What makes tuberculosis (TB) the world's most infectious killer? - Melvin Sanicas

Translator: Sandra Viz lasheras Reviewer: Servizo de Normalización Lingüística

In 2008, archeologists uncovered two 9,000-year old skeletons.

No 2008, uns arqueólogos atoparon dous esqueletos de 9000 anos de antigüidade.

There’s no definitive way of knowing what killed these ancient people,

Non hai unha maneira exacta de saber que foi o que matou esa xente,

but we do know their bones were infected by an all too familiar bacterium.

pero si que os seus ósos estaban infectados cunha recoñecida bacteria.

The ancient Greeks knew its consumptive effects as phthisis;

Os antigos gregos denominaban os seus efectos macilentos como “phthisis”,

the Incans called it chaky oncay; and the English called it tuberculosis.

os incas chamábana “chaky oncay” e os ingleses “tuberculosis”.

Today, tuberculosis, or TB,

Hoxe en día, a tuberculose ou TB

is still one of the world’s biggest infectious killers,

segue sendo unha das enfermidades infecciosas máis mortais do mundo

causing more deaths than malaria or even HIV and AIDS.

e causa máis mortes que a malaria ou a sida.

But what exactly is this disease, and how has this pathogen persisted for so long?

Pero que é o que causa esta enfermidade e como persistiu este patóxeno no tempo?

Typically, TB bacteria called mycobacterium tuberculosis, are airborne.

Polo xeral, as bacterias da TB, chamadas Mycobacterium tuberculosis, están no aire.

They travel into our airways and infect our lungs.

Viaxan polas nosas vías respiratorias e inféctannos os pulmóns.

Here, immune cells called macrophages rush to the infection site,

Aquí, unhas células inmunes chamadas macrófagos móvense ao sitio da infección

attempting to absorb and break down the bacterial invaders.

e tentan absorber e descompoñer o invasor bacteriano.

In many cases, this response is enough to remove the bacteria.

Moitas veces, esta resposta é suficiente para eliminar a bacteria,

But in individuals with other medical conditions–

pero en individuos con algunha outra afección médica,

ranging from malnutrition and HIV to diabetes and pregnancy

desde a malnutrición ata o VIH, a diabetes ou un embarazo,

–the immune response may not be strong enough to destroy the intruder.

a resposta inmunitaria pode non ser forte abondo para destruír o intruso.

If so, mycobacterium tuberculosis will reproduce inside those macrophages,

Se iso acontece, a bacteria da tuberculose reproducirase dentro dos macrófagos

and form colonies in the surrounding lung tissue.

e formará colonias no tecido circundante dos pulmóns.

As they infect more cells,

Ao ir infectando máis células, a bacteria emprega

the bacteria employ cell-degrading enzymes that destroy the infected tissue,

enzimas de degradación celular que destrúen os tecidos infectados

triggering chest pain, and causing patients to cough up blood.

e desencadean dor no peito e tose con sangue nos pacientes.

The damage to the lungs leads to oxygen deprivation.

O dano pulmonar xera falta de osíxeno.

This begins a flood of hormonal changes–

Isto inicia unha serie de cambios hormonais

including a decrease in appetite and iron production.

que inclúen diminución do apetito e da produción de ferro.

From here, microbes can spread to the skeletal system,

Neste punto, os microbios poden espallarse ao sistema esquelético

causing back pain and difficulty moving;

e causar dor nas costas e dificultade para moverse;

to the kidneys and intestines, causing abdominal pain;

ao fígado e os intestinos, o cal causa dor abdominal;

and to the brain, causing headaches and even impaired consciousness.

e ata o cerebro, o cal causa dor de cabeza e incluso alteracións da consciencia.

These symptoms produce the classic image of TB:

Estes síntomas xeran a típica imaxe da TB:

weight loss, a hacking, bloody cough, and ashen skin.

perda de peso, tose seca e sanguenta e un ton de pel cinsento.

This ghostly appearance earned TB the title of the ‘White Plague’

Esta aparencia fantasmagórica deulle o nome de “peste branca”

in Victorian-era England.

na era vitoriana inglesa.

