Tuberculosis (TB) is one of the oldest infectious diseases in human history. It is caused by bacteria named Mycobacterium tuberculosis, which the Centers for Disease Control and Prevention (CDC) estimates has been in existence for nearly three million years. Unlike influenza, which is a virus, TB is a bacterium, but is transmissible via similar channels: both primarily affect the lungs and are thus respiratory diseases. Both are transmitted through aerosol dispersal, which means they are spread through a cough, sneeze, or spit which expels infectious particles to another person.
In 1834, German professor of medicine Johann Lukas Schönlein named the organism “tuberculosis.” The ancient Greeks knew it as “phthisis,” the ancient Romans dubbed it “tabes,” and ancient Hebrews called it “schachepheth,” according to the World Health Organization (WHO). Later, in the eighteenth and nineteenth centuries respectively, people called TB the “white plague” and “consumption.” By the nineteenth century, TB infections began to decline. The famed microbiologist Robert Koch discovered the bacteria causing TB in 1882. He earned the Nobel Prize in Physiology or Medicine in 1905 for this work.
While TB mortality declined at the turn of the twentieth century, TB mortality spiked worldwide at the beginning of World War I (1914-1918). TB was one of the largest medical challenges in the American war effort. Shortly after declaring war in 1917, the US constructed a division in the Office of the Surgeon General dedicated to safeguarding American troops from contracting the disease. Nevertheless, the US Army Medical Department reported 23,000 TB cases during the war, with 18,500 emerging from US military training facilities and 3,500 from European battlefields. Initially, the Army reported 2,766 deaths from TB. Mobilization at the beginning of the war and demobilization at the end of the war facilitated the spread of TB, among other diseases like influenza and typhoid.
Various aspects of the war effort exacerbated TB infectivity and mortality. Squalid training and field living conditions, improper nutrition and hygiene, inadequate recruit screenings, overcrowding, and underdeveloped medical infrastructure all contributed to increased rates of TB infection. The absence of antibiotics made TB treatment difficult. Early twentieth century medical authorities resorted to isolating patients in TB sanatoriums and instructing proper nutrition to treat TB. In 1921, French medical scientists Albert Calmette and Jean-Marie Camille Guerin introduced the first TB vaccines in the years after the war. Research into stronger vaccines against TB continue in the twenty-first century, where new drug-resistant variations of TB continue to emerge.
“10 Facts on Tuberculosis,” World Health Organization (WHO). Accessed November 4, 2019, https://www.who.int/features/factfiles/tuberculosis/en/.
Byerly, Carol R. Good Tuberculosis Men: The Army Medical Department’s Struggle with Tuberculosis. Fort Sam Houston: Office of the Surgeon General Borden Institute, 2013.
&ldqo;Tuberculosis (TB): Basic TB Facts.” Centers for Disease Control and Prevention (CDC). Accessed July 3, 2019, https://www.cdc.gov/tb/topic/basics/default.htm.