For almost a century, and with deep satisfaction, the nation’s health workers watched the tuberculosis (ТВ) death rate plunge. They thought they had this airborne killer under control. The germs that caused ТВ were invading fewer people. Health workers even spoke of eradicating tuberculosis, just as they had eradicated smallpox. Everywhere in the United States, ТВ was dying out.

Then, about 1989, it became impossible to deny that death rates from ТВ were climbing in the United States for the first time in 80 years. Even more frightening was the discovery that some ТВ microbes had grown so strong that they now were able to withstand the drugs that formerly had wiped them out.

“ТВ was noticed again in November 1991, when a prison guard in Syracuse, New York, died of it,” says Dr. Lee B. Reichman, an expert in the treatment of ТВ. “There were stories about his death in newspapers across the country.” It was found that the guard had died of drug-resistant tuberculosis -meaning that, although the guard had been treated, the drugs couldn’t save him.

“There is no question that this resurgence of ТВ is a national catastrophe,” adds Dr. Reichman. “But the tragic part is that almost all ТВ is eminently treatable and preventable.” Reichman heads the National Tuberculosis Center in Newark, New Jersey. He also is a professor at the New Jersey Medical School.

In 1953, there were 84,304 reported cases of ТВ in the United States. By 1985, the number had fallen to 22,201. Reported cases began climbing again in 1986 and reached 26,673 by 1992. Though the number of ТВ cases is on the rise, the average healthy individual usually is not at risk. In fact, 90 percent of those exposed to the disease by inhaling the infectious microbe do not come down with ТВ. The germ is enveloped in scar tissue, which prevents its spread. The disease then lies dormant and may go undetected for an entire lifetime. It is in combination with malnutrition or infection with some other disease that the microbes become aggressive and possibly fatal.

When I was in high-school in the early 1940s, 85 percent of my fellow students, including me, tested positive for ТВ. That means that those young people had been exposed to ТВ. For unclear reasons those hidden germs remain dormant for the next half century. The germs were effectively trapped. They could not infect anybody else.

As a result, fewer and fewer young people were exposed to the disease. (And, at the same time, the ТВ death rate plunged.) Today, about 15 percent of the population, mostly in the poor inner city, tests positive.

The ТВ bacterium generally attacks the lungs, but it can spread to other body parts, including the brain, kidneys, or bones. Symptoms include persistent coughing, weight loss, fever, and spitting up blood. If you or someone in your household has such symptoms, see your doctor immediately. A quick test usually can tell whether you have ТВ. The doctor gives you an injection. If the skin hardens around the area of the injection within a few days, the doctor further examines you for ТВ. If you have it, you can be treated and made non-contagious within 2 weeks. Often, you can be cured within 6 months.

“It is not easy to catch ТВ,” says Dr. Reichman. “You need, on average, to be in contact with the disease 8 hours a day for six straight months – and even then you have only a 50 percent chance of getting it.”

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