Timeline of tuberculosis

This is a timeline of tuberculosis, describing especially major discoveries, advances in treatment and major organizations.

For a comprehensive treatment of the subject, see History of tuberculosis.

Big picture

Year/period	Key developments
Ancient times	Typical skeletal abnormalities of tuberculosis, including characteristic Pott's deformities, are found in Egyptian mummies and are depicted in early Egyptian art. Tuberculosis is also noted in the Biblical books of Deuteronomy and Leviticus. Written texts describe tuberculosis in India as early as 3300 years ago and in China 2300 years ago. Tuberculosis is well known in classical Greece, where it is called phthisis.[1][2]
Middle Ages and Renaissance	The incidence of tuberculosis grows progressively in these times, displacing leprosy, peaking between the 18th and 19th century as field workers move to the cities looking for work.[3] In parts of Europe, tuberculosis is known as the “king’s evil” and is widely believed that the kings of England and France can cure scrofula simply by touching those affected.[4]
1700s–1800s	Description of tuberculosis is developed in medical literature. Toward 1800s sanatoria start to open for treating patients, with often successful outcomes. Understanding of the pathogenesis of tuberculosis begins with the works of Laennec, Villemin and the identification of the tubercle bacillus as the etiologic agent by Robert Koch.
1920s–1930s	The International Union Against Tuberculosis (IUAT) is founded. BCG vaccine against tuberculosis is developed. Several international conferences are held, focusing on the fundamental, biological, clinical and social aspects of tuberculosis.[5]
1940s onward	During the Nazi occupation of Poland, SS-Obergruppenführer Wilhelm Koppe organized the execution of more than 30,000 Polish patients suffering from tuberculosis - little knowing or caring that by that time, a cure was nearly achieved. The isolation of streptomycin is generally considered the beginning of the modern era of tuberculosis. The revolution continues with the development of isoniazid, the first oral mycobactericidal drug. The advent of rifampin in the 1970s hastens recovery times, and significantly reduces the number of tuberculosis cases in the following years.[6][7] In Italy for some decades the Italian competitor of the French tubercular vaccine BCG vaccine.was the Salvioli's diffusing vaccine (acronym 'VDS from its Italian name Vaccino Diffondente Salvioli) used from 1948 until 1976. It was prepared by professor Gaetano Salvioli (1894–1982) of the University of Bologna.
1980s onward	Tuberculosis drug-resistant strains appear, provoking a rise in incidence in countries like Britain. Also, the association with AIDS has contributed to the rise of tuberculosis in some sectors.[8]
Present	Today, tuberculosis continues to be a top infectious disease killer worldwide. However, the death rate has dropped 47% since 1990. Over 95% of cases and deaths are in developing countries, with the most severe burden in Africa.[9] At least 1 million children fall ill with tuberculosis each year, represent about 11% of all cases.[10]

Full timeline

Evolution of incidence of tuberculosis cases per WHO region for the period 1990-2014.[11]

