Tuberculosis: a Lesson to Be Learned

Tuberculosis. One hundred years ago simply the whisper of a TB diagnosis would send panic throughout the community. Since the advent of drugs capable of treating TB in the 1940s, most of our society has simply forgotten the terror this disease caused.

The story of Andrew Speaker, a 31-year-old Atlanta Attorney, has suddenly brought Tuberculosis back into the spotlight. Speaker is now quarantined in a Denver hospital following a European vacation that left a trail of potentially infected people..

TB is a bacterial infection which primarily infects the lungs but can attack any part of the body, according to the Center for Disease Control website. Tuberculosis is spread by air when an infected patient coughs or sneezes. As with any airborne illness, confined spaces increase the risk of infection.

TB was once the leading cause of death in the United States. In 1900 in the United States, nearly 200 deaths per 100,000 were the result of TB. The death rate in the early part of the twentieth century slowly declined but peaked again during the period of the great influenza epidemic that swept the world. (Vital Statistics of the United States).

The greatest tragedy of Tuberculosis was the destruction it caused to families.

Prior to the 1940s, the only known treatment for TB was for patients to be sent to a sanatorium. Sanatoriums served to isolate patients and prevent them from spreading the disease to others. Additionally, the enforced rest, fresh air and proper diet helped aid the healing process. Those whose bodies were unable to fight the disease simply died. Those who did recover often were away from their loved ones for years.

The emotional toll of Tuberculosis was far greater than the body count. Husband and wife, Anthony and Alma Hachting, of St. Charles, MO were diagnosed with TB in the early 1900s. Their sanatorium stay meant they were sent far away from their beloved children. The four siblings were left in the care of their widowed grandfather who had little interest in their emotional needs. Contact with their parents consisted of long, loving letters which the children cherished.

Anthony died of Tuberculosis during his sanatorium stay. Alma was making a strong recovery and it looked as if the family would be reunited. Unfortunately, an error during a routine lung biopsy damaged her healthy lung and she subsequently died. TB robbed these four children of their parents at a young age. TB left a whole in the family that never fully healed, even decades later.

TB is again on the rise in the United States and other industrialized countries. Immigration has increased the number of citizens with TB. HIV and other immune diseases leave the body more susceptible to TB. The increase in prison populations places a greater number of people at risk due to the close living conditions. Most significantly, multi-drug resistant mutations of Tuberculosis have emerged.

Andrew Speaker's case is of great concern because he is infected with one of these multi-drug resistant strains of TB. A typical case of TB requires a six to twelve month regiment of multiple medications taken under strict guidelines. Missed dosages or discontinuation prior to completing the course of medication can result in the bacteria developing mutations that allow it to resist conventional treatment. These mutated bacteria are then spread to others. Treatment of this form of TB is difficult.

In what may seem like a bad dream revisited, the treatment Speaker must currently endure is eerily reminiscent of what the Hachtings endured nearly a century ago - isolation, plenty of rest and separation from family.

There is a lesson in this story. We have become reliant on our belief that modern medicine will keep us safe. Diligence must be observed whenever treatment is prescribed or we run the risk of repeating a devastating past.