Tuberculosis The Emergence and Re-emergence of Tuberculosis: Prevalence of Multi-Drug-Resistant Tuberculosis in the 21st Century

In the 2003 lung disease statistics, tuberculosis is considered the "foremost cause of death from a single infectious disease," wherein TB is prevalent among developing countries, causing 99% of deaths (ALA, 2004). Indeed, American Lung Association (2004) considers tuberculosis as the an "ancient scourge," gaining prevalence in the 19th century and resurging once again in the 21st century, despite medical technologies developed to curb the said airborne disease. Tuberculosis is an airborne disease that is characterized chronic or acute bacterial infection that attacks the lungs, and can also affect other parts and vital organs of the body, such as the bones, skin, kidney, gastrointestinal tract, and the neck (affecting the lymph nodes) (Reichman, 2002:14). It is caused by Mycobacterium tuberculosis. Symptoms of TB are coughing, chest pain, shortness of breath, fever, chills, and fatigue (Microsoft Encarta 2002).

The development and origins of TB dates back 8,000 to 10,000 years ago. It was earlier detected in Egypt, where mummified corpses where found to contain traces of tubercles, nodes that develop at the onset of TB. However, a comprehensive history of TB by Reichman (2002) traces the development of the disease from cows. Similar to the development of the SARS and avian flu (bird flu) viruses, the disease was theorized in the late 20th century to have originated from cows, and has been transmitted from animals to cows when farmers started living in close quarters and communities with the animals. The bacterium present among TB-carrying cows is the Mycobacterium bovis, which can be transmitted through the air (by breathing, sneezing, or coughing) to another living agent. Apart from being transmitted airborne, the bacterium was also transmitted through the cow's milk, thriving in the warm environment of the human body. As the bacteria learned to adapt and thrive inside the human body, specifically in the lungs, causing it to mutate and develop into another kind of bacterium -- the Mycobacterium...

Thus, TB became not only an animal disease, but a human disease as well (11).
Reichmann discusses in detail the processes that happen inside the human body as the bacteria starts developing tubercles, which signifies the onset of TB. Once the bacteria thrive inside the body, it will begin multiplying itself. However, the body's defense cells, macrophages, prevent the onset of TB by clustering around the bacteria during its process of reproduction. These macrophages, unfortunately, are eventually taken over by the TB bacteria, where they "break into the macrophages and begin multiplying inside them" (14). Once the macrophages are "devoured" by the bacteria, they start forming nodules, creating a lump called tubercle, eventually developing to TB. With the onset of TB, an individual's immune defenses start to weaken, specifically after 3 to 4 weeks of tubercle and TB development.

Since TB is an airborne disease, preventive methods adopted to stop the widespread occurrence of TB, such as the establishment of ventilation systems to prevent the airborne transmission of TB and vaccination of bacillus Calmette Guerin (BCG). Furthermore, with developments in medicine, drug therapy also helped alleviate the spread of TB, and it has become one of the most effective ways to resist and prevent the spread of M. tuberculosis. But over time, over a century after the formulation of BCG vaccine and production of TB-resistant drugs, there have been a recurrence of this disease not only among developing countries (where TB is prevalent), but also in developed countries like the U.S. The recurrence of TB is now identified as the multi-drug-resistant tuberculosis, named as such because of its ability to resist the effects of anti-TB drugs.

This phenomenon is addressed in as early as 20th century, and has remained to be a prevalent issue in the 21st century. In his journal article for the New England Journal of Medicine, Frieden et. al. (1993) addresses this phenomenon, suggesting that the occurrence of drug-resistant TB is mainly caused by "infectious disease for prolonged periods after treatment has…