TY - JOUR
T1 - Tuberculosis: medico-legal aspects.
AU - Vetrugno, Giuseppe
AU - D'Alessandro, Francesco
AU - De Giorgio, Fabio
AU - Scafetta, Ilaria
AU - Berloco, Filippo
AU - Buonsenso, Danilo
AU - Scalise, Giovanna
AU - Pascali, Vincenzo Lorenzo
AU - Valentini, Piero
PY - 2014
Y1 - 2014
N2 - Tuberculosis is a diffusive infectious disease whose typical behavior differentiates it from other infectious diseases spread by human-to-human transmission (flu, chicken pox, cholera, etc.) which follow a classically epidemic pattern. Indeed, in the presence of a known source of Koch bacilli capable of spreading themby air, not all exposed individuals inhale the bacteria, not all those who inhale them absorb them, not all those who absorb them are unable to eliminate them, not all who are able to eliminate them do so using delayed hypersensitivity, not all those who react with delayed hypersensitivity suffer lasting tissue damage (among other things, minor), not all who suffer tissue damage have anatomical sequelae, not all those who have anatomical sequelae, however minimal, become carriers of bacilli in the latent period.
The vast majority (90-95%) of the latter – which are in any case a portion, not the totality of those exposed – remain asymptomatic throughout their lives and never develop active tuberculosis.
Based on these biological characteristics and the legal concepts of“epidemic”and “disease,” it becomes highly problematic, if not impossible, to assert both that tuberculosis can cause events of sufficient magnitude to be associated with the crime of “epidemic,”and that the mere diagnosis of a latent tuberculosis infection is sufficient to assume the presence of an illness legally prosecutable in criminal proceedings or a disability prosecutable in civil proceedings.
Further, clinically apparent tuberculosis is a temporarily—in some cases permanently—disablingcondition, and in certain work environments, even with the difficulties caused by the lack ofavailable effective diagnostic tools and the insidious behavior of the disease in the early stages, itappears appropriate to engage in targeted monitoring, also for the early identification of persons who may become ill.
AB - Tuberculosis is a diffusive infectious disease whose typical behavior differentiates it from other infectious diseases spread by human-to-human transmission (flu, chicken pox, cholera, etc.) which follow a classically epidemic pattern. Indeed, in the presence of a known source of Koch bacilli capable of spreading themby air, not all exposed individuals inhale the bacteria, not all those who inhale them absorb them, not all those who absorb them are unable to eliminate them, not all who are able to eliminate them do so using delayed hypersensitivity, not all those who react with delayed hypersensitivity suffer lasting tissue damage (among other things, minor), not all who suffer tissue damage have anatomical sequelae, not all those who have anatomical sequelae, however minimal, become carriers of bacilli in the latent period.
The vast majority (90-95%) of the latter – which are in any case a portion, not the totality of those exposed – remain asymptomatic throughout their lives and never develop active tuberculosis.
Based on these biological characteristics and the legal concepts of“epidemic”and “disease,” it becomes highly problematic, if not impossible, to assert both that tuberculosis can cause events of sufficient magnitude to be associated with the crime of “epidemic,”and that the mere diagnosis of a latent tuberculosis infection is sufficient to assume the presence of an illness legally prosecutable in criminal proceedings or a disability prosecutable in civil proceedings.
Further, clinically apparent tuberculosis is a temporarily—in some cases permanently—disablingcondition, and in certain work environments, even with the difficulties caused by the lack ofavailable effective diagnostic tools and the insidious behavior of the disease in the early stages, itappears appropriate to engage in targeted monitoring, also for the early identification of persons who may become ill.
KW - Legal medicine
KW - Tuberculosis
KW - Legal medicine
KW - Tuberculosis
UR - http://hdl.handle.net/10807/61691
U2 - 10.4084/MJHID.2014.033
DO - 10.4084/MJHID.2014.033
M3 - Article
SN - 2035-3006
SP - 1
EP - 10
JO - Mediterranean Journal of Hematology and Infectious Diseases
JF - Mediterranean Journal of Hematology and Infectious Diseases
ER -