118-615: The American Lung Association is a voluntary health organization whose mission is to save lives by improving lung health and preventing lung disease through education, advocacy and research. The organization was founded in 1904 to fight tuberculosis (TB) as the National Association for the Study and Prevention of Tuberculosis (NASPT) by Edward Livingston Trudeau , Robert Hall Babcock, Henry Martyn Hall, Lawrence Flick , and S. Adolphus Knopf . Earlier in 1892, Flick had founded
236-415: A Rasmussen aneurysm , resulting in massive bleeding. Tuberculosis may become a chronic illness and cause extensive scarring in the upper lobes of the lungs. The upper lung lobes are more frequently affected by tuberculosis than the lower ones. The reason for this difference is not clear. It may be due to either better air flow, or poor lymph drainage within the upper lungs. In 15–20% of active cases,
354-535: A C grade, and improving from the 46th to 54th most polluted by ozone smog. According to daily ozone air quality data provided by the EPA, from 2021 to 2024, Pittsburgh had good or moderate air quality most of the time. Then-Allegheny County executive Rich Fitzgerald said in December 2023 that they’d seen an "80 % drop in hazardous air pollutants" and that they made EPA attainment at all eight county air monitors for
472-569: A common ancestor, remains unclear. A comparison of the genes of M. tuberculosis complex (MTBC) in humans to MTBC in animals suggests humans did not acquire MTBC from animals during animal domestication, as researchers previously believed. Both strains of the tuberculosis bacteria share a common ancestor, which could have infected humans even before the Neolithic Revolution . Skeletal remains show some prehistoric humans (4000 BC ) had TB, and researchers have found tubercular decay in
590-547: A decrease in city population, even as the metropolitan area population increased again. During the late 2000s recession , Pittsburgh was economically strong, adding jobs when most cities were losing them. It was one of the few cities in the United States to see housing property values rise. Between 2006 and 2011, the Pittsburgh metropolitan statistical area (MSA) experienced over 10% appreciation in housing prices,
708-613: A free state after the Revolution, enslaved African Americans sought freedom here through escape as refugees from the South, or occasionally fleeing from travelers they were serving who stayed in the city. There were active stations of the Underground Railroad in the city, and numerous refugees were documented as getting help from station agents and African-American workers in city hotels. The Drennen Slave Girl walked out of
826-685: A growing residential segment. Most significantly, the Pittsburgh Cultural Trust is embarking on RiverParc, a four-block mixed-use "green" community, featuring 700 residential units and multiple towers of between 20 and 30 stories. The Firstside portion of Downtown borders the Monongahela River, the historic Mon Wharf and hosts the distinctive PPG Place Gothic-style glass skyscraper complex. New condo towers have been constructed and historic office towers are converted to residential use, increasing 24-hour residents. Downtown
944-624: A leader of the first crusade and elected ruler of Jerusalem after its capture in 1099. The national tagline "Fighting for Air" was introduced in 2010 to emphasize the organization's role in reducing particulate pollution in the atmosphere and in public places. While the Cross of Lorraine was colored red since its adoption, it was changed to blue in 2021. The American Lung Association is a public health organization funded by contributions from individual donors, corporations, foundations and government agency grants. One of its best-known fundraising campaigns
1062-685: A microscope. Since MTB retains certain stains even after being treated with acidic solution, it is classified as an acid-fast bacillus . The most common acid-fast staining techniques are the Ziehl–Neelsen stain and the Kinyoun stain , which dye acid-fast bacilli a bright red that stands out against a blue background. Auramine-rhodamine staining and fluorescence microscopy are also used. The M. tuberculosis complex (MTBC) includes four other TB-causing mycobacteria : M. bovis , M. africanum , M. canettii , and M. microti . M. africanum
1180-593: A population of 2.457 million residents and is the largest metro area in both the Ohio Valley and Appalachia , the second-largest in Pennsylvania , and the 26th-largest in the U.S. Pittsburgh is the principal city of the greater Pittsburgh–Weirton–Steubenville combined statistical area which includes parts of Ohio and West Virginia . Pittsburgh is known as "the Steel City" for its dominant role in
1298-623: A program designed to increase awareness of the importance of lung health, at Woodward Elementary School in Delaware, Ohio. A modified version of the Cross of Lorraine serves as the Lung Association's logo. The Paris, France, physician Gilbert Sersiron suggested its use in 1902 as a symbol for the "crusade" against tuberculosis. The double barred cross was originally used in the coat of arms of Godfrey of Bouillon , Duke of Lower Lorraine,
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#17327657017181416-586: A public health committee be formed by The National Association for the Study and Prevention of Tuberculosis and be officially sanctioned by the United States House of Representatives . In addition, they adopted the double red cross emblem formally as the symbol for the association and its fight against tuberculosis . The National Association for the Study and Prevention of Tuberculosis executive offices were located at 105 East 22nd Street, New York, New York. Henry Martyn Hall of Pittsburgh, Pennsylvania ,
1534-539: A quarter of neighborhood names make reference to "hills," "heights," or similar features. The steps of Pittsburgh consist of 800 sets of outdoor public stairways with 44,645 treads and 24,090 vertical feet. They include hundreds of streets composed entirely of stairs, and many other steep streets with stairs for sidewalks. Many provide vistas of the Pittsburgh area while attracting hikers and fitness walkers. Bike and walking trails have been built to border many of
1652-407: A small decrease in case numbers. Some countries have legislation to involuntarily detain or examine those suspected to have tuberculosis, or involuntarily treat them if infected. The only available vaccine as of 2021 is bacillus Calmette-Guérin (BCG). In children it decreases the risk of getting the infection by 20% and the risk of infection turning into active disease by nearly 60%. It
