Tuberculosis through the years..

Ever wondered why March 24 is celebrated as World TB Day? That’s because on this very day back in 1882, German microbiologist Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacteria that causes tuberculosis (TB). At that time, one in every seven people living in the USA and Europe were dying due to TB. Our struggle against this disease is still very much alive, which is why March 24 is observed as World TB Day to increase awareness among the public about the impact of TB.

Let’s trace the history of tuberculosis, along with its distinct quirks and characteristics, right from its inception to the present day. Read on to know more:

The Starting Point
There are different sources citing different origin times for TB. TB in humans can be traced back to 9,000 years ago in Atlit Yam, a city now under the Mediterranean Sea, off the coast of Israel. The earliest written mentions of TB were in India (3,300 years ago) and China (2,300 years ago). Although the exact date and time of the first recorded case of TB may be disputable, we can all agree on the fact that this disease has been here for quite a while.

The Name Calling
This disease went through a number of names before getting fixed on tuberculosis. In ancient Greece, it was called “phthisis”, “tabes” in ancient Rome, and “schachepheth” in ancient Hebrew. Another one of its names was “the white plague”, due to the paleness of the patients. In the 1800s TB was also called the “Captain of all these men of death.”

The Discoveries Before Koch
Many efforts were made before Koch to identify and characterize the nature of TB. Rene Laennec’s (the inventor of the stethoscope) worked on the utility of pulmonary auscultation in diagnosing tuberculosis. Laennec’s work was extended by Pierre Charles Alexandre Louis, who  evaluated the different aspects of the disease’s progression, the efficacy of various therapies and individuals’ susceptibility.

Another good friend and co-worker of Laennec, Gaspard Laurent Bayle, divided phthisis into six types. Then in 1869, Jean Antoine Villemin demonstrated that the disease was indeed contagious, conducting an experiment in which tuberculous matter from human cadavers was injected into laboratory rabbits, which then became infected. Finally, in 1882, Robert Koch revealed the disease was caused by an infectious agent.

The Detection of Tuberculosis
It started with the X-rays… in 1895, Wilhelm Roentgen discovered the X-ray, which allowed physicians to diagnose and track the progression of TB, which reduced the incidence and mortality of the disease. Then followed by the skin test… in 1907, Clemens von Pirquet developed a skin test that put a small amount of tuberculin under the skin and measured the body’s reaction, which was updated by Charles Mantoux in 1908. In the 1930s, a process to create a purified protein derivative of tuberculin (PPD) for the TB skin test was developed by Florence Seibert. Seibert did not patent the technology, but the United States government adopted it in 1940. The TB skin test is still used today and has remained virtually unchanged for almost eighty years.

The Treatment of Tuberculosis
In 1944 Albert Schatz, Elizabeth Bugie, and Selman Waksman isolated streptomycin, the first effective antibiotic against M. tuberculosis, produced by a bacterial strain Streptomyces griseus. In 1952, the first oral mycobactericidal drug, isoniazid, was developed. Rifampin in the 1970s hastened recovery times, and significantly reduced the number of tuberculosis cases until the 1980s. Today, four drugs are used to treat TB disease: isoniazid, pyrazinamide (1952), ethambutol (1961), and rifampin. This 4-drug cocktail is still the most common treatment for drug-susceptible TB.

Currently, tuberculosis continues to be a top infectious disease killer worldwide. However, the death rate has dropped by 47% since 1990. India has the highest TB burden withWorld Health Organization (WHO) statistics for 2011 giving an estimated incidence figure of 2.2 million cases of TB for India out of a global incidence of 9.6 million cases. The Indian government’s Revised National TB Control Programme (RNTCP) started in India during 1997 with the objective to achieve and maintain a TB treatment success rate of at least 85% in India among new patients.

Our national TB infection rate is at a peak (world’s third highest TB infected country), and is consistently growing. At present the anti TB treatment offered in the public and private sector is not satisfactory and needs to be improved. Today India’s TB control program needs to update itself with the international TB guidelines as well as provide an optimal anti TB treatment to the patients enrolled under it. With adequate education, diagnostic services and treatment subsidies, our country can achieve its goal and safeguard its population against tuberculosis

REFERENCES:

1. History of World TB day. Available from: https://www.cdc.gov/tb/worldtbday/history.htm. Accessed on 18 March 2020.

2. History of Tuberculosis. Available from: https://en.wikipedia.org/wiki/History_of_tuberculosis. Accessed on 18 March 2020.3. Timeline of Tuberculosis. Available from: https://en.wikipedia.org/wiki/Timeline_of_tuberculosis. Accessed on 18 March 2020.

3. Timeline of Tuberculosis. Available from: https://en.wikipedia.org/wiki/Timeline_of_tuberculosis. Accessed on 18 March 2020.

4. History of Tuberculosis (TB) – World history, start of TB, then through the centuries. Available from: https://tbfacts.org/history-tb/. Accessed on 18 March 2020.

5. Tuberculosis in India. Available from: https://en.wikipedia.org/wiki/Tuberculosis_in_India. Accessed on 18 March 2020.


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