They found the bones off the coast of Israel,
in an ancient city long covered by the sea.
The village was nine thousand years old,
so old that the people who lived died and were buried there, didn't have basic technologies like pottery or the wheel.
What they did have
was Tuberculosis.
TB has followed us like a shadow for the entirety of human history.
We found it in the lung tissue of Egyptian mummies,
and references to it in the Bible, Vedic texts,
and the work of Hippocrates.
Infected seals appear to have carried it to South America long before the Columbian Exchange.
It is the closest thing humanity has to a biological nemesis and in
1944
we found a cure.
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Every child needs a check-up at least once a year.
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Though Robert Koch's tuberculin failed to become the cure doctors hoped for,
by tuberculin's rollout in 1891,
experts in other fields were already finding ways to combat tuberculosis.
Koch's mistake was that he bought into the myth of the
Scientific Genius
the idea that one man could destroy a malady with the strength of his intelligence.
But in reality, that's not how science works in the modern world.
In fact,
it would take a team of scientists
in different fields to cure the white plague
and an even larger group of non
scientists to implement that cure.
Indeed, before Koch began working on tuberculosis,
Public Health Initiatives and medical technologies
were already lowering the TB rate in Europe and North America.
In cities where people lived close and had the highest rate of infection
health department's launched ad campaigns,
encouraging the public to cover their mouths when coughing or sneezing.
They banned spittoons and punished spitting on the street with a fine.
Labor unions and reformers advocated for larger factory spaces,
so workers weren't crushed up against each other.
Hospitals created separate TB warts
to safeguard other patients.
Doctors used new detection techniques like the stethoscope and the x-ray to identify cases early and
and Koch's tuberculin though a failure as a cure flourished as a
diagnostic test,
and in 1908 a gathering of scientists
determined that a type of tuberculosis called
Scrofula which caused sores and lesions rather than lung infection,
existed in cows
and could be passed to humans via milk.
It turned out that briefly boiling the milk in a process called
pasteurization after Louis Pasteur
solved the problem.
Unfortunately,
public skepticism meant pasteurization wouldn't be widely accepted until World War Two
but once implemented,
Scrofula rates plummeted.
But this discovery of a link between bovine and human
Tuberculosis was exciting for another reason.
It provided
hope for a vaccine.
After all, the first smallpox vaccine came from a similar situation,
where doctors inoculated patients with the less deadly cow pox
in order to guard their systems against smallpox.
The problem was that unlike cow pox, bovine tuberculosis
was extremely deadly to humans.
It took a French team
13 years to create a strain weak enough that it would build immunity in a subject without
infecting them with full-blown TB,
but the resulting vaccine known as BCG finally entered human trials in
1921 and it remains the most common tuberculosis vaccine to this day.
But BCG was not a cure.
It could guard an immune system for a decade, sure,
but it couldn't help a patient after they got sick.
To find that magical substance,
Science would have to delve into the most exotic and a mysterious
biological stew known to man.
The dirt of New Jersey.
Bluahh
Selman Waksman was a soil scientist at Rutgers,
a professor who studied the biochemistry and microbiology
of dirt. At first he evaluated the microbes for possible agricultural purposes,
but after the discovery of penicillin in 1928, he increasingly searched for antibiotics, a term
he popularized that would prove effective against penicillin resistant bacteria.
He was essentially searching for microbes
that would assassinate other microbes
Over four decades Waxman and his team cultured 10,000 species of microbes from New Jersey dirt and other natural sources.
Of those,
only one was an effective antibiotic that could also be produced in sufficient quantity:
Streptomycin
and tests in 1944 proved that Streptomycin could kill
Tuberculosis. They kept it quiet at first; after all everyone remembered what happened with Robert Koch and tuberculin, and he was one
of the greatest medical minds in history.
They kept the tests small and under tight controls, rolling it out slowly by trying it on troops returning from the war.
But it was the British who proved its effectiveness with the world's first randomized clinical trial, a process
that would become standard procedure for new drugs between
1946 and 1948,
British doctors administered Streptomycin to a group of random patients,
while comparing them to a control group with similar stages of tuberculosis.
This plan came about not due to scientific rigor
but post-war belt-tightening.