1770-401: A tuberculosis infection does become active, it most commonly involves the lungs (in about 90% of cases). Symptoms may include chest pain and a prolonged cough producing sputum. About 25% of people may not have any symptoms (i.e., they remain asymptomatic). Occasionally, people may cough up blood in small amounts, and in very rare cases, the infection may erode into the pulmonary artery or
1888-474: A wide range of symptoms. Tuberculosis is spread from one person to the next through the air when people who have active TB in their lungs cough, spit, speak, or sneeze . People with latent TB do not spread the disease. Active infection occurs more often in people with HIV/AIDS and in those who smoke . Diagnosis of active TB is based on chest X-rays , as well as microscopic examination and culture of bodily fluids. Diagnosis of latent TB relies on
2006-398: Is Mycobacterium tuberculosis (MTB), a small, aerobic , nonmotile bacillus . The high lipid content of this pathogen accounts for many of its unique clinical characteristics. It divides every 16 to 20 hours, which is an extremely slow rate compared with other bacteria, which usually divide in less than an hour. Mycobacteria have an outer membrane lipid bilayer. If a Gram stain
2124-578: Is 39.61 inches (1,006 mm) and precipitation is greatest in May while least in October; annual precipitation has historically ranged from 22.65 in (575 mm) in 1930 to 57.83 in (1,469 mm) in 2018. On average, December and January have the greatest number of precipitation days. Snowfall averages 44.1 inches (112 cm) per season, but has historically ranged from 8.8 in (22 cm) in 1918–19 to 80 in (200 cm) in 1950–51. There
2242-491: Is a growing problem, with increasing rates of multiple drug-resistant tuberculosis (MDR-TB). In 2018, one quarter of the world's population was thought to have a latent infection of TB. New infections occur in about 1% of the population each year. In 2022, an estimated 10.6 million people developed active TB, resulting in 1.3 million deaths, making it the second leading cause of death from an infectious disease after COVID-19 . As of 2018, most TB cases occurred in
2360-449: Is able to reproduce inside the macrophage and will eventually kill the immune cell. The primary site of infection in the lungs, known as the Ghon focus , is generally located in either the upper part of the lower lobe, or the lower part of the upper lobe . Tuberculosis of the lungs may also occur via infection from the blood stream. This is known as a Simon focus and is typically found in
2478-404: Is additionally where Jehovah's Witnesses traces its earliest origins, and was the host of the 2009 G20 Pittsburgh summit . Pittsburgh was named in 1758, by General John Forbes , in honor of British statesman William Pitt, 1st Earl of Chatham . As Forbes was a Scotsman , he probably pronounced the name / ˈ p ɪ t s b ər ə / PITS -bər-ə (similar to Edinburgh ). Pittsburgh
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#17327657017182596-653: Is also rare and is seen almost only in immunodeficient people, although its prevalence may be significantly underestimated. Other known pathogenic mycobacteria include M. leprae , M. avium , and M. kansasii . The latter two species are classified as " nontuberculous mycobacteria " (NTM) or atypical mycobacteria. NTM cause neither TB nor leprosy , but they do cause lung diseases that resemble TB. When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets 0.5 to 5.0 μm in diameter. A single sneeze can release up to 40,000 droplets. Each one of these droplets may transmit
2714-486: Is an average of 59 clear days and 103 partly cloudy days per year, while 203 days are cloudy. In terms of annual percent-average possible sunshine received, Pittsburgh (45%) is similar to Seattle (49%). The American Lung Association's (ALA) 2023 "State of the Air" report (which included data from 2019 to 2021) showed air quality in Pittsburgh improving. The city received a passing grade for ozone pollution, going from an F to
2832-444: Is difficult, as is diagnosing the disease in those who have a weakened immune system. A diagnosis of TB should, however, be considered in those with signs of lung disease or constitutional symptoms lasting longer than two weeks. A chest X-ray and multiple sputum cultures for acid-fast bacilli are typically part of the initial evaluation. Interferon-γ release assays (IGRA) and tuberculin skin tests are of little use in most of
2950-460: Is home to large medical providers, including the University of Pittsburgh Medical Center , Allegheny Health Network , and 68 colleges and universities , including research and development leaders Carnegie Mellon University and the University of Pittsburgh . The area has served as the federal agency headquarters for cyber defense , software engineering , robotics , energy research , and
3068-413: Is home to the University of Pittsburgh , Carnegie Mellon University , Carlow University , Chatham University , The Carnegie Institute's Museums of Art and Natural History , Phipps Conservatory , and Soldiers and Sailors Memorial Hall . It is also home to many parks and public spaces including Mellon Park , Westinghouse Park , Schenley Park , Frick Park , The Frick Pittsburgh , Bakery Square , and
3186-572: Is its Christmas Seals program, which has been an annual fundraising and public awareness tool for tuberculosis and lung disease since 1907. The Lake Tour Bike Trek is an annual bicycle ride held at Illinois in early June with all donations going towards the American Lung Association of Illinois. The Trek Across Maine , a similar bicycle ride in Maine, has raised more than $ 24 million since 1985. The National Association for
3304-509: Is not widespread, but it is a significant cause of tuberculosis in parts of Africa. M. bovis was once a common cause of tuberculosis, but the introduction of pasteurized milk has almost eliminated this as a public health problem in developed countries. M. canettii is rare and seems to be limited to the Horn of Africa , although a few cases have been seen in African emigrants. M. microti
3422-574: Is now known as Washington's Landing, formerly Herr's Island , in what is now the Lawrenceville neighborhood. The first known European to enter the region was the French explorer Robert de La Salle from Quebec during his 1669 expedition down the Ohio River . European pioneers, primarily Dutch, followed in the early 18th century. Michael Bezallion was the first to describe the forks of
3540-489: Is often used to screen people at high risk for TB. Those who have been previously immunized with the Bacille Calmette-Guerin vaccine may have a false-positive test result. The test may be falsely negative in those with sarcoidosis , Hodgkin's lymphoma , malnutrition , and most notably, active tuberculosis. Interferon gamma release assays , on a blood sample, are recommended in those who are positive to