Year/period	Type of event	Event	Location
1689	Development	English physician Richard Morton first states that tubercles are always present in the tuberculosis disease of the lungs.[12]	England
1761	Development	Austrian physician Leopold Auenbrugger develops a percussion method for diagnosing tuberculosis.[13]
1768	Development	Scottish physician Robert Whytt gives the first clinical description of tuberculous meningitis.[14]
1779	Development	English surgeon Percivall Pott first describes the arthritic tuberculosis of the spine (today known as Pott disease).[15]
1810	Development	French physician Gaspard Laurent Bayle publishes his article Recherches sur la Pthisie Pulmonaire, in which he divides phthisis into six types: tubercular phthisis, glandular phthisis, ulcerous phthisis, phthisis with melanosis, calculous phthisis, and cancerous phthisis, basing his findings on more than 900 autopsies.[16]
1816	Development	French physician René Laennec, working at the Necker-Enfants Malades Hospital, develops the stethoscope, which proves to be a breakthrough. The stethoscope marks a major step in the redefinition of disease from being a bundle of symptoms, to the current sense of a disease as a problem with an anatomical system even if there are no noticeable symptoms. The work of Laennec is considered to have clearly elucidated the pathogenesis of tuberculosis and unified the concept of the disease, whether pulmonary or extrapulmonary.[17][18]	Paris, France
1839	Development	German naturalist Johann Lukas Schönlein is attributed with naming the disease tuberculosis.[19]
1854	Organization	Hermann Brehmer establishes the first German sanatorium for the systematic open-air treatment of tuberculosis, with treatment including adjusting lifestyle at high altitude, abundant diet with some alcohol, and exercise in the open air under strict medical supervision. The results are eventually regarded as highly successful, surpassing any previous treatment.[20]	Strehlen, Prussia
1865	Development	French physician Jean Antoine Villemin demonstrates of the transmissibility of Mycobacterium tuberculosis.[2]	France
1882	Discovery	German physician Robert Koch, a founder of modern bacteriology, identifies the tubercle bacillus as the etiologic agent that causes tuberculosis. Some years later, Koch develops what today is known as Koch's postulates, which he applies to describe the etiology of cholera and tuberculosis. Koch is also attributed for having created and improved laboratory technologies and techniques in the field of microbiology, and making key discoveries in public health. Koch receives the Nobel Prize in Physiology or Medicine in 1905.[2]
1890	Discovery	Hungarian physiologist Franz Tangl publishes what later became known as Baumgarten-Tangl law, stating that the location where the bacteria intrudes is the one where the inflammation can be observed first.[21]
1900	Study	French bacteriologists Albert Calmette and Camille Guérin begin research for an antituberculosis vaccine at the Pasteur Institute.[22]	Lille, France
1903	Organization	American entrepreneur Henry Phipps, Jr. founds the Phipps Institute for the Study, Treatment and Prevention of Tuberculosis at the University of Pennsylvania.[23]	Philadelphia, US
1904	Organization	The National Association for the Study and Prevention of Tuberculosis (NASPT) is founded.[24]
1907	Development	French physician Charles Mantoux introduces his eponymous Mantoux test as a serological skin test to determine whether a person is infected with tuberculosis.[25]
1908	Development	French physician Charles Mantoux, perfects test for diagnosis of tuberculosis contact (latent tuberculosis).[26]
1909	Organization	American philanthropist Nathan Straus opens the first preventorium for patients infected with tuberculosis.[27]
1921	Development	Bacillus Calmette–Guérin (BCG) vaccine is first administered. It is still the only vaccine available against tuberculosis.[22]	Paris, France
1930	Crisis	Lübeck disaster. 250 newborn babies are given doses of BCG contaminated by virulent tubercle bacilli. After four to six weeks a large number of the infants develop tuberculosis. 73 babies die in the first year and another 135 are infected but finally recover.[22]	Lübeck, Germany
1932	Development	The Löwenstein–Jensen medium is developed as diagnosis for tuberculosis. It is used for culture of Mycobacterium species, notably Mycobacterium tuberculosis.[28]
1936	Development	Brazilian physician Manuel de Abreu develops chest photofluorography, a technique for mass screening for tuberculosis.[29]	Rio de Janeiro, Brazil
1944	Development	Swedish chemist Jörgen Lehmann develops antibiotic 4-aminosalicylic acid for treating tuberculosis.[30]
1944	Development	Albert Schatz, Elizabeth Bugie, and Selman Waksman at Rutgers University isolate streptomycin, the first antibiotic and first bacterial agent effective against tuberculosis.[31]	New Jersey, US
1946–1948	Treatment	The first randomized trial of streptomycin against pulmonary tuberculosis is carried out.[32][33]	United States
1948	Treatment	Researchers at Britain's Medical Research Council demonstrate that combined treatment with streptomycin and 4-aminosalicylic acid is superior to either drug alone.[34]	UK
