Tuberculosis: A Menacing Disease Returns
Posted February 1, 1998
In 1994, Debi F., a high school junior, was flown from California to Denver, Colorado, for treatment of a serious tuberculosis (TB) infection. Debi was suffering from
a form of TB that greatly concerns the medical community; TB bacteria that are resistant to many kinds of antibiotics. Tuberculosis in the U.S. has been declining steadily for decades,
but this type of TB has recently been on the rise. As a result of multidrug-resistant TB, Debi's right lung had to be removed.
Tuberculosis is caused by an airborne bacterium, Mycobaterium tuberculosis. The infection may remain dormant in the body for months as the bacteria slowly multiply.
When the bacteria enter an active phase, they attack the lung cells, making breathing difficult. Sometimes the attack extends into the blood vessels and the patient coughs up blood.
Without treatment, the patient's lungs become so riddled with infection that he or she is unable to breathe, and the patient dies of suffocation.
Under normal circumstances, TB is completely curable, but the cure is not quick. Patients must take several medications daily for at least six months. If they fail
to follow the drug regimen, the bacteria develop resistance to that antibiotic. When this occurs, a second line of drugs must be used that is much slower-acting, more toxic, and more
expensive. If a person contracts multidrug-resistance TB, the odds are one in two that the disease will result in death.
Multidrug-resistant TB has increased 20 percent since 1985, resulting in 20,000 cases in 1996. Worldwide, TB is the number one cause of death from infection. At present,
there are 8 million new cases of TB worldwide; of these, approximately 2 million people will die from the disease. The World Health Organization reported in 1996 that deaths attributed
to TB would reach 4 million by the year 2005 if the multidrug-resistant form of TB continues to spread.
Molecular techniques are currently being used to study TB. Projects to establish the DNA nucleotide base code of the TB bacterium are underway. It is hoped that this
basic information about TB will provide new leads for drug design and treatment.
Remember Debi? Debi's right lung harbored so many bacteria that she probably would not have been able to survive, even with extensive drug therapy. She would have
been so contagious that she could not have been allowed to be in contact with other people. After her lung was removed, she began two months of multidrug antibiotic therapy. Eventually
she was able to return home and is slowly resuming a normal life. But she still takes 14 pills a day because the TB bacteria in her left lung remain in a dormant state.
References
Hall, S. "The Return of Tuberculosis," The Race Against Lethal Microbes, Howard Hughes Medical Institute, 1996, pp. 6-21.
Caldwell, M. "Resurrection of a Killer," Discover, December 1992, pp. 58-64.
Caldwell, M. "Control of Tuberculosis in the United States," American Review of Respiratory Disease, Vol. 146:6, December 1992, pp. 1623-1633.
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