3658-508: Is one of the ten original founders and was honored at the 50th Anniversary Annual Meeting of the National Tuberculosis Association at Atlantic City, New Jersey , in 1954. U.S. President Grover Cleveland was an honorary vice president from 1905 to 1908; U.S. President Theodore Roosevelt was an honorary vice president from 1905 to 1919. Tuberculosis Tuberculosis ( TB ), also known colloquially as
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3776-501: Is performed, MTB either stains very weakly "Gram-positive" or does not retain dye as a result of the high lipid and mycolic acid content of its cell wall. MTB can withstand weak disinfectants and survive in a dry state for weeks. In nature, the bacterium can grow only within the cells of a host organism, but M. tuberculosis can be cultured in the laboratory . Using histological stains on expectorated samples from phlegm (also called sputum), scientists can identify MTB under
3894-423: Is poor as of 2019 . The Centers for Disease Control and Prevention (CDC) stopped recommending yearly testing of health care workers without known exposure in 2019. Tuberculosis prevention and control efforts rely primarily on the vaccination of infants and the detection and appropriate treatment of active cases. The World Health Organization (WHO) has achieved some success with improved treatment regimens, and
4012-679: Is primarily composed of residential neighborhoods and is noteworthy for its well-constructed and architecturally interesting homes. Many buildings date from the 19th century and are constructed of brick or stone and adorned with decorative woodwork, ceramic tile, slate roofs and stained glass. The North Side is also home to attractions such as Acrisure Stadium , PNC Park , Kamin Science Center , National Aviary , Andy Warhol Museum , Mattress Factory art museum, Children's Museum of Pittsburgh , Randyland , Penn Brewery , Allegheny Observatory , and Allegheny General Hospital . The South Side
4130-573: Is referred to as "the Point." The city extends east to include the Oakland and Shadyside sections, which are home to the University of Pittsburgh , Carnegie Mellon University , Chatham University , Carnegie Museum and Library , and many other educational, medical, and cultural institutions. The southern, western, and northern areas of the city are primarily residential. Many Pittsburgh neighborhoods are steeply sloped with two-lane roads. More than
4248-513: Is served by the Port Authority 's light rail system and multiple bridges leading north and south. It is also home to Point Park University and Duquesne University which borders Uptown . The North Side is home to various neighborhoods in transition. The area was once known as Allegheny City and operated as its own independent city until 1907, when it was merged with Pittsburgh despite great protest from its citizens. The North Side
4366-464: Is termed caseous necrosis . If TB bacteria gain entry to the blood stream from an area of damaged tissue, they can spread throughout the body and set up many foci of infection, all appearing as tiny, white tubercles in the tissues. This severe form of TB disease, most common in young children and those with HIV, is called miliary tuberculosis. People with this disseminated TB have a high fatality rate even with treatment (about 30%). In many people,
4484-590: Is the second-most populous city in Pennsylvania , after Philadelphia , and the 68th-most populous city in the U.S., with a population of 302,971 as of the 2020 census . The city is located in southwestern Pennsylvania at the confluence of the Allegheny River and the Monongahela River , which combine to form the Ohio River . It anchors the Pittsburgh metropolitan area , which had
4602-420: Is the most widely used vaccine worldwide, with more than 90% of all children being vaccinated. The immunity it induces decreases after about ten years. As tuberculosis is uncommon in most of Canada, Western Europe, and the United States, BCG is administered to only those people at high risk. Part of the reasoning against the use of the vaccine is that it makes the tuberculin skin test falsely positive, reducing
4720-623: Is water. The 80th meridian west passes directly through the city's downtown. The city is on the Allegheny Plateau , within the ecoregion of the Western Allegheny Plateau . The Downtown area (also known as the Golden Triangle) sits where the Allegheny River flows from the northeast and the Monongahela River from the southeast to form the Ohio River . The convergence is at Point State Park and
4838-582: The Allegheny Mountains . The Great Fire of Pittsburgh destroyed over a thousand buildings in 1845. The city rebuilt with the aid of Irish immigrants who came to escape the Great Famine . By 1857, Pittsburgh's 1,000 factories were consuming 22 million coal bushels yearly. Coal mining and iron manufacturing attracted waves of European immigrants to the area, with the most coming from Germany . Because Pennsylvania had been established as
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4956-786: The Edgar Thomson Steel Works in North Braddock, Pennsylvania , which evolved into the Carnegie Steel Company . He adopted the Bessemer process to increase production. Manufacturing was key to growth of Pittsburgh and the surrounding region. Railroad lines were built into the city along both rivers, increasing transportation access to important markets. In 1901, J. P. Morgan and attorney Elbert H. Gary merged Carnegie Steel Company and several other companies into U.S. Steel . By 1910, Pittsburgh
5074-744: The Iroquois Confederacy , based in New York, had maintained control of much of the Ohio Valley as hunting grounds by right of conquest after defeating other tribes. By the terms of the 1768 Treaty of Fort Stanwix , the Penns were allowed to purchase the modern region from the Iroquois . A 1769 survey referenced the future city as the "Manor of Pittsburgh". Both the Colony of Virginia and
5192-487: The Köppen climate classification , Pittsburgh falls within either a hot-summer humid continental climate ( Dfa ) if the 0 °C (32 °F) isotherm is used or a humid subtropical climate ( Cfa ) if the −3 °C (27 °F) isotherm is used. Summers are hot and winters are moderately cold with wide variations in temperature. Despite this, it has one of the most pleasant summer climates between medium and large cities in
5310-746: The Pittsburgh Post-Gazette was started, and in 1787, the Pittsburgh Academy was chartered. Unrest during the Whiskey Rebellion of 1794 resulted in federal troops being sent to the area. By 1797, glass manufacture began, while the population grew to around 1,400. Settlers arrived after crossing the Appalachian Mountains or through the Great Lakes . Fort Pitt (now Pittsburgh) at the source of