The British government could only afford
so much of the rare drug, and they wanted to make sure the data they got back from it was as clean as possible.
But while the initial results looked good, once the treatment ran out,
the patients taking streptomycin took a turn for the worse.
They discovered a fact that would bedevil tuberculosis researchers for decades. Unless killed off completely, TB is
extremely good at developing resistance to antibiotics.
Luckily the Swedish researchers Jorgen Lehmann and Carl Gustav-
Rosdoe had synthesized an acid,
PAS, that could inhibit the bacterias' metabolism. The British team tried using it on their resurgent microbes.
It was the first combination drug therapy, and it worked for the first time in human history.
There was a cure for tuberculosis and that discovery wasn't down to one brilliant scientist.
It was a team effort, a fact highlighted in
1952 when Waxman received the Nobel Prize for
Streptomycin despite the fact that his student Albert Schatz had actually made the discovery. An ugly lawsuit ensued.
Eventually winning, Schatz co-credit and royalties from the drug. Within a decade, a new battery of for anti TB drugs had pushed
Streptomycin and PAS into the background, things to be brought out when the front line drugs failed, and it was
important to have them in reserve, because despite having a cure in hand, Tuberculosis revealed a certain stubbornness. It
absolutely refused to die.
Because, to kill tuberculosis and I mean really,
permanently, kill it a patient, has to take a course of antibiotics that lasts weeks.
In fact,
they have to continue taking
Antibiotics even after they feel better, which is difficult since the drugs themselves can have side effects, ranging from nausea to hearing loss.
Many patients quit, letting the microbe come roaring back,
resistant to the antibiotics that treated it, even when resistance isn't the problem.
Persistence can play a role. When antibiotics
attack TB, the vast majority of microbes will die at a quick steady rate
But a few will enter a kind of hibernation and persist, not immune, but waiting it out.
Tricky little buggers, not to mention, the drugs themselves were expensive.
Meaning that while
Tuberculosis became rarer and rarer in the developed world, it still burned on in India, East Asia,
Africa and Latin America. and as patients received treatment,
but didn't finish the course, more antibiotic resistant strains emerged. These strains required longer courses of treatment,
some, up to a year of doses totaling 20,000 pills and multiple approaches to make sure it died.
These longer courses of antibiotics,
along with hospitalization might cost a million dollars per patient.
But in the early 1980s overseas charities and hospitals were making headway for a brief moment,
it seemed like the 10,000 year dream was possible.
We could eradicate TB like we had smallpox but two things changed the balance:
fast international travel and AIDS.
With a quick plane flight,
drug-resistant tuberculosis
could spread to areas where it had been nearly wiped out. and where doctors had stopped screening for it. and with the rise of HIV
AIDS it found a new immunocompromised
subset of the population to infect.
Particularly in places like South Africa , where medical care was harder to obtain, the White Plague once again threatened to become a fact of life.
But there's no need to panic, and there's cause for hope.
Currently, the World Health Organization governments and medical charities like the Bill and Melinda Gates Foundation are throwing
resources into new low-cost
diagnostic tests and improved vaccines, and there are new drugs in the testing phases that may help us combat these new
Antibiotic resistant strains. And local doctors are much more diligent about keeping TB on their radar when diagnosing patients.
The battle between humanity and tuberculosis
rages on, and beating it will be a team effort between governments,
scientists, health care professionals, and you. In fact, the single biggest thing you can do to stop the spread of
drug-resistant strains of, well anything really, not just TB, is to make sure you finish a full course of
Antibiotics when you're sick, and look, we know that can SUCK. Actually, Rob wrote this while taking some pretty unfun
Antibiotics for bronchitis, but as much as he dislikes those pills he's going to take all of them,
so the next person doesn't get infected with something worse.
We've cured tuberculosis, but we still have to beat it, and
that takes everyone, including you. So do your part, and breathe easy my friends.
Once again, thanks so much to Child and Teen Checkups programs for sponsoring this series!
Tuberculosis isn't as common as it once was, but it does still exist.
Children should receive a health check-up every year and,
Doctors can ask questions to find out if your child is at risk. If you live in Minnesota,
learn more at get CTC com. If you don't, click the link in the description below.