Tuberculosis remains one of the infectious diseases more prevalent

24 March, World TB Day

– in 2010 in all the world there were 8.8 million new cases of the disease, with 1.4 million people overall mortality

– occur each year worldwide 500,000 cases of MDR tuberculosis

– currently it is investigating in new vaccines to prevent the development of the disease, with new drugs that shorten the time of treatment

Madrid, March 2011.- the Spanish society of infectious diseases and Clinical Microbiology (SEIMC) binds to the commemoration of the World TB day. One-third of the world’s population is infected with Mycobacterium tuberculosis, and 5-10% will develop the disease throughout his life. According to the annual report of the WHO Global Tuberculosis Control 2011, estimated during the year 2010 around the world there were 8.8 million new cases of the disease and 1.4 million deaths directly related to the same.

Tuberculosis is transmitted by air, through coughing, sneezing or talking; affects mainly the lungs, although it can cause injuries in any organ or tissue. The most frequent symptoms are: cough coughing, sometimes with blood in the sputum, fever, night sweating, lack of appetite and weight loss. We know that TB is only spread from ill persons, the latent infection do not represent any risk for others.

Dr. Juan José Palacios, Mycobacteria of Asturias and member of the SEIMC Regional reference unit, warns that each sick with active TB can infect between 10 and 15 people, if left untreated. For this reason, from the SEIMC want society to raise awareness of the importance of prevention and early detection of this disease, which remains one of the most important causes of mortality in the world ”.

The disease particularly affects people living in conditions of pobreza-malnutrición – overcrowding, and is often associated with other chronic diseases and immunodeficiencies such as for example the caused by the HIV virus. Co-infection TB / HIV represents 12% of cases in the world. In addition, in the HIV risk of developing TB disease increases about 34 times. In 2010 he developed tuberculosis 1.1 million HIV-positive people, 82 per cent in Africa (900,000).

TB has developed a form resistant to antibiotics, MDR-TB, which affects about 500,000 people worldwide every year. Dr. Juan José Palacios says MDR TB does not respond to standard treatment; It needs much more time to treatment and has to resort to less effective drugs; whose side effects are more frequent. All this without forgetting that it is much more expensive and that the therapeutic success rate does not pass of 55%. ”
current situation in Spain

Spain was until few years one of the countries of Western Europe with an increased incidence of tuberculosis, fortunately today the number of cases has been reduced to more than half in the last decade and the rates are similar to those of the rest of developed countries. In 2011 the incidence rate was 15-20 cases per 100,000 inhabitants, depending on the autonomous community. According to data of the National Centre for epidemiology, in communities with higher rates are Ceuta, Galicia, Melilla and La Rioja; Although declared by number of cases include Catalonia, Andalusia and Madrid. Keep noting a predominance of cases in men, being young adults between 25 and 34 years old have the highest rates, with almost double the cases in men than in women.

Dr. Juan José Palacios credited advances in control of tuberculosis in Spain, on the one hand to universal access to health services, and on the other to the diagnostic technology currently available therein, which allows faster and more accurate diagnoses. With regard to the change of trend at the global level, directly related it to the new pardons and funding sources that have contributed to the development and distribution of the new rapid test for the diagnosis of tuberculosis and MDR-TB, as well as making possible the access to the medicine.

How tuberculosis is diagnosed

The generalization in the use of the IGRA (interferon-gamma release assays) allows that the diagnosis of latent TB infection currently is simple, reliable and fast. There are currently two commercialized formats (QuantiFERON TB Gold In – tube ® and T-SPOT.)TB ®). Numerous published studies worldwide and several international guides recommended their incorporation into the diagnostic arsenal.
New techniques of genomic amplification (real time PCR in compact and individualised format) are revolutionizing the diagnosis of tuberculous disease, when the infection is active, in little more than two hours gives the result. The published works presents figures on very encouraging sensitivity and specificity. In addition, the same test detected forms of MDR TB; speed is essential to the appropriateness of this type of tuberculosis management. In the next meeting scientific group comments, expert group of infections by Mycobacteria of the SEIMC, within the program of the XVI Congress of the SEIMC to be held in Bilbao on May 9-12, 2012, will update the information available on this new diagnostic technology.

A promising future

There are several candidates for new vaccines against tuberculosis, around a dozen have already reached the clinical stage of the experiments. Most are based on antigens recognized by the immune system during the initial stages of infection. One of them, H56/IC3 has obtained encouraging results in animals, and this year will begin the trial in humans. It is a triple fusion vaccine, it combines two proteins that the bacteria produced in the early stage of infection (Ag85B and ESAT-6) with a protein produced in the late phase (Rv2660c).

Several groups of Spanish researchers are also participating in the development of candidates for new vaccines with promising preliminary results in animals; they are currently preparing to carry out phase III studies. One group is researching in a live recombinant vaccine of M. tuberculosis attenuated. Another Spanish group works in a poliantigénica vaccine for the treatment of latent TB infection.

As for medication, shorten treatment regimens is a priority. Three trials are currently in phase III, and published between 2012-2013; While two trials related to new drugs against MDR-TB are in phase II with results expected for this year.

Comments

COMMENTS is a group of multidisciplinary study of the SEIMC comprising all those members of the society interested in any of the aspects related to infections by Mycobacteria, including tuberculosis. This group seeks to promote, encourage and disseminate the study and multidisciplinary research into the different aspects related to these diseases.

The SEIMC

The Spanish society of infectious diseases and Clinical Microbiology (SEIMC), brings together professionals working in the field of Infectious Pathology, etiological, both from a clinical point of view and the diagnosis, treatment and prevention of infectious processes. Its fundamental purpose is promote, encourage and disseminate the study and research of infectious diseases and clinical microbiology, referred to as regards epidemiology, pathogenesis, diagnosis, treatment, prevention and control, as well as in their interrelations. Infectious diseases are recognized as a new specialty in the draft of the Royal Decree of new medical specialties of the MSC, which is pending approval by the new Government.

The society currently has more than 2,700 partners, more than 1,530 section of the clinical microbiology and about 1,170 to infectious diseases.