Tuberculosis, the forgotten pandemic but that persists in Peru

This Thursday March 24 is the World Tuberculosis Day. The date, designated by the United Nations, seeks to motivate the fight against this respiratory disease, which has a mortality rate of 50% in untreated infections, much higher than COVID-19. Despite a century of efforts and advances to combat it, tuberculosis (TB) causes more than 1.5 million deaths each year.

One of the casualties of the pandemic was the global effort to eradicate tuberculosis. With the rapid spread of the new coronavirus, the need to isolate activities and personnel, and the scarcity of resources, a global health emergency situation was created, causing the urgent to sideline the important.

Combat of more than a century

The date of celebration remembers the day of 1882 in which the German Robert Koch made public his discovery of the cause of the disease: a microscopic bacillus, ‘Mycobacterium tuberculosis‘. Koch had already discovered the microbe that causes anthrax and confirmed the cause of cholera (‘Vibrio cholerae’).

The tuberculosis it has possibly existed since prehistory. We have definitive evidence in identifiable genetic remains of bacilli found in mummified bodies, including confirmed cases of tuberculosis in pre-Inca and ancient Egyptian mummies. Without effective treatment, the disease continued to affect and kill people throughout history. For many centuries, tuberculosis was treated indirectly, relieving symptoms and strengthening the patient.

“The fight against TB in Peru has made notable progress, reducing its incidence in the last decade.”

Transmission and prevention

At the beginning of the 19th century, the development of modern medicine and scientific study began to differentiate the tuberculosis of other ills, to identify their origin and to achieve advances in prevention. It was also speculated -correctly- that it could be infected by drinking infected milk. Thanks to pasteurization (invented by Louis Pasteur, some 20 years before Koch’s findings), milk was no longer a vehicle for the transmission of tuberculosis and other diseases.

Despite the advances, the 19th century was also a time of great contagion. The industrial revolution generated the explosive growth of urban centers.

Sanatoriums away from overcrowding became popular, where the sick could breathe fresh air, rest and eat well, which helped those with sufficient means to recover and heal.

The tuberculosis it is not spread as easily as COVID-19. Contagion requires prolonged or frequent exposure with active, non-latent or asymptomatic infected. Most people casually exposed to ‘Mycobacterium tuberculosis‘, if they have healthy defenses, they defeat the bacillus before it multiplies.

“Despite the advances, the 19th century was also a time of great contagion. The industrial revolution generated the explosive growth of urban centers.

The tuberculosis it is more common than many would think: up to 25% of the world’s population, mostly in Africa and Asia, have been exposed. because the bacillus, in order to escape the body’s defenses, has walled itself off by wrapping itself in protective material and ceasing activity.

The bacillus can multiply and thrive when conditions become right. For example, when the person is malnourished, with weak defenses and lungs, and lives or works in conditions that constantly expose them to contagion. As Dr. Uriel García Cáceres, distinguished researcher of this disease in Peru, has said:

Treatment and vaccines

The tuberculosisIt can usually be detected with x-rays of the lungs due to the lesions caused by the bacillus, and confirmed by laboratory tests. It is cured with antibiotics, but the bacillus is stubborn and requires about six months of uninterrupted treatment.

If they are not used continuously until eliminated, the bacillus can generate resistance, making the antibiotic useless. This creates resistant strains, whose treatment is more complicated, extensive and even useless. The disciplined and complete use of antibiotics is imperative.

With the benefit of advances made during the pandemic, including RNA vaccines, new vaccines are being developed that are expected to be more accessible and effective.

The fight against tuberculosis in Peru it has made notable progress, reducing its incidence in the last decade. Our free screening and treatment mobile campaigns have been emulated around the world.

We cannot neglect detection and treatment, supported by awareness and prevention; neglecting ourselves would have a cost in health and progress. As the motto of this year’s World Tuberculosis Day says, we must

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