How Tuberculosis Is Spread And Methods Of Prevention
( Originally Published 1936 )
Tuberculosis of the lungs (consumption) is one of the most hopeful of all chronic diseases. Hopeful for the individual who has it because cure is probable.
Hopeful, too, for the world, because, more than any other chronic disease, it is disappearing.
Tuberculosis can now almost be said to be a rare disease. In Denver, which, on account of its climatic position, is naturally a criterion for the prevalence of tuberculosis, deaths from tuberculosis fell from nearly 700 in 1917 to 459 in 1927. Comparing this with another chronic disease, heart disease, in Denver heart deaths in-creased from 157 in 1917 to 449 in 1927.
The decline in the death rate represents also a decline in the number of cases of tuberculosis. This decline has been going on for over 50 years. Tuberculosis, which was once "Captain of the Men of Death," is no longer so.
The cause of this decline in the amount of tuberculosis in the world is probably due to many factors. Better living conditions, more out-door living, more abundant food supply have all played important parts.
What can we do to help control this disease and drive this plague from the face of the earth?
One thing is to support public health measures aimed at the inspection of dairy herds. There is a distinct kind of tuberculosis which occurs in cattle—bovine tuberculosis—and this form can infect man.
The germs get in the milk and infect the intestinal tract of infants. Careful dairy inspection will stop this source.
The anti-spitting campaign can be enforced by marshalling public opinion. Most human tuberculosis is probably conveyed from one human being to another. The principal source of this cross-infection is droplet infection from a tuberculous patient. Sputum carelessly spit out on the street, or more especially indoors, dries, and the germs blow about for others to inhale.
It is perhaps fair to say that a large majority of people with tuberculosis do not know they have it. And they may live to ripe years with the disease.
The present theory of the origin of tuberculosis is that it practically always begins in infancy. After the infant is infected, the disease has a certain nature in childhood, and only in early adult life does it assume the characteristic form of tuberculosis of the lungs.
If this theory be true, the infant probably acquires it in most instances from contact with a tuberculous person in the household. Parents, brothers or sisters, nurses or even grandparents are likely to infect a baby by kissing or fondling it. It is a hard, and perhaps unacceptable doctrine, that a beloved member of the household can do this, but for the baby's own safety the people who handle it should know whether they have tuberculosis or not. Any thin person with a chronic cough is a suspect. Too much kissing is bad for the baby under any circumstances.