Discovering Tuberculosis

May 15, 2015

Tuberculosis (TB) has been an infectious scourge for thousands of years. Robert Koch discovered the cause, Mycobacterium tuberculosis, in 1882, but the disease continues to be a major public health dilemma in many parts of the world--one billion people will contract TB by 2020. McMillen (history, Univ. of Virginia) examines the attempts to control the disease, which, for the most part, have failed. Early efforts to track the problem led to the belief that there were racial links--Africans and Native Americans appeared to be more likely to be infected. This genetic theory turned out to be false. Two French researchers, Albert Calmette and Camille Guerin, developed the BCG vaccine to prevent TB, but its effectiveness varies widely and it is not used everywhere for this reason. Mycobacterium tuberculosis is also resistant to most antibiotics, making it extremely difficult to treat. The disease is most prevalent in third-world countries and those who are infected with HIV are also likely to contract it. Given all of these issues, the author notes that the best a historian can do is make readers aware so that they can try something new instead of repeating past unsuccessful efforts. VERDICT Readers interested in medical history and those working in public health fields will learn a great deal from this fascinating look at an old disease that is still very much with us.--Barbara Bibel, formerly Oakland P.L.

Copyright 2015 Library Journal, LLC Used with permission.

June 1, 2015
Tuberculosis is an ancient and resilient infectionthe most lethal disease in human history. Even today, TB resides dormant in an estimated two billion individuals. In this scholarly work (supported by nearly 100 pages of notes and references), historian McMillen investigates why we continue to struggle to control TB despite the availability, for over 50 years, of drugs to treat it. His discussion highlights the issue of race and TB, different methods to keep TB in check, and the TB/HIV coepidemic. Obstacles to the prevention and cure of tuberculosis are related to treatment, multidrug-resistant strains of the bacteria, drug delivery, and a predilection of TB to prey on poor people. He comprehensively chronicles the controversial BCG (Bacillus Calmette-Guerin) vaccination program, noting that more individuals worldwide have received the safe but ineffective BCG than any other vaccine ever. The teaming of an old scourge (TB) and a modern plague (HIV) remains an ongoing medical challenge. Despite breakthroughs, our attempt to rein in tuberculosis continues to include setbacks, frustration, and failure. McMillen's important study shows why.(Reprinted with permission of Booklist, copyright 2015, American Library Association.)