TUBERCULOSIS

TUBERCULOSIS. Tuberculosis, MTB, or TB (short for tubercle bacillus), in the past was also called "consumption." The disease is a common, and in many cases fatal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis typically attacks the lungs, but can also affect other parts of the body. It is spread through the air when people who have an active TB infection cough, sneeze, or otherwise transmit respiratory fluids through the air. Most infections do not have symptoms, known as latent tuberculosis. About one in ten latent infections eventually progresses to active disease which, if left untreated, kills more than 50% of those so infected. (1)

The classic symptoms of active TB infection are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss (the latter leading to the formerly common term consumption). Infection of other organs causes a wide range of symptoms. Diagnosis of active TB relies on radiology (commonly chest X-rays), as well as microscopic examination and microbiological culture of body fluids. Diagnosis of latent TB relies on the tuberculin skin test (TST) and/or blood tests. Treatment is difficult and requires administration of multiple antibiotics over a long period of time. Social contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in multiple drug-resistant tuberculosis (MDR-TB) infections. Prevention relies on screening programs and vaccination with the bacillus Calmette–Guérin vaccine. (2)

Tuberculosis was romanticized in the nineteenth century. Many people believed the disease produced feelings of euphoria referred to as Spes phthisica ("hope of the consumptive"). It was claimed that sufferers who were artists had bursts of creativity as the disease progressed. It was also believed that TB sufferers acquired a final burst of energy just before they died that made women more beautiful and men more creative.

The Dubuque Herald on June 20, 1874 referred to a group of twenty-three children being present at the gas works when the purifers were changed. It was thought that the escaping gas from the decomposing lime was a remedy if inhaled properly. (3)

After the establishment in the 1880s that the disease was contagious, there were campaigns to stop spitting in public places, and the infected poor were pressured to enter sanatoria that resembled prisons; the sanatoria for the middle and upper classes offered excellent care and constant medical attention. Whatever the benefits of the fresh air and labor in the sanatoria, even under the best conditions, 50% of those who entered were dead within five years (1916).

In 1904 the promotion of Christmas Seals began in Denmark as a way to raise money for tuberculosis programs. It expanded to the United States and Canada in 1907 – 1908 to help the National Tuberculosis Association (later called the American Lung Association). In the United States, concern about the spread of tuberculosis played a role in the movement to prohibit public spitting except into spittoons.

In 1905 the Dubuque County Medical Society was considering a "tent colony" for those with the disease. "The experience of other tent colonies has dispelled any doubt about the effectiveness of the system and a curative method" stated an newspaper article at the time. The tents used, however, were made of wood and not heated. "The temperature problem in winter has been suggested as an obstacle here," but the experience of other places with temperatures no lower than in Dubuque "proves the temperature will be no hindrance here." (4)

On April 30, 1911 churches throughout Dubuque observed "Tuberculosis Sunday." Advocated by the State Board of Health, the services included speeches by prominent physicians. Facts about the disease's cause and prevention were emphasized. (5) In 1917 SUNNYCREST MANOR originally opened as a tuberculosis sanatorium. (6)

There is no record whether "Don't Spit on Sidewalk" bricks were used in Dubuque. However, the proximity of Iowa to Kansas where the idea was born leads to the theory they have have been present. This was a campaign started by Dr. Samuel Crumbine of Dodge City, Kansas after he witnessed tuberculosis patients spitting on the floor of a train. He was especially moved to act after watching one of these patients take a drink from a public drinking cup & then observed a mother giving her child a drink from the same cup without rinsing it first. Dr. Crumbine succeeded in abolishing the common drinking cup, the common or "roller towel", and spitting in public places. He served as the Secretary of the Kansas State Board Of Health from 1904 to 1924. (7)

In Dubuque as in other places, the sufferers of the disease were isolated. Because it was believed that fresh air could help cure the disease, people afflicted were often placed in unheated front porches in the winter on beds with only a thin blanket. Some families built screen-walled sheds for the sufferers to live in on the yard.

In April, 1954 Tuberculosis Control mobile x-ray machines were helping to quell another rise in the disease in Dubuque. Parked near the DUBUBQUE CHAMBER OF COMMERCE building, the mobile unit made more than 500 chest x-rays in 3.5 hours one afternoon. The unit had returned to Dubuque after visiting Cascade, Dyersville, Epworth, Farley and Worthington earlier in the week. In these communities more than 1,700 x-rays given free of charge were made. The unit visited every rural high school in Dubuque County; the program was limited to those who were 16 years-of-age or older. Children under these ages only received x-rays if possessing a physician's request. People over 30 years of age were especially urged to receive the examination. The effort was sponsored by the Dubuque County Tuberculosis and Health Association and was approved by the Dubuque County Medical Society. (8)

The program differed from programs in other parts of Iowa because it included complete coverage of certain groups and was still open to the public.

In 2010 tuberculosis is one of the three primary diseases of poverty along with AIDS and malaria. The Global Fund to Fight AIDS, Tuberculosis and Malaria was started in 2002 to raise finances to address these infectious diseases. Globalization has led to increased opportunities for disease spread. In 2007, a tuberculosis scare occurred when Andrew Speaker flew on a transatlantic flight infected with multi-drug-resistant tuberculosis.

In the United States, the National Center for HIV, STD, and TB Prevention, as part of the Center for Disease Control and Prevention (CDC), is responsible for public health surveillance and prevention research.

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Source:

1. "Tuberculosis." Online: Wikipedia

2. Ibid.

3. "Little Crusaders," Dubuque Herald, June 20, 1874, p. 4. Online: https://news.google.com/newspapers?nid=uh8FjILnQOkC&dat=18740620&printsec=frontpage&hl=en

4. "Plan to Have Tent Colony," Telegraph-Herald, November 17, 1905, p. 3

5. "Churches Observe Tubercular Sunday," Dubuque Telegraph-Herald, May 1, 1911, p. 8

6. "Coffeyville Bricks," Coffeyville, Kansas website. Online: http://www.coffeyville.com/index.aspx?NID=337

7. Hogstrom, Erik, "1954: Officials Tried to Curb Local Tuberculosis Cases," Telegraph Herald. April 12, 2024, p. 2A

8. Ibid.