Friday, July 12, 2013

Everything you probably don't want to know about TB

I've been thinking about Saranac Lake's tubercular past these days, as multidrug-resistant tuberculosis (MDR-TB) has been in the news a lot lately. Tuberculosis itself is the second leading cause of death by an infectious agent worldwide (behind AIDS). The World Health Organization estimates that one-third of our entire population is infected with the TB bacilli, even if it does not actively cause symptoms. So, the emergence and spread of a drug-resistant strain is a wee bit unsettling, in my opinion.

The map below shows the numbers of  MDR-TB diagnoses in 2012. (The map also links to the original web site, where the map is more interactive.

World Health Organization Tuberculosis Report 2012
The World Bank (not a bank, but an organization that works on ending poverty) also has a great interactive map that shows the incidence of drug-resistant TB all over the world. (I LOVE interactive maps!)

The CDC Fact Sheet on drug-resistant TB gives you the low-down on the disease itself.

Tuberculosis may have put Saranac Lake on the map in the late 1800's, but I'm hazarding a guess that y'all probably don't want that kind of fame this time around.

On the upside (for us, at least), the U.S. and Canada have seen very few cases of MDR-TB so far. The disease proliferates mostly due to the mismanagement of medication for regular TB. In countries that are relatively poor, the drug supply is not always available, or the
drugs may not be high quality. Providers may not understand how to properly prescribe drug treatments, or patients may not be educated on the importance of following drug regimens.

The disease, like regular TB, is spread by the bacteria being coughed, sneezed, or breathed into the atmosphere, and can be controlled somewhat effectively by taking precautions such as using a mask over the mouth, avoiding closed or crowded spaces, etc.

Plus, Giant African Pouched Rats are more effective at sniffing out TB than a scientist with a microscope. I wonder if you can order one online?

I'll end with four books related to tuberculosis, or the spread of disease in general:

The Magic Mountain, by Thomas Mann, c1924.
Protagonist Hans Castorp is diagnosed with tuberculosis and stays at a sanatorium in the mountains of the Swiss Alps (sound familiar?). While there, he encounters several characters whose personalities taken together define pre-war Europe in a microcosm.

The Air We Breathe, by Andrea Barrett, c2007.
A fictional story about a man with tuberculosis who leaves New York City for a TB sanatorium in the ... Adirondack mountains, of all places! Yes, you all probably already know this book by heart. :-)

The Ghost Map, by Steven Johnson, c2006.
In 1854, cholera raged through London. Though believed to be spread by "vapors" by most, Dr. John Snow mapped the cases of outbreaks throughout the city until it became clear that cholera hotspots centered around water pumps. This analysis saved millions of lives, gave rise to better city infrastructure, and also spurred on the field of epidemiology.

The End of Poverty, by Jeffrey D. Sachs, c2005.
I did say tangentially related. TB, and especially MDR-TB tends to proliferate in poverty-stricken areas of the world. Striking at the heart of what keeps these areas destitute is one sure way to halt the spread of infectious disease. Sachs analyzes these forces and suggests remedies to end poverty.


  1. This information is very interesting, especially given our (Saranac Lake's) history.
    I like the "books I've read at least twice". I would list Pride and Prejudice as one I can never read too much. I can even quote sections of the book. Janet Evanovich's series on Stephanie Plum (One for the Money, etc.) makes me laugh out loud no matter how many times I've read it. And then there is the Louise Penny series. I've read them all, and am now in the process of buying them all, and rereading them one at a time. They take place Canada near the Vermont border, and are so well-written that you are there.

  2. I'm an interactive map junkie, as well! Although, I must also admit, I love looking at old maps, too! Thanks for sharing the information. After reading this and visiting the WHO & CDC sites, I am surprised at the number of reported MDR-TB cases ... especially in the US. I must say, I find it somewhat unsettling.