The Forgotten Plague

Although the discovery of three drugs effective against tuberculosis took the combined genius of many researchers, this research centered around the work of Selman Waksman, a Ukrainian Jew transplanted to New Jersey; the German Gerhard Domagk, who had to work in Bayer laboratories battered by bombing raids; and the brilliantly intuitive Swede, Jorgen Lehmann, who was overlooked by the Nobel committee.

In 1933, Domagk discovered that a new chemical, Prontosil rubrum, killed streptococci. In 1947, he found that Conteben, a drug developed from a new group of compounds, the thiosemicarbazones, worked against tuberculosis. This breakthrough was followed by the synthesis of isoniazid, a potent drug against tuberculosis.

Meanwhile, Selman Waksman was working at Rutgers University with Albert Schatz on the properties of soil microbes. What they found was the powerful antibiotic streptomycin. Administered with isoniazid and PAS, streptomycin saved the lives of many tuberculosis patients.

PAS (para-aminosalicylic acid) was synthesized in 1943 by the Swedish chemist Karl-Gustav Rosdahl at the request of the physician Jorgen Lehmann, who deduced that a small change in the aspirin molecule would interfere with the respiration of the tuberculosis germ. Lehmann was right, and he cured his first critical patient in 1944.

Ryan’s work, first published in Great Britain in 1992, chronicles the worldwide resurgence of tuberculosis in recent years. The early success of multidrug therapy has been cut short by the terrifying concurrence of AIDS and of drug-resistant tuberculosis. According to Ryan, the most common secondary infection that threatens the life of the AIDS patient is Mycobacterium Avium Complex (MAC), a strain of tuberculosis first discovered among birds. As the AIDS epidemic spreads and the conditions for the development and transmission of drug-resistant tuberculosis continue to exist, prospects of a serious tuberculosis epidemic seem almost inevitable.