5428-468: The Pittsburgh Zoo and PPG Aquarium. The neighborhoods of Shadyside and Squirrel Hill are large, wealthy neighborhoods with some apartments and condos, and pedestrian-oriented shopping/business districts. Squirrel Hill is also known as the hub of Jewish life in Pittsburgh, home to approximately 20 synagogues. Oakland , heavily populated by undergraduate and graduate students, is home to most of
5546-523: The Province of Pennsylvania claimed the region under their colonial charters until 1780, when they agreed under a federal initiative to extend the Mason–Dixon line westward, placing Pittsburgh in Pennsylvania. On March 8, 1771, Bedford County, Pennsylvania was created to govern the frontier. On April 16, 1771, the city's first civilian local government was created as Pitt Township . William Teagarden
5664-522: The history of the U.S. steel industry . It developed as a vital link of the Atlantic coast and Midwest , as the mineral-rich Allegheny Mountains led to the region being contested by the French and British Empires, Virginians , Whiskey Rebels , and Civil War raiders . For part of the 20th century, Pittsburgh was behind only New York City and Chicago in corporate headquarters employment; it had
5782-458: The lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis ), and the bones and joints (in Pott disease of the spine), among others. A potentially more serious, widespread form of TB is called "disseminated tuberculosis"; it is also known as miliary tuberculosis . Miliary TB currently makes up about 10% of extrapulmonary cases. The main cause of TB
5900-445: The nuclear navy . In the private sector, Pittsburgh-based PNC is the nation's fifth-largest bank, and the city is home to ten Fortune 500 companies and seven of the largest 300 U.S. law firms. Other corporations that have regional headquarters and offices have helped Pittsburgh become the sixth-best area for U.S. job growth. Pittsburgh is sometimes called the "City of Bridges" for its 446 bridges . Its rich industrial history left
6018-420: The tuberculin skin test (TST) or blood tests. Prevention of TB involves screening those at high risk, early detection and treatment of cases, and vaccination with the bacillus Calmette-Guérin (BCG) vaccine. Those at high risk include household, workplace, and social contacts of people with active TB. Treatment requires the use of multiple antibiotics over a long period of time. Antibiotic resistance
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#17327657017186136-616: The " white death ", or historically as consumption , is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria . Tuberculosis generally affects the lungs , but it can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis . Around 10% of latent infections progress to active disease that, if left untreated, kill about half of those affected. Typical symptoms of active TB are chronic cough with blood-containing mucus , fever , night sweats , and weight loss . Infection of other organs can cause
6254-587: The 1850 Fugitive Slave Act , as it required cooperation from law enforcement even in free states and increased penalties. From 1850 to 1860, the black population in Allegheny County dropped from 3,431 to 2,725 as people headed to more safety in Canada. The American Civil War boosted the city's economy with increased iron and armament demand by the Union. Andrew Carnegie began steel production in 1875 at
6372-454: The Central, North Side/North Hills, South Side/South Hills, East End, and West End. Downtown Pittsburgh has 30 skyscrapers, nine of which top 500 feet (150 m). The U.S. Steel Tower is the tallest, at 841 ft (256 m). The Cultural District consists of a 14-block area of downtown along the Allegheny River . This district contains many theaters and arts venues and is home to
6490-518: The Elder , while the settlement was named "Pittsborough". During Pontiac's War , a loose confederation of Native American tribes laid siege to Fort Pitt in 1763; the siege was eventually lifted after Colonel Henry Bouquet defeated a portion of the besieging force at the Battle of Bushy Run . Bouquet strengthened the defenses of Fort Pitt the next year. During this period, the powerful nations of
6608-698: The Mantoux test. These are not affected by immunization or most environmental mycobacteria , so they generate fewer false-positive results. However, they are affected by M. szulgai , M. marinum , and M. kansasii . IGRAs may increase sensitivity when used in addition to the skin test, but may be less sensitive than the skin test when used alone. The US Preventive Services Task Force (USPSTF) has recommended screening people who are at high risk for latent tuberculosis with either tuberculin skin tests or interferon-gamma release assays . While some have recommend testing health care workers, evidence of benefit for this
6726-568: The Monongahela House in 1850, apparently to freedom. The Merchant's Hotel was also a place where African-American workers would advise slaves the state was free and aid them in getting to nearby stations of the Underground Railroad. Sometimes refugee slaves from the South stayed in Pittsburgh, but other times they continued North, including into Canada. Many slaves left the city and county for Canada after Congress passed
6844-522: The North American front of the Seven Years' War , began with the future Pittsburgh as its center. British General Edward Braddock was dispatched with Major George Washington as his aide to take Fort Duquesne. The British and colonial force were defeated at Braddock's Field . General John Forbes finally took the forks in 1758. He began construction on Fort Pitt , named after William Pitt
6962-728: The North Side, and the Golden Triangle are characterized by more density of housing, walking neighborhoods, and a more diverse, urban feel. Pittsburgh falls within the borders of the Northeastern United States as defined by multiple US Government agencies. Pittsburgh is the principal city of the Pittsburgh Combined Statistical Area , a combined statistical area defined by the U.S. Census Bureau . Pittsburgh falls within
7080-692: The Ohio River became the main base for settlers moving into the Northwest Territory . The federal government recognizes Pittsburgh as the starting point for the Lewis and Clark Expedition . Preparations began in Pittsburgh in 1803 when Meriwether Lewis purchased a keelboat that would later be used to ascend the Missouri River . The War of 1812 cut off the supply of British goods, stimulating American industry. By 1815, Pittsburgh
