition that was thought to be in decline in the Western World its incidence is rising, with drug-resistant strains appearing, possibly as a result of inadequately treated cases (not because the doctors can't treat them, but because the patients, many of whom are alcoholics, aren't good at taking the medication). In the past a major source of infection was milk from infected cattle, causing abdominal TB, but now the usual route is by droplet inhalation from the sputum of an infected individual. The body may respond by producing an inflammatory reaction that wards the infection off - called a primary focus. There may be no symptoms, and while the disease is effectively contained, it lies latent and can be re-activated. There are skin tests - called Mantoux, Heaf and Tine - where protein extracted from the bacterium is injected into the skin: a person with active infection produces a vigorous response after a period of days, indicating the need for treatment. Those who produce no response when screened, and any baby born into a family where a member has TB, are offered vaccination with BCG - which is the Bacille Calmette-Guerin. This is a live TB bacterium which has been weakened, or attenuated, and it confers immunity in about 80% of cases. TB in children can be difficult to diagnose: it should be considered in those groups at high risk, such as communities from parts of the world where the disease is widespread, such as Asia and Africa. Treatment involves anti-tuberculous medication, which may need to be taken as a cocktail of different agents for a prolonged period of time. Once the infection - which may spread from the lungs to affect any part of the body or the brain - has been eradicated, the child should be vaccinated.
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