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Keeping a killer in check

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The Encyclopaedia Britannica once described tuberculosis (TB) as 'the most serious menace to health in Hong Kong'. Author John Bunyan called the disease the 'captain of all the men of death'.

More than 100 years since Robert Koch identified the bacterium that causes TB, it is still the world's top infectious killer and in recent weeks has become a nightmare haunting many a parent in Hong Kong.

Although the disease has long ceased to be the territory's top killer, 310 people died of it last year.

When four children and a female helper at Fuk Loi Estate Kindergarten in Tsuen Wan were diagnosed with the disease, parents were duly alarmed. The TB 'crisis' escalated when another 12 students from Morning Sun Nursery in Tsuen King Circuit tested positive in a skin test. Parents rushed their children for a check-up. Others demanded that the kindergarten be closed and that children be kept away.

Are such precautions necessary? The rod-shaped bacterium that causes TB can lodge in the lungs (pulmonary TB) or affect organs such as the lymph nodes, bones, joints, kidneys, intestines or abdomen.

Foreign studies show these extra-pulmonary diseases occur in about 25 per cent of children younger than 15 with TB. Of all the infections, tuberculous meningitis (inflammation of the coverings of the brain and spinal cords) is 'undoubtedly' the most devastating if left untreated, said a group of local doctors in a recently published paper. It is also very difficult to diagnose. 'You need to be a wine taster to taste this one,' said a paediatrician.

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