Tuberculosis; the Epidemiology of a Communicable Disease
By Shawna LaCoss, RN
September 7, 2014
Colleen Darrow, Instructor
NRS-427V Grand Canyon University

Although it has been found in the bones of our ancestors as far back as 2400 BC, and due to the variety of its symptoms, TB was not identified as a unified disease until the 1820s, and was not named tuberculosis until 1839 by J.L. Schonlein. However, it then took until March 24, 1882, for Dr. Robert Koch to announce his discovery of Mycobacterium tuberculosis; which is the bacteria that causes tuberculosis (TB). Sadly during this time, TB killed one out of every seven people living in the United States and Europe. TB remains the second leading cause of death in adults in the world, with 1.5 million deaths in 2010 (CDC, 2014). Mycobacterium tuberculosis generally attacks the lungs and this is the most commonly known form; however, it can also attack the kidney, spine and brain which can be fatal if not treated. TB is spread through the air or droplets and is contracted when one person breaths the air of an affected person after they have coughed, sneezed, spoken or even sang. It is an airborne disease and cannot be contracted by shaking hands or even kissing someone who is infected. There are two forms of the condition; the latent form in which a person has been infected but their body is able to fight the infection and they do not get sick, nor can they infect others unless the bacteria become active and multiple. In this case the person is considered to have the disease and cannot fight the infection, and they become sick and can infect others. Some symptoms of TB are a bad cough that lasts 3 weeks or longer, pain in the chest, coughing up blood or sputum, weakness or fatigue, weight loss, no appetite, chills, fever or night sweats. Once infected with TB bacteria, the chance of developing the disease is higher if the person has HIV infection, has been recently infected with TB bacteria (in the last 2 years), or has other health problems, like diabetes, that make it hard for the body to fight bacteria, abuses alcohol or uses illegal drugs, or was not treated correctly for TB infection in the past. Those who are also at risk include those who live with or care for someone with active TB such as healthcare workers, homeless or poor with little or no healthcare, migrant workers, prison workers and those who travel to or were born in places where untreated TB is common, such as Latin America, Africa, Asia, Eastern Europe, and Russia. In 1943, Selman A. Waksman, finally successful; he had been working for decades to find an antibiotic to treat TB and came up with streptomycin, this was first administered to a human on November 20, 1944. The results were very impressive and led to a combination of drugs which allowed for full treatment and recovery. Treatment for TB can be a long process but it is very important to make sure to take the medications until they are completely gone. If treating for latent TB, usually a course of antibiotics for up to six months is the standard plan; if for the disease itself then a course of four medications for up to nine months is recommended. The most important determinant of the outcome of treatment of TB is the access the patients have to reliable diagnosis and treatment. In 2010 the world saw more cases of tuberculosis than ever before in human history; the majority of these cases continue to be among the poor, the hungry and the ethnic minorities of the world (Hargreaves, 2011). Generally groups that have historically had greater obstacles to health because of race, ethnicity or culture are hit harder by TB and even though cases have declined; the percentage of cases that occur in Hispanics, African Americans and Asians, is higher than expected. In fact approximately 84% of cases in the U.S. were in minorities and foreign-born cases increased to 63% in 2012 (CDC, 2013). When reviewing the epidemiologic