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Tuberculosis

I have a list of people and a disease in mind. The list of people: Anne and Emily Bronte, Catallus, George Orwell, Jean-Jacques Rousseau, Walt Whitman, Frederic Chopin, Niccolo Paganini, Henry Purcell, Igor Stravinsky, Ringo Starr, John C. Calhoun, Andrew Jackson, Sir Wilfrid Laurier, a couple Louis of France, Nelson Mandela, Mary Tudor, Napoleon II of France, Eleanor Roosevelt, Alexander Graham Bell, Anders Celsius, Dmitri Mendeleev, Friedrich Miescher, Immanuel Kant, Erwin Schrodinger, and Florence Nightingale. They are all connected by this disease. Do you know what it is?


If you do, I'm very impressed. The answer I'm thinking of is tuberculosis.


Overview:

- TB stats

- Bacterium/disease/symptoms

- History + cultural significance

I'm not going to start with the disease itself because ✨I feel like it✨ and also these stats will be useful for the third section.


Stats

According to the WHO, TB is (as of April 21, 2023)...

- the 13th leading cause of death globally

- the SECOND leading infectious killer after COVID-19, putting it above HIV and AIDS

In 2021...

- 1.6 million people died from TB

- Estimated 10.6 million had TB - 6 million men, 2.4 million women, and 1.2 million children

- $13 billion USD is needed annually for TB to achieve the global target from the 2018 UN meeting on TB

Those numbers are high. Second leading infectious killer is nothing to sneeze at.


TB: the disease

So why exactly are TB stats so crazy?

TB, caused by Myobacterium tuberculosis generally affects the lungs and often people with TB do not present symptoms, which is called latent TB. Around 10% of latent TB cases eventually become active, which, when left untreated, kill half of those affected. Active TB symptoms include weight loss, night sweats, chronic cough, fever...things you expect from a lung disease, but around 1/4 of folks with active TB are symptomless. TB is airborne but can only be transmitted by someone with the active form. In 15-20% of cases, it can spread outside the lung area (extrapulmonary TB) but I will not go into that because I mostly care about the history. I will say that treatment is hard because TB has this cell wall that's thick and doesn't die when immune cells eat it, so it's also hard to medicate. However, it is possible!


History

"I was hot. I went to parties a lot, ya know?" - Miss Argentina from Beetlejuice: The Musical, but also Myobacterium tuberculosis, probably.

The Dying Artist™

It horrified me to learn that TB was known as "the romantic disease" in ye olden days. Thinking back to the long list of people I started with, many famous artists and other influential figures are known to have had TB. It was associated with poetic and romantic qualities, because nothing says love like coughing bloody mucus, amirite. The disease was often thought to make people more talented because so many great artists were affected by it. Apparently that belief also stemmed from the fever and the bacteria in the blood (that is a very bad thing. VERY VERY BAD). These symptoms were thought to help them see more clearly or something because fever dreams are clearly the same as reality.

Beauty from bacterium

You may remember the crazy Victorian women and their weird beauty things. Well, surprise surprise, having a really dangerous disease is now extremely trendy. We love that emaciated look, and the pale complexion complements it wonderfully. Who cares if you're about to die? Suffer for fashion to new extremes my friends. According to Cultured magazine, this is actually what started the weird "let's eat wafers of arsenic" thing (see arsenic). Ironically, that's probably safer than getting TB. However, TB gives you the added benefits of weight loss and appetite suppression, not to mention more translucent skin. Oh, and did we mention the bacteria in your blood? Sparkly or dilated eyes, rosy cheeks, red lips - anyone feeling like these are fever signs? No? Just me?

The whole tuberculosis thing really emphasized tragically harmful stereotypes and ideas about a disease that still plagues us today. Unsurprisingly and unfortunately, it affects mostly developing areas that lack the funds for prevention and care, but it also disproportionally affects minority groups and those living in poverty. This is a problem that we can solve, but it will take a lot of money and collaboration internationally.


Tuberculosis the disease

Myobacterium tuberculosis

Image from the Myobacterium tuberculosis Wikipedia page.

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