Health Wanted: World Tuberculosis Day
HEALTH WANTED, a weekly radio show and podcast produced in partnership with WABE, brings need-to-know public health headlines and breaks down the science behind trending topics.
The Episode
The topic: Every year, tuberculosis claims over 1 million lives worldwide, and the United States has long been a key contributor to global efforts in preventing, treating, and researching the disease. This week on Health Wanted, host Laurel Bristow and guest Kenneth Castro, MD, discuss the ongoing challenges of tuberculosis and the impact that recent cuts to the U.S. Agency for International Development budget are having on global tuberculosis efforts.
The takeaway: Tuberculosis is a serious but curable infectious disease that is especially prevalent in low-income countries. Access to testing, effective treatments, and resources is limited, and the rise of drug-resistant strains makes controlling the disease increasingly difficult.
- Tuberculosis is the world’s deadliest infectious disease, affecting 2 billion people worldwide. It has existed since ancient times, with documentation through the writings of authors, doctors, and scientists. By the early 1800s, it had claimed the lives of one in seven people who had ever lived.
- There are two stages of tuberculosis: latent and active. In the latent stage, a person carries the bacteria but shows no symptoms and is not contagious. However, if the immune system weakens, the bacteria can become active, making the person contagious and causing serious symptoms.
- Tuberculosis disproportionately affects low-income communities with limited access to health care. Poor living conditions, overcrowded housing, and malnutrition heighten the risk of progression from latent to active disease. These factors make it more difficult to control tuberculosis in vulnerable populations, highlighting the urgent need for comprehensive social and health care interventions.
- While antibiotics are an effective treatment for tuberculosis, the rise of drug-resistant strains presents a major challenge to current treatment strategies. Developing new antibiotics to combat this evolving threat would help, but funding is limited, and tuberculosis research is often not prioritized by high-income countries.
The Interview
The guest: Kenneth Castro, MD
The key takeaways:
- The U.S. Agency for International Development (USAID) invests $250 million annually in global tuberculosis efforts, funding research, drug access, and technical support to countries with high tuberculosis burdens. Their funding supports the global drug facility, which negotiates drug prices, making treatment more affordable for low-income nations.
- Cuts to USAID funding could result in a significant increase in tuberculosis cases and deaths. Ongoing clinical trials may also be halted, putting people at risk of worsened health outcomes. This is especially dangerous for people who currently receive treatment from participating in multidrug-resistant tuberculosis studies.
- Tuberculosis is also a concern in the U.S., and to effectively treat and eliminate it here, it is crucial to address the issue in other regions as well. Without proper treatment in other areas, Americans are at a higher risk of contracting tuberculosis through travel or working abroad.
- New advancements like ultra-portable chest X-rays linked to AI diagnostics and faster molecular testing are revolutionizing tuberculosis diagnosis and bringing hope to the field. These tools allow for same-day results and treatment, improving efficiency and reducing delays in diagnosing tuberculosis, particularly in low-resource settings.
The Listener Questions
I heard a celebrity died of hantavirus. What is it?
Actor Gene Hackman was discovered dead in his home in February, and his wife, Betsy Arakawa, was also found dead in the bathroom. Hackman was 95 and Arakawa was 65.
Multiple dead bodies in a home raises alarm bells and it appeared they’d been gone for some time, so it was a mystery that got the true crime podcasts talking.
But, recently the investigation has concluded that Arakawa died of hantavirus a week before her husband died of heart disease. Hackman was showing signs of advanced Alzheimer’s, so it’s possible he did not know she was dead.
Hantavirus is a family of viruses that can cause disease in humans when people are exposed to infected rodents through contact with their urine, droppings, or saliva. In the U.S. it’s most commonly caused by contact with the deer mouse.
Hantavirus can cause what’s known as hantavirus pulmonary syndrome, which is what Ms. Arakawa died of.
The symptoms can start one to eight weeks after contact with infected rodents and include a lot of flu-like symptoms of muscle aches, fever, and fatigue. These can develop into coughing, shortness of breath, and chest pain.
38% of people who develop respiratory symptoms may die of the disease, but it is unclear how much of that has to do with people not seeking appropriate care.
The good news though, is that it cannot be passed from person to person. So you don’t need to worry about a new outbreak. Just try to maintain a mouse-free home.
Why was Donald Trump talking about transgender mice?
Donald Trump recently caused a stir by talking about the government spending $8 million on making mice transgender.
Some people and new organizations were quick to jump in and claim he obviously misspoke and meant to say “transgenic,” which is what we call it when mice are engineered to express cells that are not naturally found in the animals.
Scientists make mice transgenic so that they can do things like express human ACE2 cells and then we can do experiments to see how a virus like SARS-CoV-2 binds to these cells. They are used to model human diseases without infecting humans to do this research.
But Trump did not mean “transgenic,” he meant “transgender.”
What Trump was talking about was government-funded research that involved using hormones on mice.
Some of the research was regarding transgender healthcare, like seeing if gender-affirming hormone therapy impacts the immune response to HIV. It is an important thing to study given that transgender women are at higher risk of acquiring HIV.
But some of it is just looking at the impact that hormones have on chronic illnesses. One study was asking the question of why there are sex differences in the risk of developing asthma. The easiest way to look at whether hormones like estrogen increase your risk of asthma is to remove a mouse’s ability to produce its own sex hormones and then expose it to estradiol.
Aside from the fact that it is still important to study medical issues that might only affect transgender people, hormone-based studies on mice can help us learn about the role hormones play in the development of disease.
Catch all the listener questions and Laurel’s answers on the full episode of Health Wanted by:
- Streaming at wabe.org or the WABE app
- Subscribing on Apple or Spotify
- Watching on WABE's YouTube channel
