Assignment Task: Tuberculosis in Social Context E.L. Trudeau was quick to distinguish between a helpful therapy and a cure. He opened the Adirondack Cottage Sanitarium, where poor and rich alike could come and receive the benefits of fresh air, plenty of sunlight, rest, and abundant but simple nourishing food. Hundreds benefited. Similar institutions opened up in the U.S., and the movement was already well underway in Western Europe. But the cure would only come in the 1950s with the discovery of antibiotics that were effective against the mycobacterium.
Question 1: The curve shown in Figure has three parts, from 1700-1800, 1800 to approx. 1955, and 1955 to approximately 1985. Te data used to produce the curve are from Western Europe, but a similar one could be expected for the United States. From what you know of the history and culture of the United States and Western Europe, write a sentence telling why each part of the curve looks the way it does. In looking just at this graph, what would you predict about the death rate from TB in 2000 and 2005? In recent years, a combination of development of antibiotic resistant strains of MTb along with the creation of a reservoir of immuno compromised people by the worldwide AIDS epidemic have contributed to a resurgence of tuberculosis in the United States and Figure 2: Western European mortality statistics-TB deaths over time (Based on Murray, 2001). 1700 1750 1800 1850 1900 1950 2000 Death rate per 100,000 1000 500 100 50 10 5 1 0.5 Year a worldwide upswing in TB cases and deaths. This resurgence has been accompanied by a resurgence of interest in the disease by scientists asking new questions about the nature of true host genetic susceptibility/resistance genes for tuberculosis, about virulence genes within the mycobacterium itself which might offer new drug targets, and about the epigenetic factors that may influence disease predisposition and outcome in people with tuberculosis.
Question 2: Tuberculosis causes nearly 2 million deaths worldwide each year. Between 1985 and 1992, cases of TB in the United States increased by 20 percent, as shown in Figure
Question 3: Write a paragraph suggesting a few reasons why this resurgence of TB might have occurred in the United States. Question 3: Te resurgence lasted until approximately 1992, then, in the United States, it began to abate. In 2005 the TB case rate in the U.S. was 4.8 per 100,000, as the U.S. medical community brought the epidemic under control (Centers for Disease Control & Prevention, National Prevention Information Network, n.d.). However, in U.S. prisons and all over the world TB remains a serious health problem. In the U.S., zero tolerance drug laws have resulted in a burgeoning incarcerated population, which constitutes a significant reservoir of disease, with a far higher incidence rate than the general population. In New York prisons, the incidence rate of TB is 156.0/100,000compared to the rate of 10.4/100,000 in the general population (U.S. Agency for International Development, 2009). Considering all you have learned in Parts I and II, discuss why these rates may be so much higher in prison.