Harlan Shay Dr. Eloise Perez English 1002 Tuberculosis: A Disease Making a Comeback Tuberculosis was once an untreatable disease that meant certain death for those infected. With the development of antibiotics the disease was brought under control and thought to soon be eradicated. Today TB, as it is more commonly referred to, "is the worlds's foremost cause of death from a single infectious agent"(Bloom 11). Why has tuberculosis returned to threaten the lives of millions? Tuberculosis is a disease capable of decimating the human population and has proven itself as such in the past. "By the mid-seventeenth century it was recorded in the London Bills of Mortality that one in five of the deaths in the city was due to consumption," on of the earlier names given TB (Ryan 7). TB is caused by an organism called Mycobacterium tuberculosis. "The bacterium that causes tuberculosis dies in direct sunlight but survives in dust for several weeks or even months"(6).
The most common form of TB is contracted through the air. This makes the disease all the more dangerous. Unlike HIV and AIDS, which demand an exchange of bodily fluids, this disease lingers in the air and waits for anyone who dares take in a breath. The second and least common mode of contraction is through food or drink. This method of transmission is rare with the development of pasteurization and the inspection of foods we consume.
Tuberculosis is a disease that has been around for thousands of years. We can trace back TB as far as ancient Egypt by studying the remains of mummies (Ryan 5) . These remains show skeletal and spinal disfigurement common with TB. "The earliest definite evidence of the disease in Britain has been found in Cirencester in graves dating from the Roman occupation."(Ryan 6).
As time progressed so did TB reeking havoc on all communities it invaded. It was not until 1945, with the development of streptomycin and other antibiotics, did a cure for TB exist. These antibiotics proved to be most effective and the mortality rate associated with TB declined. "From 1953, when national surveillance began, through 1984, the United States experienced a significant decline in TB cases: from 84,304 cases in 1953 to only 22,225 cases in 1984"(Bloom 7). It would appear that the war against TB was won and the disease would soon be eradicated. "The wake-up call alerting the public to the resurgence of tuberculosis came between 1985 and 1993, when the number of cases reported in the United States began to increase steadily and dramatically" (The People's Plague Online).
Many factors can be attributed to the resurgence of TB. Persons living in poverty, immigration of persons with TB, and the HIV epidemic are all contributing factors associated with the resurgence of TB. "Poor people generally live in crowded areas, an increasing number are homeless, and malnutrition is common; each of these accompaniments of poverty may foster the development of tuberculosis"(Rom,Garay 66). Immigration is another factor that is responsible for TB's come back. "Many immigrants are poor and hence are obliged to settle in low-income areas, particularly in innercities, where housing is densely crowded. Reactivation of tuberculosis in these circumstances results in heavy exposure to household members. This problem is worsened by the presence of illegal immigrants, who are moving in increasing numbers from high-prevalence to industrialized countries, taking their M tuberculosis with them"(69). HIV may be the most responsible factor of them all. "In comparison wit non-HIV-infected persons, it appears that those with HIV infection have increased susceptibility to tuberculosis infection after exposure to tubercle bacilli, which means that their innate defenses are impaired, and it is clear that tuberculous infection, whether recent or old, in HIV-infected patients is highly likely to progress to clinically active disease"(66).
Tuberculosis, once thought to be defeated has returned to threaten the lives of millions. It is the leading cause of death among communicable diseases. "It is estimated that between now and 2020, nearly one billion more people will be newly infected, 200 million people will get sick and 70 million people will die from TB - if control is not strengthened"(The World Health Organization). Works Cited Bloom, Barry R., ed. Tuberculosis: Pathogenesis, Protection and Control. Washington, DC: American Society for Microbiology, 1994.
Ryan, Frank,M.D. The Forgotten Plague. Canada: Little, Brown and Company, 1993.
Rom, William N., and Stuart Garay. Tuberculosis. New York: Little, Brown and Company, 1996.
The World Health Organization. "Tuberculosis: Fact Sheets". Feburary 1998 (18 Sept 98).
The People's Plague Online. "Facts and Figures: Tuberculosis Today". 1995 (24 Oct 98).