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The Great Literary Killer Returns

One of the world’s greatest killers is making a comeback. Once thought to be nearly eliminated as a public health threat, tuberculosis is again becoming a serious danger due to a rapid increase in drug-resistant strains of the disease around the world. Although the U.S. has long been able to avoid most of the deadlier varieties, the boom in international travel has made it easier than ever for deadly strains in other countries to make the leap across the ocean. And sure enough, more of these cases are beginning to appear in the United States, as the Wall Street Journal reports:

“We cannot be safe in the U.S.” while drug-resistant TB is an “epidemic in the rest of the world,” said Barbara Seaworth, medical director of the Heartland National TB Center in San Antonio. Outbreaks are “absolutely” possible in the U.S., said Dr. Seaworth, who has treated hundreds of patients with drug-resistant strains.

Tuberculosis, an airborne disease characterized by the coughing of blood, is one of the world’s great killers. In some developing countries, drug-resistant strains are rampant. A doctor in India this year startled the global health community by finding patients carrying a particularly dangerous strain—one all but incurable. The Wall Street Journal in November detailed how long-standing global strategies for fighting TB have unintentionally helped make the disease harder to cure.

Most drug-resistant cases are imported into the U.S. by foreigners arriving from places where the disease rages. Of 124 multidrug-resistant cases in 2011, 106 were in foreign-born individuals, the CDC says. Most cases are in California and Texas, many along the border with Mexico. Cases come from Mexico, Vietnam, and India, among others. The U.S. doesn’t vaccinate against TB because there is no vaccine considered widely effective for adults.

Consumption was a favorite of 19th-century authors and composers, killing the young and the beautiful slowly and lyrically. This is how Mimi died in La Bohème. It is how Violetta died in Verdi’s La Traviata. It is the disease that dominated Thomas Mann’s Magic Mountain. And countless real-life authors and artists succumbed to the disease as well. Indeed it may have killed as many as one out of four Europeans during parts of the 19th century.

That such a dangerous and contagious disease may be returning in an era of urbanization and globalization is a truly frightening thought.

[Correction: A previous version of this post mistakenly claimed that Beth of Little Women died of consumption. She died of scarlet fever. This error has been corrected.]

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