March 24 was the 35th annual observance of World Tuberculosis Day, and a spate of articles (including this from the Washington Post) caught my eye. I’m usually the kind of person who skips the “deadly disease” reading, but my research on TB for Beyond Chicken Soup raised my consciousness. So I looked it up: March 24, 1882, was the day German physician Robert Koch announced the discovery of the tuberculosis bacillus, the necessary first step toward the development of an effective treatment.
Tuberculosis is an ancient killer. The bones of Egyptian mummies show signs of this highly contagious disease, and Hippocrates said that it was the most widespread disease of his time. (In fact, he advised doctors against treating it, since it was almost always fatal and attempting to help could only damage the reputation of the practitioner – read more here: http://pubs.acs.org/subscribe/journals/mdd/v05/i02/html/02timeline.html)
In the 19th century, and well into the 20th, TB, or “consumption” as it was then commonly known in the English-speaking world, was rampant, killing one in seven people in Europe and the Americas. There was little physicians could do for sufferers other than create an environment where patients could rest, breathe fresh air and eat a nutritious diet—essentially aiding the body’s immune system to fight the infection. Thus, in the early 1900s sanatoria were built throughout the United States countryside to provide this long-term treatment of choice for tuberculosis patients.
Jewish communities established many such institutions under their auspices, such as Baltimore‘s Mt. Pleasant Hospital (first known as Jewish Hospital for Consumptives), built in Reisterstown, Maryland in 1908. Most Jewish communal TB hospitals served all patients regardless of ethnicity, and were free for those who were impoverished. Jewish hospitals were also the only institutions that served Jewish patients who wanted to observe Judaism and eat kosher food during their resident treatment of many months.
Jewish communities were also moved to “take care of their own” because of an ongoing debate about whether Jews were more or less susceptible to tuberculosis. Was consumption a “tailor’s disease” (a reference to the large number of Jewish immigrants toiling in America’s garment industry in the early 20th century), or was there less TB than should be expected among the Jewish tenement-dwellers, considering their crowded and insalubrious living conditions? On either side of this argument, the Jews would not look well. If they were more prone to disease, they could be characterized as unwanted immigrants. And if they seemed resistant to TB, would they be seen as dangerous carriers and spreaders of disease, as had happened in Europe in earlier centuries?
In the end, it was Jewish immigrant Selman Waksman and his microbiology team at Rutgers University who in 1943 isolated streptomycin, the first antibiotic that attacked the tuberculosis bacillus. Sanatoria closed and the incidence of TB dropped precipitously throughout the developed world. In 1987, the American Medical Association predicted that TB would be extinct by 2010.
That hasn’t happened. In fact, strains of TB have become resistant to antibiotics, and the disease is on the rise in this country and around the world. With almost 10,000 cases in the United States last year, the Washington Post notes that “two-thirds of the total [cases] were among people born abroad.” So we mark World Tuberculosis Day and remind ourselves that this disease is still a threat that demands our attention.
Post by curator Karen Falk.
*Update: In the news – Chewa, a 3-pound African giant-pouched rat, has been taught by staff at the NGO called APOPO to know tuberculosis by its smell! Read more.