CDC History of Tuberculosis Control - Medical and Public Health ...

A Glimpse at the Colorful History of TB:
Its Toll and Its Effect on the
U.S. and the World
by Dan Ruggiero
Division of TB Elimination
In their 1969 book Tuberculosis, Lowell et al.
tell us that “Tuberculosis is an ancient disease
with a lineage that can be traced to the earliest
history of mankind . . . In the last millennium
it has been universally distributed among all
branches of the human race.”
Notable Events in TB Control
Phthisis (from the Greek word to waste away),
scrofula (swellings of the lymph nodes of the
neck), the white plague (the TB epidemic in
Europe during the 18th century), consumption
(progressive wasting away of the body), TB
(the presence or products of the tubercle
bacillus) are all words for tuberculosis marking
a specific point in history. Each has a significant
connotation and meaning to millions of
people about a disease that has afflicted humans
from the dawn of history and continues
to ravage mankind in large numbers. During
World TB Day 1999 it was reported that an
estimated one billion persons died of the
disease worldwide during the 19th and early
20th centuries alone. This invisible enemy
continues to challenge man’s knowledge and
mock his efforts; the “Captain of the men of
death” continues to march forth leaving
behind a trail of human misery, economic
chaos, and death. What is the origin of this
invisible predator that even today has been
able to adapt and survive by fending off the
many remedies and cures that the best minds
in science have placed before it?
The tubercle bacillus, the organism that causes
TB disease, can be traced as far back as 5000
BC when archeologists found evidence in
human bones of the existence of TB. Evidence
was found in ancient Egyptian mummies
which showed deformities consistent with TB
disease. Paleontologists have concluded that
the disease must have been prevalent in that
part of the civilized world.
1
Evidence of TB in ancient human bone
Evidence of TB appears in Biblical scripture,
in Chinese literature dating back to around
4000 BC, and in religious books in India
around 2000 BC. In ancient Greece
Hippocrates mentions TB around 400 BC, as
does Aristotle, who talked about “phthisis and
its cure” (ca. 350 BC).
It was widely believed that European explorers,
sailors, and the settlers who followed
Columbus to the new world brought with
them many infectious diseases, among them
TB. However, paleopathologists suspected that
TB existed in the New World before 1492,
based on ancient skeletons and bones that
contained lesions resembling those caused by
TB. Evidence to that effect was found in 1994,
when scientists reported that they had identified
TB bacterium DNA in the mummified
remains of a woman who had died in the
Americas 500 years before Columbus set sail
for the New World.
The TB epidemic in Europe that came to be
called the “Great White Plague” probably
started in the early 1600s and continued for
the next 200 years. The epidemic reached its
peak in western Europe and in the United
States in the late 1700s and early 1800s. In
early 19th century England, TB was so pervasive
a killer that it dwarfed other dreaded
diseases like cholera and typhus. So common
and so little understood was TB that death
from the disease was accepted as inevitable. TB
in the early 19th century may have accounted
for one third of all deaths. Death from TB