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Sci Tech    H3'ed 3/23/22

World TB Day | Treatment of the world's oldest epidemic: the past, present and future

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Treatment of the world's oldest epidemic: the past, present and future


This article is dedicated to all those who lost their lives to world's most deadly infectious disease - TB - and to those who defeated it

TB is preventable. Then why did 10 million people get the active TB disease last year? Why 1.5 million died of TB?
TB is preventable. Then why did 10 million people get the active TB disease last year? Why 1.5 million died of TB?
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Is it not shocking that an ancient disease that has been with human since long before the recorded history, and is preventable and treatable, still kills around 1.5 million people every year? Molecular analysis of causative microbe of tuberculosis (TB) suggests that the first infections of humans occurred as much as 70,000 years ago. But the actual cause of TB was known only 140 years ago, when on March 24, 1882, Dr Robert Koch announced his discovery of Mycobacterium - the microbe that causes TB. Even today, TB remains the leading infectious cause of death globally. 1.8 billion people (nearly 25% of the world's population), harbour Mycobacterium tuberculosis. Every year nearly 10 million people contract the disease and around 1.5 million die from it.

same disease, but many names

In the past, this debilitating disease has been known by many names- like consumption, phthisis, white plague, king's evil, etc, till in 1834, a German physician Johann Schonlein coined the term 'tuberculosis'. Many eminent personalities have succumbed to it- King Edward VI of England, King Louis XIII of France, poet John Keats, music composer Fre'de'ric Chopin, writers like Emilie Bronte, Jane Austen, Moliere, Chekhov, Maxim Gorky, Khalil Gibran and George Orwell, educator Louis Braille, USA's longest serving first lady Eleanor Roosevelt, India's first female doctor Anandi Gopal Joshi- to name just a few.

Drug resistance is among the challenges threatening to reverse the gains made in fight against TB

In the decades following Koch's discovery, the BCG (Bacillus Calmette-Guerin) vaccine, antibiotic streptomycin, and other anti-TB drugs were developed. While the BCG vaccine, made 100 years ago in 1921 does protect children from severe forms of TB, especially TB meningitis, it has little or no effect in preventing TB in adults. In 1944 streptomycin, the first antibiotic against TB was discovered by Selman Wakman. It literally brought patients with TB meningitis (for which there had been no cure at that time) 'back to life'. But very soon it also led to the emergence of streptomycin-resistant TB bacilli. In the following years many other anti-TB drugs were developed and combinations of antibiotics were used to treat patients. But resistance to many anti-TB drugs has emerged and drug-resistant forms of TB are now a major problem globally.

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