1950	Campaign	Mass tuberculosis immunization is under way with the BCG vaccine. This vaccine is recommended to be given intradermally, immediately after birth. This vaccine is mandatory to attend school in France between 1950 and 2007, introduced in Brazil in 1967, and to the Philippines in 1979.[35][36][37]
1952	Discovery	Isoniazid is first used in the treatment of tuberculosis.[2][38]
1952	Treatment	The amino acid derivative cycloserine is first isolated. It is found to be effective against Mycobacterium tuberculosis.[39]
1962	Treatment	The bacteriostatic drug ethambutol is developed as a medication primarily used to treat tuberculosis.[40]
1971	Treatment	The antibiotic rifampicin is first sold as a medication to treat several types of bacterial infections, including tuberculosis.[41]
1976	Organization	The Seattle Biomedical Research Institute (today known as Center for Infectious Disease Research) is founded as a non-profit organization focused solely on infectious disease discovery research, including tuberculosis.[42][43]	Issaquah, Washington, US
1995	Program launch	The World Health Organization launches DOTS (Directly Observed Treatment, Short-Course) program as a control strategy for tuberculosis. DOTS works as an intermittent, supervised system of drug intake by patient, which eliminates drug default. DOTS has been described by WHO as "the most important public health breakthrough of the decade in terms of lives saved".[44][45]
1998	Development	The mycobacterium tuberculosis (H37Rv strain) genome is sequenced, with aims at helping scientists develop better therapies, ranging from treatments for tuberculosis to vaccines to prevent it.[46][47]
1999	Campaign	Médecins Sans Frontières launch the Campaign for Access to Essential Medicines. It pushes to lower the prices of existing drugs, vaccines and diagnostic tests, to stimulate research and development into new treatments for diseases (tuberculosis among them) that primarily affect the poor.[48]
2000	Organization	The Mycobacterium tuberculosis Structural Genomics Consortium is formed as a worldwide consortium of scientists with the goal of providing a structural basis for the development of therapeutics for tuberculosis. The consortium has five core facilities (located at Lawrence Livermore National Laboratory, Los Alamos National Lab, Lawrence Berkeley National Laboratory, University of California, Los Angeles and Texas A&M University) that carry out an increasing fraction of routine tasks such as protein production, crystallization and X-ray data collection.[49]	United States
2000	Organization	The Global Alliance for TB Drug Development (TB Alliance) is established as a nonprofit organization dedicated to the discovery and development of new, faster-acting and affordable tuberculosis medicines.[50]	Cape Town, South Africa
2001	Organization	The Stop TB Partnership is established with the purpose of eliminating tuberculosis as a public health problem. It has 1000 partner organizations, including international, nongovernmental and governmental organizations and patient groups.[51]	Geneva, Switzerland
2002	Organization	The Global Fund to Fight AIDS, Tuberculosis and Malaria is founded as an international financing institution dedicated to attract and fund additional resources to stop and treat those diseases.[52]	Geneva, Switzerland
2006	Organization	Unitaid is launched as a global health initiative. It provides sustainable funding in order to tackle inefficiencies in markets for medicines, diagnostics and prevention for HIV/AIDS, malaria and tuberculosis in developing countries. UNITAID finances its project through the international solidarity levy on airline tickets that is currently collected in nine out of 29 UNITAID member countries.[53]	France, Brazil, Chile, Norway and United Kingdom
2008	Organization	The Millennium Foundation for Innovative Finance for Health is established. Its project MassiveGood is meant to collect funds for combating HIV/AIDS, malaria and tuberculosis.[54]	United States, United Kingdom, Germany, Austria, Switzerland and Spain (serves worldwide)
2009		WHO calls for universal access to tuberculosis culture by 2015.[28]
2012	Treatment	FDA approves bedaquiline for treating multi-drug-resistant tuberculosis. It is the first new medicine for tuberculosis in more than forty years.[55][56]	United States
2012	Report	155 000 people fall ill with tuberculosis in low-incidence countries, averaging 10,000 deaths (30 TB deaths a day).[57]
2012	Report	More than 180 countries sign a pledge, vowing to redouble efforts to stop children from dying of preventable diseases, including tuberculosis.[10]
2014	Report	The World Health Organization and partners launch first-ever targeted and costed roadmap with key steps to scale up the response to childhood tuberculosis and end childhood tuberculosis-related deaths.[10]	United States (Washington DC)
2014	Report	At a global level, 9.6 million people fell ill with tuberculosis and 1.5 million died from the disease in 2014.[9]

See also

• Timeline of cholera
• Timeline of malaria
• Timeline of HIV/AIDS
• Timeline of global health

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