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TB Transmission

> Date: Wed, 18 Jun 1997 01:42:54 -0700 (PDT)
> From: "A. Inniss" <andrewi at u_washington.edu>
> Subject: TB, Minocycline & Erythromycin
> >Since there might be a risk of transmission to humans,
> 	Well, I'm a little (okay, way ;-)) behind on the latest research,
> but last I knew, it appeared M. fortuitum wasn't transmittable from fish 
> to human...

I'm turning the keyboard over to my wife the MD, who just said "lemme
answer that one!"...

M. fortuitum can definitely be transmitted to humans.  It is considered
one of the atypical mycobacterial infections, and is often missed by
doctors who forget about these rarer infections (there are a few commonly
transmitted diseases from fish/water to humans.  In the mycobacterium
category there are a few as well, besides fortuitum....inc marinum (more
common than fortuitum).  Usually, healthy humans are not bothered by these
pathogens unless they have a cut or open sore on their hand/arm, or are
immunocompromised (ie diabetic, HIV/AIDS, asthmatic on steroids, or organ
transplant patient).  In rare cases the infection can rapidly progress.  A
few cases of lung infections with M. fortuitum have been noted in healthy
people with no idea on the origin of the infection.  Often we'll see a
person with a ulcer/sore or progressive infection that has been seen by
another doctor and then referred on because they can't figure out it out!
So, if you get a weird sore/infection on your arm make sure your doctor
knows you keep tanks!  (I ask but then I love knowing as much as I can and
hate missing things)

(on treatment, several drugs are used in humans inc minocyclin,
erythromycin, bactrim, etc...but usually cultures are done for resistence.
Drug combinations are used as well....but I'll spare the details)

> > The medications you mentioned [Erythromycin & Maracyn II (Minocycline)]
> > are quite ineffective for TB treatment in ornamental aquaria
> 	Well, I don't know about that: I've seen cases of "TB" treated
> effectively with the combination of these two meds.  (Assuming, of course,
> that it was, in fact, "TB" ;-) )

Not a combination I have seen used in humans, they have a similar
mechanisms ofaction.  Usually we would use a combination of drugs that 
attack the bacteria in different ways.

Kathy (on Eriks email)

Erik D. Olson					         amazingly, at home
eriko at wrq_com