During this period, tuberculosis was considered a ‘romantic disease,'

Durante este período, a tuberculose considerouse unha “enfermidade romántica”,

because it tended to affect poverty- stricken artists and poets–

xa que adoitaba afectar a artistas e poetas asolagados pola pobreza,

those with weaker immune systems.

que tiñan un sistema inmunitario máis feble.

TB’s outward symptoms even helped fuel the popular myth of vampirism.

Os propios síntomas da tuberculose alimentaron o mito popular do vampirismo.

In spite of– or perhaps because of these less than scientific concerns,

A pesar destas preocupacións pseudocientíficas, ou grazas a elas,

this period also marked the first strides toward curing TB.

este período tamén marcou os primeiros pasos na cura da tuberculose.

In 1882, the German physician Robert Koch

En 1882, o físico alemán Robert Koch

identified the disease’s bacterial origins.

deu coa orixe bacteriana da enfermidade.

13 years later, physicist Wilhelm Roentgen  discovered the X-ray,

Trece anos despois, o físico Wihelm Roentgen descubriu os raios X,

enabling physicians to diagnose and track its progression through the body.

que permitiron aos médicos diagnosticala e seguir a súa progresión polo corpo.

These techniques allowed researchers to develop reliable and effective vaccines–

Isto permitiu que os investigadores desenvolveran vacinas efectivas,

first for smallpox, and again in 1921,

primeiro para a varíola e, de novo en 1921,

when scientists developed the BCG vaccine to battle TB.

a vacina BCG para loitar contra a tuberculose.

These developments laid the groundwork for the modern field of antibiotics–

Estes avances sentaron as bases para o mundo moderno dos antibióticos,

currently home to our most effective TB treatments.

que hoxe constitúen o tratamento máis efectivo para a TB.

But, antibiotics fail to address a major diagnostic complication:

Porén, os antibióticos non suplen a principal dificultade diagnóstica:

about 90% of people infected with TB don’t show any symptoms.

arredor do 90 % das persoas infectadas con TB son asintomáticas.

In these latent infections, the TB bacterium may be dormant,

Nestas infeccións latentes, a bacteria da TB pode estar inactiva

only activating when someone’s immune system is too weak to mount a defense.

ata que o sistema inmunitario está demasiado feble para defender o organismo.

This makes TB much harder to diagnose.

Isto fai que a TB teña unha difícil diagnose.

And even when properly identified,

E cando se identifica ben,

traditional treatments can take up to 9 months,

os tratamentos convencionais poden durar ata 9 meses,

requiring multiple drugs and a high potential for side effects.

requiren moitos medicamentos e adoitan de causar efectos secundarios.

This discourages people from finishing the full course,

Isto fai que a xente se desalente e interrompa o tratamento,

and partial treatment enables bacteria to develop resistance to these drugs.

o cal lle permite á bacteria desenvolver resistencia fronte a eses medicamentos.

Today, the disease is still prevalent in 30 countries,

Hoxe en día, a enfermidade segue sendo prevalente en 30 países,

most of which face other health crises

que na súa maioría atravesan outras crises sanitarias

that exacerbate TB and trigger latent cases.

que exacerban a TB e desencadean casos latentes.

Worse still, accessing treatment can be difficult in many of these countries,

Ou aínda peor: o acceso aos tratamentos é difícil en moitos deses países

and the stigma towards TB can discourage people from getting the help they need.

e o estigma da TB pode desanimar a xente para pedir a axuda que precisan.

Health experts agree we need to develop better diagnostics,

Os expertos da saúde concordan na necesidade de mellorar o diagnóstico,

faster acting antibiotics, and more effective vaccines.

desenvolver antibióticos de acción rápida e vacinas máis efectivas.

Researchers have already developed a urine test that yields results in 12 hours,

Os investigadores crearon unha proba de urina que ofrece resultados en 12 horas

as well as a new oral treatment that could cut treatment time by 75%.

e un novo fármaco oral que podería acurtar a duración do tratamento nun 75 %.

Hopefully, with advancements like these,

Esperemos que, con avances coma estes,

we’ll finally be able to make TB exclusively a thing of the past.

poidamos facer da tuberculose algo exclusivo do pasado.