Tuberculosis, Today’s Ebola

If you are one of our older readers, you most likely remember those dedicated tuberculosis hospitals that were in every corner of the United States in the 20th century.

Tuberculosis (TB), an infectious disease that is often fatal and for much of the 19th and 20th centuries, was considered the infection of the century. The disease attacks the lungs but can affect other parts of the body if the infection is allowed to spread. It is easily transmitted by a human through a cough, sneeze or respiratory fluids through the air. Ebola is a disease caused by ebolavirus that is also often fatal. It affects multiple organs and is contagious only through contact with blood or bodily fluids of an infected human or animal, and has not been proven to be airborne.

Both diseases have a high mortality rate and treatments for both require a heavy dosage of medication. For those with tuberculosis, medication can take several months to become effective. Several antibiotics can also be combined to reduce the risk of the bacteria developing antibiotic resistance. That is where the similarities stop, however.

Ebola has only killed over 4,000 in its brief tenure for 2014 and only several thousand since its discovery in the 1970s. Tuberculosis took the lives of over 1.5 million in 2012 alone, and its death rate is second only to AIDS. Ebola has remained fresh on late-night news channels and pundits and politicians across the aisles are calling for travel bans, school closures and extreme measures for a risk that remains extremely low to the average person. As for tuberculosis, which has a very high-risk factor, there has been little to no discussion.

How scary is tuberculosis in comparison to ebola? Those with tuberculosis can develop a drug-resistant form that is extremely difficult to treat – taking years instead of months or is impossible to cure. Over 10% of cases in 2012 were drug-resistant and that percentage increases with each year. And although Ebola has no known cure, advanced supportive efforts, including oral rehydration therapy and other care, greatly reduces the chance of death.

Ebola is the new tuberculosis.

Why the discrepancy? Tuberculosis is no longer prevalent in western civilizations. Rates of the disease began to rise in the early-1600’s to the late-1800’s when it caused nearly 25% of all deaths.

Across the United States, tuberculosis hospitals were found in every state and many hospitals had dedicated wards just for tuberculosis patients. Most were opened in the early-1900’s and featured amenities such as sun decks, as fresh air and sunshine were once thought of as a key element in fighting tuberculosis.

In Kentucky alone, there were seven tuberculosis hospitals in Ashland, Glasgow, Hazelwood, London, Louisville, Madisonville, and Paris. Another sizable sanatorium, Silvercrest, was located in New Albany, Indiana. All but three were opened around 1950.

By the 1950s, this rate had decreased by nearly 90% due to improvements in public health and sanitation. An antibiotic introduced in 1946 made tuberculosis treatment and cure possible. As such, legacy tuberculosis-only facilities quickly became outdated and most were closed in the 1960s and 1970s. The last dedicated tuberculosis hospital in the United States closed in Florida in 2012.

With tuberculosis out of sight in the western world, it has become out of mind.

There are only four properly equipped hospitals in the United States that can treat patients with the Ebola virus. If Ebola spreads, will we see the return of dedicated hospitals for specific infectious diseases?


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Drug-resistant tuberculosis at crisis levels, warns WHO
Wed Oct 22 13:06:40 UTC 2014
By Kate Kelland
LONDON, Oct 22 (Reuters) – Multi drug-resistant tuberculosis remains at crisis levels, with about 480,000 new cases this year, and various forms of lung disease killed about 1.5 million people in 2013, the World Health Organization (WHO) said on Wednesday.
In recent years, the emergence of multi drug-resistant TB — a manmade problem caused by regular TB patients being given the wrong medicines, the wrong doses, or failing to complete their treatment — has posed an increasing global health threat.
About 9 million people contracted tuberculosis during the year and about 3.5 percent of those had a strain that was to some extent drug-resistant — cases that are much harder to treat and have significantly poorer cure rates, it said.
“There are severe epidemics in some regions, particularly in Eastern Europe and Central Asia,” the U.N. health agency said in its annual assessment of the global burden of TB, noting that in many places, the treatment success rate is “alarmingly low”.
Furthermore, extensively drug-resistant TB, which is even more expensive and difficult to treat than multi drug-resistant strain, has now been reported in 100 countries around the world.
Once known as the “white plague” for its ability to render its victims skinny, pale and feverish, TB causes night sweats, persistent coughing, weight loss and blood in the phlegm or spit. It is spread through close contact with infected people.
Of all infectious diseases, only the human immunodeficiency virus (HIV) that causes AIDS kills more people than TB.
The Geneva-based agency also warned that a lack of funding is hampering efforts to combat the global epidemic.
An estimated $8 billion is needed each year to be able to tackle the disease fully, it said, and an annual shortfall of about $2 billion means that is not possible for now.
However, efforts to better diagnose and treat the lung disease are beginning to pay off, the WHO said, noting such progress has saved an estimated 37 million lives since 2000.
While “a staggering number of lives are being lost to a curable disease”, the WHO said the TB death rate fell by 45 percent since 1990 and the number of people developing TB is declining by an average of 1.5 percent a year.

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