When Mycobacterium Tuberculosis first invades the body, the person's immune system can usually fight it, and the person feels healthy. But the bacteria will never completely die… and the worst can happen when a person who has the bacteria becomes ill. If the person's illness makes the immune system weak, then the bacteria can become powerful again and make the person feel worse - coughing up blood, losing weight, and feeling weak.

Not all bacteria do this to people; only the Mycobacterium Tuberculosis will.

In the United States, Tuberculosis is now rare. Drugs were developed to treat TB in the 1950s. A strong commitment to public health practices was also necessary. Before the 1950s, TB was a killer disease in the United States.

Tuberculosis in History
Tuberculosis (TB) has killed more than a billion people (1,000,000,000) during the past 200 years. In the United States during the 1800s, it was the main cause of death. TB is still killing people today (see Tuberculosis Today, below).

Even though there were no drugs to treat TB until the 1950s, there was still a kind of cure: people who were infected with the TB bacteria could benefit from fresh air, rest, and sunshine. People with TB were encouraged to live in a "Sanitorium" where they could be cared for. Many people moved to our region as part of a cure for TB during the late 1800s and early 1900s.

With no easy cure for TB, medical experts thought about ways to prevent it. They observed that the family members and co-workers of people with TB were catching the disease in their lungs. It appeared that the violent coughing of TB sufferers was spreading the bacteria through the air and into the lungs of people nearby. This was a good explanation for why people in crowded cities and factories were more likely to catch TB.

In the late 1800s, the cities of the United States were growing quickly, and new arrivals to a city usually could only afford to live in rickety, overcrowded buildings. Usually they had to work long hours in crowded factories, too. Medical experts recognized that these cities were a perfect breeding ground for the TB bacteria (which had been discovered in 1882).

In the early 1900s, a group of concerned citizens and doctors formed the Association that would eventually become the American Lung Association. Their mission was to fight TB through public education and treatment for those with TB. They suggested changes that would prevent the spread of TB. They encouraged a public health movement to provide sanitoriums to house people with the disease. They urged improvements in the living and working conditions for poor people so that the bacteria would not flourish as easily.

Because TB was a killer disease spread through the air, an outbreak of TB would often spark fear, as neighbors felt afraid that they, too, might catch the disease. This in turn promoted secrecy and shame as families tried to hide the fact that one of their loved ones had TB disease. In San Diego, people who lived near a TB sanitorium asked the government to shut it down. The Supreme Court of California kept it open, however, because of the need to provide treatment for TB disease.

In the United States, the story ends with optimism. New drugs and improved public health have kept TB in check.

But elsewhere, TB is still a killer disease that grows because of poverty and the lack of knowledge.

Tuberculosis Today
Today in many parts of the world Tuberculosis (TB) is a rampant disease. This year more than 2 million people will die from it. In 20 years this number could grow to 35 million deaths per year.

Right now, one-third of the world's people carry the TB bacterium. The challenge is to make sure that their infection doesn't grow worse and become active TB disease.

Because people are free to travel all over the world, TB outbreaks in one country can spread to other countries. In San Diego and Imperial Counties, TB can be found in communities whose members have immigrated to the United States from countries where TB is widespread. It is also a problem for people who have diseases that weaken their immune system (such as AIDS or kidney failure). The important thing is to find TB wherever it is and begin treatment with anti-TB drugs.

TB is a stubborn bacteria. Drugs don't kill it easily. They must be taken for a long time to do the job completely. Sometimes a new strain of the TB bacteria is able to fight off the drugs meant to kill it. This is a new and even more dangerous form of TB called "Multiple Drug Resistant" or MDR TB. About one in ten TB cases is of this type.