Diseases Back from the Dead: Tuberculosis
Tuberculosis has been a scourge of humanity for thousands of years. Experts think that even ancient Egyptians had it, judging from the skeletal abnormalities of certain mummies. TB is a bacterial lung infection transmitted through the cough or sneeze of an infected person. At one point in history, it was called consumption because of how it causes its victims to waste away. It spread unchecked in places where people lived very close together in unsanitary conditions, such as tenements. At the turn of the 20th century, it was the leading cause of death in the United States. As living conditions improved, TB retreated. But not forever.
When AIDS appeared in force in the United States in the 1980s, TB suddenly reemerged. It happened because AIDS attacks the body’s immune system, creating a window of opportunity for TB. “AIDS was rampant during the ’80s and ’90s,” Olano says. “Patients were dying right and left, the medication was expensive and not available to everybody, and tuberculosis went up with it.”
Because of this piggybacking effect, TB is now a big problem in sub-Saharan Africa, where AIDS killed 1.3 million people in 2009 alone. CDC expert Dr. Philip LoBue says that in some sub-Saharan African countries, it’s not unusual for 50 or 60 percent of patients with TB to also have AIDS.
And as TB has reemerged, the virus has gained antibiotic resistance, too. Treating TB is a long and complicated ordeal, in which patients get a cocktail of least four drugs for at least six months. But in countries with poor public health resources, the full treatment might not be available. And if the patient only takes one TB drug, those bacteria that have mutated immunity to it survive and spread. Today doctors are facing tuberculosis that is resistant to multiple antibiotics. Treating these infections successfully can take as long as two years, and the second-line drugs that have to be used have unpleasant side effects.
"We don’t have too many new medications to treat tuberculosis," says Olano. "The last great discovery was in the late ’60s." Tuberculosis is just one of diseases facing this problem—there are now strains of malaria that are also multidrug resistant, and even once easily-treatable infections like gonorrhea are becoming more and more difficult to get rid of. The only real solution, says Heymann, is to create vaccines. But for many diseases, those are likely far off.