After all the hype about SARS and now the avian flu one could be tempted to forget about old classics like tuberculosis (TB).Now the Russians are having problems.
Sometimes I suspect that public health is severely misunderstood. It isn't about charity, and it is no place for laissez-faire - even the stingiest of us ought to be aware that permitting diseases to become established beyond certain levels becomes a threat to us all. It's not just that the disease has more chances to get you - it actually becomes more dangerous. (A couple of years ago the Atlantic had an excellent article about this, but I haven't found the link).
How? Disease bugs evolve like anything else. Bacteria such as TB can evolve very rapidly. The critters that survive for the next meal are the ones that will sire the successors. Over time this tends to "mellow out" the bugs - if they're too virulent they'll kill their hosts before they get a chance to spread. But if we make it easier for the disease to spread, suddenly the nastier strains have a better chance of survival. So the spread of such diseases becomes everybody's business - it's no longer about saving someone else's skin, but about saving your own. (with one disgraceful exception, but that's another post).
It's difficult to exaggerate about TB, aka "consumption". It's popularly associated with the lungs, but can in fact get you about anywhere, especially in the bones. It has killed cruelly in the millions, and even into the 60's my smallish Midwestern home town had a large sanitorium for the patients on the edge of town. Losing control of it could be devastating. Yet the last couple of generations probably has heard little of it.
So keep an eye on TB. There's nowhere to run.
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