7198-565: The Ohio headwaters was long inhabited by the Shawnee and several other settled groups of Native Americans . Shannopin's Town was an 18th-century Lenape (Delaware) town located roughly from where Penn Avenue is today, below the mouth of Two Mile Run, from 30th Street to 39th Street. According to George Croghan , the town was situated on the south bank of the Allegheny, nearly opposite what
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#17327657017187316-507: The Ohio in a 1717 manuscript, and later that year European fur traders established area posts and settlements. In 1749, French soldiers from Quebec launched an expedition to the forks to unite Canada with French Louisiana via the rivers. During 1753–1754, the British hastily built Fort Prince George before a larger French force drove them off. The French built Fort Duquesne based on LaSalle's 1669 claims. The French and Indian War ,
7434-568: The Pennsylvania Society for the Prevention of Tuberculosis, the world's first society dedicated to the preventing TB. In 1907, the Lung Association began their Christmas Seal campaign to raise money for a small TB sanatorium in Delaware. Emily Bissell , a Red Cross volunteer at the time, created holiday seals to sell at the post office for a penny a piece. By the end of her fundraising campaign, she had raised more than ten times
7552-677: The Study and Prevention of Tuberculosis held their ninth annual meeting in Washington, D.C., May 8 and 9, 1913. In attendance were Association President Homer Folks, Honorary Vice President Theodore Roosevelt , Vice Presidents Robert Hall Babcock, Sir William Osler and Edward R. Baldwin , Treasurer William H. Baldwin, Secretary Henry Barton Jacobs . Notable life members included Andrew Carnegie , Henry C. Frick , Mrs. H. Knickerbocker, Louis Marshall , Francis E. May, Cyrus H. McCormick , Henry Phipps , John D. Rockefeller , Rodman Wanamaker , Felix M. Warburg . The association members recommended
7670-481: The U.S. The city lies in the USDA plant hardiness zone 6b except along the rivers where the zone is 7a. The area has four distinct seasons: winters are cold and snowy, springs and falls are mild with moderate levels of sunshine, and summers are warm. As measured by percent possible sunshine, summer is by far the sunniest season, though annual sunshine is low among major US cities at well under 50%. The warmest month of
7788-454: The US , up to 35% of those affected by TB were also infected by HIV. Handling of TB-infected patients in US hospitals was known to create airborne TB that could infect others, especially in unventilated spaces. Pittsburgh, Pennsylvania Pittsburgh ( / ˈ p ɪ t s b ɜːr ɡ / PITS -burg ) is a city in and the county seat of Allegheny County, Pennsylvania , United States. It
7906-516: The United States test positive via the tuberculin test. Tuberculosis has been present in humans since ancient times . Tuberculosis has existed since antiquity . The oldest unambiguously detected M. tuberculosis gives evidence of the disease in the remains of bison in Wyoming dated to around 17,000 years ago. However, whether tuberculosis originated in bovines, then transferred to humans, or whether both bovine and human tuberculosis diverged from
8024-443: The WHO regions of South-East Asia (44%), Africa (24%), and the Western Pacific (18%), with more than 50% of cases being diagnosed in seven countries: India (27%), China (9%), Indonesia (8%), the Philippines (6%), Pakistan (6%), Nigeria (4%), and Bangladesh (4%). By 2021, the number of new cases each year was decreasing by around 2% annually. About 80% of people in many Asian and African countries test positive, while 5–10% of people in
8142-688: The active disease. Use of certain medications, such as corticosteroids and infliximab (an anti-αTNF monoclonal antibody), is another important risk factor, especially in the developed world . Other risk factors include: alcoholism , diabetes mellitus (3-fold increased risk), silicosis (30-fold increased risk), tobacco smoking (2-fold increased risk), indoor air pollution , malnutrition, young age, recently acquired TB infection, recreational drug use, severe kidney disease, low body weight, organ transplant, head and neck cancer, and genetic susceptibility (the overall importance of genetic risk factors remains undefined ). Tobacco smoking increases
8260-399: The air and the rivers. The "Renaissance II" project followed in 1977, focused on cultural and neighborhood development. The industrial base continued to expand through the 1970s, but beginning in the early 1980s both the area's steel and electronics industries imploded during national industrial restructuring. There were massive layoffs from mill and plant closures. In the later 20th century,
8378-437: The amount needed to save the sanatorium, and the tradition of Christmas Seals was launched. The NASPT was renamed the National Tuberculosis Association (NTA) in 1918, and then the National Tuberculosis and Respiratory Disease Association (NTRDA) in 1968; it adopted its current name in 1973. The association is a defender of the Clean Air Act . In October 2018, the association launched its school-based initiative, "Yoga Power",
8496-425: The area shifted its economic base to education, tourism, and services, largely based on healthcare/medicine, finance, and high technology such as robotics. Although Pittsburgh successfully shifted its economy and remained viable, the city's population has never rebounded to its industrial-era highs. While 680,000 people lived in the city proper in 1950, a combination of suburbanization and economic turbulence resulted in
8614-609: The area with renowned cultural institutions, including the Carnegie Museums of Pittsburgh , Pittsburgh Parks Conservancy , Pittsburgh Zoo & Aquarium , Phipps Conservatory and Botanical Gardens , the National Aviary , and a diverse cultural district . The city's major league professional sports teams include the Pittsburgh Steelers , Pittsburgh Penguins , and Pittsburgh Pirates . Pittsburgh
8732-458: The arrival of streptomycin and other antibiotics, although the disease remained a significant threat. In 1946, the development of the antibiotic streptomycin made effective treatment and cure of TB a reality. Prior to the introduction of this medication, the only treatment was surgical intervention, including the " pneumothorax technique", which involved collapsing an infected lung to "rest" it and to allow tuberculous lesions to heal. Because of
8850-423: The bacterium is enveloped by the macrophage and stored temporarily in a membrane-bound vesicle called a phagosome. The phagosome then combines with a lysosome to create a phagolysosome. In the phagolysosome, the cell attempts to use reactive oxygen species and acid to kill the bacterium. However, M. tuberculosis has a thick, waxy mycolic acid capsule that protects it from these toxic substances. M. tuberculosis
