130 years ago, a spring was born for those suffering from tuberculosis. On the night of March 24, 1882, the German Heinrich Robert Koch presented, in the amphitheater of the Berlin Society of Physiology, for the first time, the microbial agent causing tuberculosis: the bacillus of Koch, as it became known, later and in your honor (Mycobacterium tuberculosis is its scientific name).
Silence followed his presentation and no one coughed. That night was a milestone in humanity's incessant struggle against the anthrax of tuberculosis, a disease that killed (and kills) a very significant percentage of the population.
In addition, Robert Koch would win, in 1905, the Nobel Prize in Physiology or Medicine for his pioneering work in epidemiology.
This discovery was very important. The article of his discovery established the first aetiology of tuberculosis and contained the important Postulates of Henle-Koch. These make it possible to establish, even today, a causal relationship between a given microbial agent and a given disease. It should be noted that the postulates were only revised in 1976 by Alfred Evans, such was their clinical and scientific robustness.
Since then, and similarly to other diseases, identifying the bacillus is essential to stop its spread by contagion and thus be able to treat those infected.
Today we know that Koch's bacillus is a distant companion of human evolution. Already existing long before our first hominid ancestors, surely even before the first mammals, the M. tuberculosis it has adapted amazingly to human lung tissue. In such a way that the lung is its shelter par excellence, its microbial paradise, and it is very difficult to fight it once installed there.
To make matters worse, and just like with other bacteria, this bacillus has the ability to gain resistance to the antibiotics we've developed against it.
In particular, the M. tuberculosis it develops multi-resistance, that is, it resists cocktails of various antibiotics, so the rampant relapse of tuberculosis worldwide is a growing concern for health authorities.
And in fact, the apparent public tranquility contrasts with the large number of research projects on tuberculosis currently underway worldwide.
This was inventoried in 2012 in the journal “The Lancet Infectious Diseases”, in an article in which the main areas of research referred to in 33 other publications are highlighted. Particular concern is found worldwide in the prevention and treatment of multidrug-resistant tuberculosis in people infected with HIV.
The importance that the discovery of Koch's bacillus 130 years ago had for the history of modern medicine is reviewed, from various perspectives, in an article now published in the "New England Journal of Medicine".
This article highlights the great disparity between public knowledge, the political agenda for public health and the cruel reality of the numbers of deaths caused today by tuberculosis. 500 new cases of MDR-TB patients have emerged every year!
In Portugal, although the disease is apparently under control, data from the World Health Organization indicate the detection of about 2600 new cases in 2009 and an incidence of 29 per 100 inhabitants in 2010.
Author Antonio Piedade
Science in the Regional Press – Ciência Viva
Article References:
J. Rylance, M. Father, C. Lienhardt, P. Garner. Priorities for tuberculosis research: a systematic review. The Lancet Infectious Diseases, volume 10, Issue 12, pages 886 - 892, December 2010. doi:10.1016/S1473-3099(10)70201-2
S. Keshavjee, PE Farmer, Tuberculosis. Drug Resistance, and the History of Modern Medicine. New England Journal of Medicine, volume 367, pages 931-936, 6 September, 2012.
http://www.nejm.org/doi/full/10.1056/NEJMra1205429?query=featured_home
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