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

Prevodilac: Kristina Radosavljević Lektor: Ivana Krivokuća

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

Godine 2008, arheolozi su otkrili dva skeleta stara 9 000 godina.

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

Ne postoji precizan način da se odredi šta je ubilo ove drevne ljude,

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

ali znamo da su njihove kosti bile zaražene dobro poznatom bakterijom.

The ancient Greeks knew its consumptive effects as phthisis;

Stari Grci su poznavali njeno dejstvo propadanja kao „ftiza”;

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

Inke su je nazivale „čaki onkaj”, a Englezi tuberkuloza.

Today, tuberculosis, or TB,

Danas je tuberkuloza ili TB

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

i dalje jedna od najvećih zaraznih ubica na svetu,

causing more deaths than malaria or even HIV and AIDS.

koja uzrokuje više smrti nego malarija, pa čak i više nego HIV i sida.

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

Ali šta je u stvari ova bolest i kako je ovaj patogen opstao tako dugo?

Typically, TB bacteria called mycobacterium tuberculosis, are airborne.

Obično se TB bakterije nazvane Mycobacterium tuberculosis

nalaze u vazduhu.

They travel into our airways and infect our lungs.

One putuju vazdušnim putevima i inficiraju naša pluća.

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

Tada imunološke ćelije, zvane makrofagi, hrle ka zaraženom području,

attempting to absorb and break down the bacterial invaders.

pokušavajući da upiju i slome bakterijske osvajače.

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

U mnogim slučajevima, ova akcija je dovoljna da se otkloni bakterija.

But in individuals with other medical conditions–

Ali u pojedinim slučajevima, gde postoji još neki zdravstveni problem -

ranging from malnutrition and HIV to diabetes and pregnancy

počev od neuhranjenosti i HIV-a do dijabetesa i trudnoće,

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

imunološka reakcija može biti nedovoljno snažna da uništi uljeza.

If so, mycobacterium tuberculosis will reproduce inside those macrophages,

U tom slučaju, Mycobacterium tuberculosis će se razmnožavati unutar ovih makrofaga

and form colonies in the surrounding lung tissue.

i oformiti kolonije u okolnom tkivu pluća.

As they infect more cells,

Kako inficira sve više ćelija,

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

bakterija aktivira enzim koji razara ćelije i uništava inficirano tkivo,

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

što uzrokuje bol u grudima i iskašljavanje krvi kod pacijenta.

The damage to the lungs leads to oxygen deprivation.

Oštećenje pluća dovodi do nedostatka kiseonika.

This begins a flood of hormonal changes–

Ovo započinje niz hormonskih promena -

including a decrease in appetite and iron production.

uključujući gubitak apetita i smanjenu proizvodnju gvožđa.

From here, microbes can spread to the skeletal system,

Odatle mikrobi mogu da se prošire na koščani sistem,

causing back pain and difficulty moving;

uzrokujući bol u leđima i teškoće pri kretanju,

to the kidneys and intestines, causing abdominal pain;

zatim na bubrege i creva, stvarajući bol u stomaku,

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

te do mozga, što uzrokuje glavobolje, pa čak i gubitak svesti.

These symptoms produce the classic image of TB:

Ovi simptomi predstavljaju tipičnu sliku tuberkuloze:

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

gubitak težine, kašalj, iskašljavanje krvi i suva koža.

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

Bleda pojava je zaslužna što je TB dobila naziva „bela kuga”

in Victorian-era England.

u viktorijansko doba Engleske.

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

Tada se tuberkuloza smatrala „romantičnom bolešću”,

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

zato što je obično pogađala siromašne umetnike i pesnike -

those with weaker immune systems.

one sa slabijim imunološkim sistemom.

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

Spoljni efekti TB su čak potpirili popularni mit o vampirizmu.

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

Uprkos - ili možda upravo zbog ovih ne baš naučnih razloga,

this period also marked the first strides toward curing TB.

u ovom razdoblju su napravljeni prvi koraci ka izlečenju TB.

In 1882, the German physician Robert Koch

Godine 1882, nemački lekar Robert Koh

identified the disease’s bacterial origins.

otkrio je poreklo ove bakterije.

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

Lekar Vilhelm Rentgen je 13 godina kasnije otkrio X-zrake,

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

omogućavajući lekarima da otkriju i prate njeno širenje telom.

These techniques allowed researchers to develop reliable and effective vaccines–

Ove tehnike su omogućile istraživačima da razviju pouzdane i efikasne vakcine -

first for smallpox, and again in 1921,

prvo za velike boginje, a potom su 1921. godine

when scientists developed the BCG vaccine to battle TB.

naučnici razvili BCG vakcinu protiv tuberkuloze.

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

Ova otkrića su postavila temelj modernom polju antibiotika -

currently home to our most effective TB treatments.

trenutnoj bazi naših najefikasnijih lekova protiv tuberkuloze.

But, antibiotics fail to address a major diagnostic complication:

Ali antibiotici nisu uspeli da reše najveći dijagnostički problem:

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

oko 90% ljudi zaraženih TB-om ne pokazuje nikakve simptome.

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

Kod ovih skrivenih infekcija, bakterija TB može biti uspavana

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

i aktivira se samo kada je imuni sistem osobe suviše slab da bi se odbranio.

This makes TB much harder to diagnose.

Ovo čini TB mnogo težom za otkrivanje.

And even when properly identified,

Pa čak i kad je otkrivena,

traditional treatments can take up to 9 months,

tradicionalno lečenje može trajati i do devet meseci,

requiring multiple drugs and a high potential for side effects.

uz razne lekove i veliku verovatnoću nuspojava.

This discourages people from finishing the full course,

Ovo obeshrabruje ljude da završe tretman,

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

a delimičan tretman omogućava bakteriji da postane otporna na te lekove.

Today, the disease is still prevalent in 30 countries,

Danas je ova bolest još uvek raširena u 30 zemalja,

most of which face other health crises

od kojih se većina suočava i sa drugim zdravstvenim krizama

that exacerbate TB and trigger latent cases.

koje pogoršavaju TB i predstavljaju okidač za potencijalne slučajeve.

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

Najgore je što pristup lečenju može biti težak u mnogim od ovih zemalja,

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

a stigma koja obavija TB može obeshrabriti ljude da potraže potrebnu pomoć.

Health experts agree we need to develop better diagnostics,

Zdravstveni stručnjaci se slažu da treba da razvijemo bolju dijagnostiku,

faster acting antibiotics, and more effective vaccines.

antibiotike koji brže deluju i efikasnije vakcine.

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

Istraživači su već razvili test urina koji daje rezultate u roku od 12 sati,

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

kao i novo oralno lečenje koje bi moglo da skrati period lečenja za 75%.

Hopefully, with advancements like these,

Nadajmo se da ćemo, sa ovakvim napretkom,

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

konačno moći tuberkulozu da smatramo kao stvar prošlosti.