8968-547: The borders of Appalachia as defined by the Appalachian Regional Commission , and has long been characterized as the "northern urban industrial anchor of Appalachia." In its post-industrial state, Pittsburgh has been characterized as the "Paris of Appalachia", recognizing the city's cultural, educational, healthcare, and technological resources, and is the largest city in Appalachia. Under
9086-425: The cattle and human tuberculosis diseases were similar, which delayed the recognition of infected milk as a source of infection. During the first half of the 1900s, the risk of transmission from this source was dramatically reduced after the application of the pasteurization process. Koch announced a glycerine extract of the tubercle bacilli as a "remedy" for tuberculosis in 1890, calling it "tuberculin". Although it
9204-485: The cause of pulmonary tuberculosis. J. L. Schönlein first published the name "tuberculosis" (German: Tuberkulose ) in 1832. Between 1838 and 1845, John Croghan, the owner of Mammoth Cave in Kentucky from 1839 onwards, brought a number of people with tuberculosis into the cave in the hope of curing the disease with the constant temperature and purity of the cave air; each died within a year. Hermann Brehmer opened
9322-494: The city's population. Pittsburgh also became a main destination of the African-American Great Migration from the rural South during the first half of the 20th century. Limited initially by discrimination, some 95% percent of the men became unskilled steel workers. During World War II , demand for steel increased and area mills operated 24 hours a day to produce 95 million tons of steel for
9440-542: The city's rivers and hollows. The Great Allegheny Passage and Chesapeake and Ohio Canal Towpath connect the city directly to downtown Washington, D.C. (some 335 miles [539 km] away) with a continuous bike/running trail. The city consists of the Downtown area, called the Golden Triangle, and four main areas surrounding it. These surrounding areas are subdivided into distinct neighborhoods (Pittsburgh has 90 neighborhoods). Relative to downtown, these areas are known as
9558-476: The community and various developers to create a master plan for a mixed-use development that included a riverfront park, office space, housing, health-care facilities, and indoor practice fields for the Pittsburgh Steelers and Pitt Panthers . Construction of the development began in 1998. The SouthSide Works has been open since 2005, featuring many stores, restaurants, offices, and the world headquarters for American Eagle Outfitters . The East End of Pittsburgh
9676-711: The declaration of a global health emergency by the World Health Organization (WHO) in 1993. There is a popular misconception that tuberculosis is purely a disease of the lungs that manifests as coughing . Tuberculosis may infect many organs, even though it most commonly occurs in the lungs (known as pulmonary tuberculosis). Extrapulmonary TB occurs when tuberculosis develops outside of the lungs, although extrapulmonary TB may coexist with pulmonary TB. General signs and symptoms include fever, chills , night sweats, loss of appetite , weight loss, and fatigue . Significant nail clubbing may also occur. If
9794-640: The developing world. IGRA have similar limitations in those with HIV. A definitive diagnosis of TB is made by identifying M. tuberculosis in a clinical sample (e.g., sputum, pus , or a tissue biopsy ). However, the difficult culture process for this slow-growing organism can take two to six weeks for blood or sputum culture. Thus, treatment is often begun before cultures are confirmed. Nucleic acid amplification tests and adenosine deaminase testing may allow rapid diagnosis of TB. Blood tests to detect antibodies are not specific or sensitive , so they are not recommended. The Mantoux tuberculin skin test
9912-610: The disease became common among the urban poor. In 1815, one in four deaths in England was due to "consumption". By 1918, TB still caused one in six deaths in France. After TB was determined to be contagious, in the 1880s, it was put on a notifiable-disease list in Britain. Campaigns started to stop people from spitting in public places, and the infected poor were "encouraged" to enter sanatoria that resembled prisons. The sanatoria for
10030-620: The disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10 bacteria may cause an infection). People with prolonged, frequent, or close contact with people with TB are at particularly high risk of becoming infected, with an estimated 22% infection rate. A person with active but untreated tuberculosis may infect 10–15 (or more) other people per year. Transmission should occur from only people with active TB – those with latent infection are not thought to be contagious. The probability of transmission from one person to another depends upon several factors, including
10148-470: The downtown skyline, and numerous other residential neighborhoods such as Sheraden and Elliott . Many of Pittsburgh's patchwork of neighborhoods still retain ethnic characters reflecting the city's settlement history. These include: Several neighborhoods on the edges of the city are less urban, featuring tree-lined streets, yards and garages, with a more suburban character. Oakland, the South Side,
10266-463: The emergence of multidrug-resistant tuberculosis (MDR-TB), surgery has been re-introduced for certain cases of TB infections. It involves the removal of infected chest cavities ("bullae") in the lungs to reduce the number of bacteria and to increase exposure of the remaining bacteria to antibiotics in the bloodstream. Hopes of eliminating TB ended with the rise of drug-resistant strains in the 1980s. The subsequent resurgence of tuberculosis resulted in
10384-552: The first TB sanatorium in 1859 in Görbersdorf (now Sokołowsko ) in Silesia . In 1865, Jean Antoine Villemin demonstrated that tuberculosis could be transmitted, via inoculation, from humans to animals and among animals. (Villemin's findings were confirmed in 1867 and 1868 by John Burdon-Sanderson . ) Robert Koch identified and described the bacillus causing tuberculosis, M. tuberculosis , on 24 March 1882. In 1905, he
10502-574: The first genuine success in immunization against tuberculosis in 1906, using attenuated bovine-strain tuberculosis. It was called bacille Calmette–Guérin (BCG). The BCG vaccine was first used on humans in 1921 in France, but achieved widespread acceptance in the US, Great Britain, and Germany only after World War II. By the 1950s mortality in Europe had decreased about 90%. Improvements in sanitation, vaccination, and other public-health measures began significantly reducing rates of tuberculosis even before
