The history of tuberculosis

Abstract

Tuberculosis should be thought of as a slowly progressing worldwide epidemic. Initially it was a diseases of lower mammans and the etiologic agent probably preceded the development of man on eart. It became an uncommon endemic disease in man about the time man began to settle in villages and develop agriculture. Crowding in European cities, and later the industrial revolution in Europe, provided to necessary environmental conditions for the endemic diseases to become epidemics. Tuberculosis has not always been the woldwide disease that it is today. It reached some geographic areas at least 400 years ago and reached others near the middle of this century. This discrepancy created great differences regarding the time this epidemic began in various parts of the world and the development of specific innate resistance of various population to this infection. By the mid-1950's many principles of tuberculosis chemotherapy were understood and effective treatment regimens were available. In the 1980's the success of 6-month regimens allows clinicians to shorten the duration of treatment in some patients. The long decline of morbidity due to tuberculosis ended in 1984. Since 1985 there has been an increase in the number of cases of tuberculosis. Several outbreaks caused by isolates resistant to two or more antituberculous medications have been documented in the United States and in many other countries.