The rare disease killed the actress who played Scarlett O’Hare and Henry David Thoreau, the author of the book known by many as “On Walden Pond”!
On May 6th 1862, at the age of 45, the author of the book, “Walden” passed away from a disease that was both common and incurable. His book would later be known to many as “on Walden Pond” as they read the classic words written a century earlier. That year naturalist Henry David Thoreau would pass away as a result of consumption, better known today as Tuberculosis. During his time this disease was a common ailment that took many lives. At forty five he was an old man; today he would just be going through his midlife crisis.
Slightly more than a century later the Indian born actress who won an Oscar for her portrayal of the glamorous Miss Scarlett O’Hara would meet the disease that had moved to the status of a Rare Disease in the United States as a result of a successful vaccination program. On July 8th 1967, Miss Vivian Leigh succumbed to Tuberculosis, a disease realizing a revival that would make any old time preacher man proud. Miss Leigh was 53 years old.
What is it about this disease that was once common, nearly passed into oblivion, and now appears to be making a comeback that would be the envy of a great actor or actress.
Tuberculosis is a rare disease (attacks less than 200,000 Americans per year) that usually attacks the lungs. It can attack other parts of the body but the most common form of the disease is seen attacking the lungs.
The disease can be fatal if not treated or if it is a form resistant to treatment. The treatment resistant forms may or may not be able to be treated with currently available medications.
Each year it is estimated that nine million people contract the disease and two million die world wide. In the United States the number of people who died from Tuberculosis has steadily gone down with effective treatment programs. In 1953 84,304 people died from Tuberculosis (also known as TB) in the United States. In 1967, the year Miss Leigh died, 47,767 people succumbed to the disease. And in 2005 only 14,097 people died from the disease in the U.S.
It is estimated that only one in ten people who have the bacteria, Mycobacterium tuberculosis, in their body will actually get the disease. This is because most healthy people have immune systems that can fight off the infection. Unfortunately the ability to fight the infection without eliminating the disease from our bodies; makes us the perfect target for the disease when something causes our immune systems to be compromised.
Symptoms of TB are similar to any lung infection in most cases. Coughing, congestion, sneezing and so forth can be symptomatic of the disease. If you have these symptoms and your immune system is not compromised, you probably have a cold, flu or allergy. If your immune system is compromised by AIDS, Cancer, Leukemia or treatments that affect the immune system it is one of many possibilities.
In the United States TB is rare in part because the government usually does a good job of isolating the disease and quickly making sure anyone who came in contact with someone with TB is tested and if need be treated.
I personally experienced how the government responds when I worked in a shipyard where a food worker was identified with TB. Every person with whom the worker had come in contact with was notified and tested, including myself.
The chance of getting TB from incidental contact with a carrier of the disease is very low. Although the disease can be spread through the air it usually requires a lot of contact with the infected person to contract the infection. Even when one is infected, the chance of developing of communicable disease is low for those who have healthy immune systems.
In order to identify TB the Centers for Disease Control (CDC) uses a set of criteria.
First a positive skin test is needed.
Then they look for signs and symptoms of the disease. They use things like x-rays and other tests to look for chest abnormalities.
Third they will order laboratory samples to confirm that the M. tuberculosis is present.
Treatment, which will probably begin early after the disease is suspected, will usually be in the form of two or more antituberculosis medications. This reduces the likelihood of a treatment resistant form of the disease surviving the treatment.
The term TBI is used to identify people who have the germ in their body but are not in a diseased state and are not contagious.
The term TBII is used to identify people who have the germ in their body and are in a diseased state. They may be contagious if they are not currently under treatment.
Treatment for TB can take from nine months to more than a year. Successful treatment requires strict adherence to the treatment as prescribed. This generally works well in the United States but is a major barrier to containing the disease beyond our shores.
Symptoms associated with TB are: a cough which will not go away, unexplained weight loss, loss of appetite, constant tiredness, night sweats, fever and coughing up blood. These symptoms also are related to other diseases. A visit to a medical doctor is the best way of determining just what the symptoms are truly related to.
Those who are most at risk are people with compromised immune systems. Diseases that commonly are associated with compromising immune systems are diabetes, leukemia, many cancers, silicosis (dust disease), AIDS and many other diseases and conditions. Treatments for many diseases also compromise the immune system in order to target diseased areas. Poor personal health brought on by alcohol, drug abuse and malnutrition are other things that can leave the immune system severely compromised.
Health workers that have constant close contact with TB patients have a special risk and need to maintain vigilance.
Even with rises in AIDS, Diabetes and similar conditions, TB is a rare disease in the United States and the unnecessary deaths from it continue on a downward slope.
In the developing world the situation is just the opposite. This represents a problem for us in both the fact that the disease is expected to kill two million people every year between now and 2020. Unless we find ways to bring medical care to these places the human suffering will continue. In many countries, singers, actors, actresses, teachers, politicians and other wonderful human beings are having their lives cut short by a totally preventable and curable disease.
One note, presently more than half of the people who die in the U.S. emigrated here from other countries. Surprisingly they are divided one third from Mexico, one third from Asia and one third from all other countries. And just so this doesn’t start a new myth, they have been here for more than five years before they showed any signs of the disease. Given that most are here for more than five years before they develop the disease, it is not clear if they are carrying the germ with them when they enter the country or whether living conditions here are placing them at risk. Either way there is a possibility that these lives could be saved by finding out which situation was true.
There is a vaccine for TB called Bacille Calmette Guerin (BCG). It is the most widely used vaccination in the world. Created by Albert Calmette in 1919, BCG was first used in 1921 in humans. BCG is made of a live, weakened strain of Mycobacterium bovis, (a cousin of Mycobacterium tuberculosis, the TB bacteria). It is not used in the United States where TB is rare. It can create a false result on the current TB tests. There are side effects and conditions like pregnancy that are contra-indicators for this vaccine.
A new vaccine MVA85A has been developed in England and will be tested in the coming year in Gambia. The first test results indicate that when used as a booster to the BCG vaccine, MVA85A creates a much more robust increase in the “T” cells that help protect children from TB.
In the United States testing with the use of drugs continues to reduce the total number of TB cases from over 80 thousand in 1953 with nearly 20 thousand deaths; down to a little more than 14 thousand in 2004 and less than 700 deaths.
In the United States the disease is under control. In the world as a whole the disease is having its greatest comeback since World War I. Rural parts of the developing world in Asia and Africa are providing fertile grounds for existing forms of the disease and for new drug resistant forms of the disease that could threaten the developed world.