10620-437: The highest appreciation of the largest 25 metropolitan statistical areas in the United States, with 22 of the largest 25 metropolitan statistical areas experiencing depreciations in housing values. In September 2009, the 2009 G20 Pittsburgh summit was held in Pittsburgh. Pittsburgh has an area of 58.3 square miles (151 km ), of which 55.6 square miles (144 km ) is land and 2.8 square miles (7.3 km ), or 4.75%,
10738-431: The host's immune system. Macrophages and dendritic cells in the granulomas are unable to present antigen to lymphocytes; thus the immune response is suppressed. Bacteria inside the granuloma can become dormant, resulting in latent infection. Another feature of the granulomas is the development of abnormal cell death ( necrosis ) in the center of tubercles . To the naked eye, this has the texture of soft, white cheese and
10856-400: The infected macrophages. When other macrophages attack the infected macrophage, they fuse together to form a giant multinucleated cell in the alveolar lumen. The granuloma may prevent dissemination of the mycobacteria and provide a local environment for interaction of cells of the immune system. However, more recent evidence suggests that the bacteria use the granulomas to avoid destruction by
10974-439: The infection spreads outside the lungs, causing other kinds of TB. These are collectively denoted as extrapulmonary tuberculosis. Extrapulmonary TB occurs more commonly in people with a weakened immune system and young children. In those with HIV, this occurs in more than 50% of cases. Notable extrapulmonary infection sites include the pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis ),
11092-613: The infection waxes and wanes. Tissue destruction and necrosis are often balanced by healing and fibrosis . Affected tissue is replaced by scarring and cavities filled with caseous necrotic material. During active disease, some of these cavities are joined to the air passages ( bronchi ) and this material can be coughed up. It contains living bacteria and thus can spread the infection. Treatment with appropriate antibiotics kills bacteria and allows healing to take place. Upon cure, affected areas are eventually replaced by scar tissue. Diagnosing active tuberculosis based only on signs and symptoms
11210-491: The life from the other family members. Although Richard Morton established the pulmonary form associated with tubercles as a pathology in 1689, due to the variety of its symptoms, TB was not identified as a single disease until the 1820s. Benjamin Marten conjectured in 1720 that consumptions were caused by microbes which were spread by people living close to each other. In 1819, René Laennec claimed that tubercles were
11328-537: The middle and upper classes offered excellent care and constant medical attention. What later became known as the Alexandra Hospital for Children with Hip Disease (tuberculous arthritis) was opened in London in 1867. Whatever the benefits of the "fresh air" and labor in the sanatoria, even under the best conditions, 50% of those who entered died within five years ( c. 1916). Robert Koch did not believe
11446-435: The most U.S. stockholders per capita. Deindustrialization in the late 20th century resulted in massive layoffs among blue-collar workers as steel and other heavy industries declined, coinciding with several Pittsburgh-based corporations moving out of the city. However, the city divested from steel and, since the 1990s, Pittsburgh has focused its energies on the healthcare, education, and technology industries. Pittsburgh
11564-596: The newly infected person becomes infectious enough to transmit the disease to others. A number of factors make individuals more susceptible to TB infection and/or disease. The most important risk factor globally for developing active TB is concurrent HIV infection; 13% of those with TB are also infected with HIV. This is a particular problem in sub-Saharan Africa , where HIV infection rates are high. Of those without HIV infection who are infected with tuberculosis, about 5–10% develop active disease during their lifetimes; in contrast, 30% of those co-infected with HIV develop
11682-599: The number of infectious droplets expelled by the carrier, the effectiveness of ventilation, the duration of exposure, the virulence of the M. tuberculosis strain , the level of immunity in the uninfected person, and others. The cascade of person-to-person spread can be circumvented by segregating those with active ("overt") TB and putting them on anti-TB drug regimens. After about two weeks of effective treatment, subjects with nonresistant active infections generally do not remain contagious to others. If someone does become infected, it typically takes three to four weeks before
11800-504: The record cold daily maximum is −3 °F (−19 °C), which occurred three times, most recently the day of the all-time record low, while, conversely, the record warm daily minimum is 82 °F (28 °C) on July 1, 1901. Due to elevation and location on the windward side of the Appalachian Mountains, 100 °F (38 °C)+ readings are very rare, and were last seen on July 15, 1995. Average annual precipitation
11918-435: The risk of developing active TB increases to nearly 10% a year. If effective treatment is not given, the death rate for active TB cases is up to 66%. TB infection begins when the mycobacteria reach the alveolar air sacs of the lungs, where they invade and replicate within endosomes of alveolar macrophages . Macrophages identify the bacterium as foreign and attempt to eliminate it by phagocytosis . During this process,
12036-414: The risk of infections (in addition to increasing the risk of active disease and death). Additional factors increasing infection susceptibility include young age. About 90% of those infected with M. tuberculosis have asymptomatic , latent TB infections (sometimes called LTBI), with only a 10% lifetime chance that the latent infection will progress to overt, active tuberculous disease. In those with HIV,
12154-549: The spines of Egyptian mummies dating from 3000 to 2400 BC. Genetic studies suggest the presence of TB in the Americas from about AD 100. Before the Industrial Revolution , folklore often associated tuberculosis with vampires . When one member of a family died from the disease, the other infected members would lose their health slowly. People believed this was caused by the original person with TB draining
12272-465: The test's usefulness as a screening tool. Several vaccines are being developed. Intradermal MVA85A vaccine in addition to BCG injection is not effective in preventing tuberculosis. Public health campaigns which have focused on overcrowding, public spitting and regular sanitation (including hand washing) during the 1800s helped to either interrupt or slow spread which when combined with contact tracing, isolation and treatment helped to dramatically curb
