HISTORY OF TUBERCULOSIS

Tuberculosis has been known for thousands of years. It has also been possible to identify the sequelae of this disease on Egyptian mummies.

The Greeks called tuberculosis “phthisis”.

If it had already been very well described in the time of Hippocrates, it was not until 1882 that Robert Koch discovered the microbe responsible for this terrible disease of which we knew, moreover, the contagious nature.

This microbe has been called the bacillus of Koch, in honor of the one who brought it to light.

TB is becoming a scourge in the late 18th and early 19 th century. At that time, the cure “hygiene-dietary” and rest in specialized institutions (sanatoria) were the only chance

of cure for tuberculosis, because there was no drug treatment yet.

In Belgium, the first sanatorium opened in 1903 in Borgoumont in the Liege region. 1900: 12% of global mortality is due to tuberculosis.

TRANSMISSION OF THE TBC

Tuberculosis is a contagious disease. It can be transmitted to others when it affects the lungs ( pulmonary tuberculosis ). It is transmitted by air.

A patient is contagious if he can project BK into the air . In this case, the bacilli in his lungs are released via tiny droplets of saliva when he coughs, talks or sneezes. Inhaled bacilli can cause tuberculosis in the contact person.

A TB patient who follows his treatment correctly becomes rapidly non-contagious . Doctors can check if the person is still contagious through a bacteriological examination of their sputum.

Tuberculosis is not transmitted through foods or objects used by TB patients (cutlery, glasses, bedding, etc.) but through the droplets of saliva they throw into the air.

The extrapulmonary forms are not contagious unless they are accompanied by a pulmonary localization.

At the stage of latent tuberculosis infection, there is no risk of contamination.

INFECTION AND DISEASE

When Koch’s bacilli are inhaled and reach the respiratory tract, the body defends itself and can directly eliminate BK in 30-50% of cases.

If it can not eliminate them, two scenarios are possible:

Tubercle bacilli remain dormant. They are present in the body but the immune system makes it possible to control them, and therefore no symptoms or radiological lesions are observed. This is the stage of latent tuberculosis infection. The individual is not at this time contagious. It will keep a “memory” of the infection and will, therefore, be positive for the tuberculin skin test. This scenario applies to 90% of individuals infected with the bacillus.

if the defenses of the organism are insufficient or exceeded, the bacilli can “wake up”, multiply, and cause tuberculosis-disease, with the most often the presence of symptoms. Of those infected with BK, 10% will develop the disease in their lifetime, half of which will be soon after infection. In contrast, in immunocompromised individuals (e.g., HIV infection), this risk is significantly higher (10% per year).

my last will

Important Factors to Consider When Will Disputes Emerge

Will disputes are often messy, complicated and emotional processes that impact upon the wellbeing of individuals.

However, given the stakes involved with financial assets and items of sentimental value, this is a matter that speaks to the livelihood of family members.

Rather than being consumed by animosity or being anxious about making a claim, it is worthwhile understanding the important factors that are involved in such cases.

We will take a closer look at what is involved with Will disputes and how the people involved can make progress.

 

Not Everyone is Entitled to Dispute

Before the subject of Will disputes is breached, it is worthwhile to take stock of the parameters that are involved for those parties interested in the exercise. Unless the individual is of age (18 years or older) and is either a spouse or a direct family member, then there are major restrictions and limitations at play. Beneficiaries who are explicitly listed on the document will be eligible to apply for certain provisions if they so wish, but depending on the laws of the state then there can be some avenues that cannot be explored for certain constituents.

 

Contesting & Challenging Are Two Distinct Actions

It is an easy piece of oversight to make, but Will disputes can be contested or challenged depending on the context of the situation. On one hand with a contest, a participant is of the belief that they have been poorly treated by the deceased or the executor or they have been left off the document entirely. This is where they can lodge a claim and seek representation to ensure that their entitlements are upheld. There will be other constituents though who make another type of claim, believing that the actual formation and signing of the Will was an illegitimate process – forcing a challenge to take place. It might appear like an exercise in semantics, but they are two very distinct exercises.

 

There Are Different Settings Where Disputes Can Occur

signing a will

There are two key domains where Will disputes officially take place. While talks can often take place in private homes or public spaces, they will regularly occur in either mediation centres or in courtrooms. The former is an environment where beneficiaries and executors alike can come together in a room and hold private talks that remain confidential. An independent arbiter will facilitate the discussions and formalise proceedings, but it can be held in more of an informal regard that is purely voluntary. The alternative measure is to head straight for a hearing in a courtroom, seeing an applicant file for a claim and make their case before a judge.

 

Probate Status is Key

Will disputes cannot occur before probate status is granted. This is where the document is officially filed through the court system to ensure that all terms and conditions are considered authenticated and the funds and assets for the beneficiaries can be released. This is a process that commonly takes anywhere between 8-12 weeks depending on the logistics involved. It is only when this status has been granted that applicants can file for a contest or a challenge.

 

Myriad of Determining Factors

There are simply no guarantees at play when the topic of Will disputes emerges. This is in large part because no two people who file for such claims come from the same set of circumstances. From the age of the applicant to their relationship to the deceased, the financial needs of the applicant, any disability they may have, the debt and liabilities that are placed on the estate, when the document was signed, in what conditions and beyond – they will all factor into the decision-making process.

 

 

SYMPTOMS OF TBC

In the case of pulmonary tuberculosis, the following symptoms may occur:

  • A persistent cough (> 3 weeks)
  • chest pain or difficulty breathing
  • sputum (sometimes tinged with blood)
  • tired
  • fever
  • emaciation
  • night sweats

In the case of extra-pulmonary tuberculosis, the symptomatology depends on the affected organ.

The symptoms are sometimes unobtrusive or nonexistent, and the disease can go completely unnoticed; this can happen in children or adolescents, as well as in subjects whose immunity is impaired as in the elderly or those infected with HIV.

In the stage of latent tuberculosis infection, there are no symptoms!

Diagnosis Of TBC

Various diagnostic means are available to highlight TB infection and TB disease:

TUBERCULIN SKIN TEST (TST) TO DIAGNOSE BK INFECTION

Also called intradermal or Mantoux test, this test allows to know if a person is infected or not by the bacillus of Koch.

It consists of injecting tuberculin into the dermis of the forearm and seeing, 3 to 5 days later, if a reaction appears. This one indicates probable contamination by tubercle bacilli.

Vaccination with BCG may also cause a reaction during the test but is not a contraindication.

IGRA tests are more expensive blood tests that offer an alternative to TCT, but they are not currently used routinely in USA.

TST and IGRA tests are the only way to detect latent TB infection.