For Immediate Release
March 22, 2010

KDHE Office of Communications
communications@kdheks.gov, 785-296-0461

Remembering the Forgotten Killer: Tuberculosis

An Op-Ed Column by Jason Eberhart-Phillips, MD
Kansas State Health Officer

March 24th marks World Tuberculosis Day, the day in 1882 when the microbiologist Robert Koch revealed to a gathering of scientists in Berlin that he had discovered the bacteria that cause tuberculosis (TB).

At that time, TB was humanity’s single largest disease threat.

Known then as “consumption” for the way its victims would waste away, TB struck the young and old, the rich and poor, the famous and obscure throughout the world.

Among the dead were many beloved writers and musicians, such as Henry David Thoreau, Franz Kafka, Robert Louis Stevenson, Steven Foster, D.H. Lawrence, Emily Bronte, Frederic Chopin, John Keats and Anton Chekhov.

Koch and his fellow scientists were sure that his discovery would lead to a cure that one day would rid the world of TB.

But today, more than 125 years after Koch’s breakthrough, TB is still one of the gravest threats to human health – although it is often overlooked.

The dimensions of the global TB emergency almost defy comprehension. TB kills about 5,000 people a day – nearly two million every year – despite the fact that most cases are completely curable.

Two billion people, roughly one-third of the world’s population, are chronically infected with tuberculosis. Someone acquires a new infection with TB every second of every day.

Usually the body’s normal immune response walls off the infection and keeps it under check for life. But in five to 10 percent of infected people the TB organism breaks free at some time in their lives and makes them sick with active tuberculosis.

In most cases of active TB, the organism takes hold of the lungs, which helps spread the infection to others. People with active pulmonary TB can propel the organism into the air around them whenever they cough, sneeze or simply talk.

Left untreated, someone with active TB will infect on average 10 to 15 other people. As some of these people become ill with active disease, they keep the infectious cycle going.

Today tuberculosis goes hand-in-hand with poverty. An overwhelming majority of active disease occurs in less developed countries in Asia, Africa and Latin America, where it cripples economic advancement, social progress and political freedom. The disease is also on the rise in Eastern Europe and the former Soviet Union.

In Kansas, the majority of cases arise in people who have come from countries where TB infections are pervasive, or in those who have close contact with active TB at home or at work. Two other high-risk groups for TB are the homeless and elderly people who may have been infected as children.

Identifying people infected with TB and treating them before they spread the disease to others is an essential function of state and local health departments.

Kansas is fortunate to have a dedicated group of well-trained TB investigators, led by one of America’s most respected experts on the disease, Phil Griffin.

Phil and his team in my division of KDHE ensure that public health professionals track down tuberculosis whenever it turns up in our state, sometimes in places that few others would dare to enter. With compassion and unwavering determination, these dedicated public servants provide treatments and support to people infected with TB for periods up to 9 months or more.

Because TB treatment takes so long, the organism is especially prone to develop resistance to antibiotics if doses are missed. New drug-resistant strains are driving up the cost of treating this disease, and in some cases are making it incurable.

That’s why it is so important that public health staff work tirelessly on each case of active disease to make sure that every pill is swallowed every day by every patient.

Beyond this, they trace and test contacts of anyone suspected of having active TB, to ensure that the disease is contained. Thanks to their hard work at the front lines of the global war on TB, the rest of us can enjoy life in Kansas with a very low risk of exposure to this disease.

As the anniversary of Koch’s discovery approaches, it’s impossible not to feel some regret that the early hopes of eradicating TB remain unfulfilled. But here in Kansas we can mix our disappointment with a feeling of pride in the way that unsung public health heroes are overcoming TB in our communities every day, wherever it is found.

Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment. He can be reached at jeberhart-phillips@kdheks.gov. Previous columns are now available online at Dr. Jason’s Blog, www.kdheks.gov/blogs/dr_jasons_blogs.htm.