12390-565: The top of the lung. This hematogenous transmission can also spread infection to more distant sites, such as peripheral lymph nodes, the kidneys, the brain, and the bones. All parts of the body can be affected by the disease, though for unknown reasons it rarely affects the heart , skeletal muscles , pancreas , or thyroid . Tuberculosis is classified as one of the granulomatous inflammatory diseases. Macrophages , epithelioid cells , T lymphocytes , B lymphocytes , and fibroblasts aggregate to form granulomas, with lymphocytes surrounding
12508-467: The transmission of both tuberculosis and other airborne diseases which led to the elimination of tuberculosis as a major public health issue in most developed economies. Other risk factors which worsened TB spread such as malnutrition were also ameliorated, but since the emergence of HIV a new population of immunocompromised individuals was available for TB to infect. During the HIV/AIDS epidemic in
12626-862: The universities, and the Petersen Events Center . The Strip District to the west along the Allegheny River is an open-air marketplace by day and a clubbing destination by night. Bloomfield is Pittsburgh's Little Italy and is known for its Italian restaurants and grocers. Lawrenceville is a revitalizing rowhouse neighborhood popular with artists and designers. The Hill District was home to photographer Charles Harris as well as various African-American jazz clubs. Other East End neighborhoods include Point Breeze , Regent Square , Highland Park , Homewood , Lincoln-Lemington-Belmar , Larimer , East Hills , East Liberty , Polish Hill , Hazelwood , Garfield, Morningside, and Stanton Heights. The West End includes Mt. Washington , with its famous view of
12744-572: The value of homes in the South Side had increased in value by about 10% annually for the 10 years leading up to 2014. East Carson Street has developed as one of the most vibrant areas of the city, packed with diverse shopping, ethnic eateries, vibrant nightlife, and live music venues. In 1993, the Urban Redevelopment Authority of Pittsburgh purchased the South Side Works steel mill property. It collaborated with
12862-400: The war effort. This resulted in the highest levels of air pollution in the city's almost century of industry. The city's reputation as the "arsenal of democracy" was being overshadowed by James Parton 's 1868 observation of Pittsburgh being "hell with the lid off." Following World War II, the city launched a clean air and civic revitalization project known as the "Renaissance," cleaning up
12980-604: The year in Pittsburgh is July, with a 24-hour average of 73.2 °F (22.9 °C). Conditions are often humid, and combined with highs reaching 90 °F (32 °C) on an average 9.5 days a year, a considerable heat index arises. The coolest month is January, when the 24-hour average is 28.8 °F (−1.8 °C), and lows of 0 °F (−18 °C) or below can be expected on an average 2.6 nights per year. Officially, record temperatures range from −22 °F (−30 °C), on January 19, 1994 to 103 °F (39 °C), which occurred three times, most recently on July 16, 1988;
13098-526: Was awarded the Nobel Prize in Physiology or Medicine for this discovery. In Europe, rates of tuberculosis began to rise in the early 1600s to a peak level in the 1800s, when it caused nearly 25% of all deaths. In the 18th and 19th century, tuberculosis had become epidemic in Europe , showing a seasonal pattern. Tuberculosis caused widespread public concern in the 19th and early 20th centuries as
13216-486: Was federally recognized as "Pittsburg", though use of the final h was retained during this period by the city government and other local organizations. After a public campaign, the federal decision to drop the h was reversed. The Pittsburg Press continued spelling the city without an h until 1921. [REDACTED] Kingdom of France 1690s–1763 [REDACTED] Great Britain 1681–1781 [REDACTED] United States 1776–present The area of
13334-545: Was incorporated as a borough on April 22, 1794, with the following Act: "Be it enacted by the Pennsylvania State Senate and Pennsylvania House of Representatives of the Commonwealth of Pennsylvania ... by the authority of the same, that the said town of Pittsburgh shall be ... erected into a borough, which shall be called the borough of Pittsburgh for ever." From 1891 to 1911, the city's name
13452-478: Was not effective, it was later successfully adapted as a screening test for the presence of pre-symptomatic tuberculosis. World Tuberculosis Day is marked on 24 March each year, the anniversary of Koch's original scientific announcement. When the Medical Research Council formed in Britain in 1913, it initially focused on tuberculosis research. Albert Calmette and Camille Guérin achieved
13570-517: Was once the site of railyards and associated dense, inexpensive housing for mill and railroad workers. Starting in the late 20th century, the city undertook a Main Street program in cooperation with the National Trust for Historic Preservation , encouraging design and landscape improvements on East Carson Street, and supporting new retail. The area has become a local Pittsburgher destination, and
13688-542: Was producing significant quantities of iron, brass, tin, and glass. On March 18, 1816, the 46-year-old local government became a city. It was served by numerous river steamboats that increased trading traffic on the rivers. In the 1830s, many Welsh people from the Merthyr steelworks immigrated to the city following the aftermath of the Merthyr Rising . By the 1840s, Pittsburgh was one of the largest cities west of
13806-625: Was the nation's eighth-largest city , accounting for between one-third and one-half of national steel output. The Pittsburgh Agreement was subscribed in May 1918 between the Czech and Slovak nationalities, as envisioned by T. G. Masaryk , concerning the future foundation of Czechoslovakia . The city suffered severe flooding in March 1936. The city's population swelled to more than a half million, attracting numerous European immigrants to its industrial jobs. By 1940, non-Hispanic whites were 90.6% of
13924-584: Was the first constable, and William Troop was the first clerk. Following the American Revolution , the village of Pittsburgh continued to grow. One of its earliest industries was boat building for settlers of the Ohio Country . In 1784, Thomas Vickroy completed a town plan which was approved by the Penn family attorney. Pittsburgh became a possession of Pennsylvania in 1785. The following year,
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