Terrified by TB? My girlfriend just shared with me the fact that she was treated last year for tuberculosis. She says that the doctors told her that she was not contagious due to the treatment. Is this true? Or is the treatment something less than 100 percent effective? The outcome depends on how well your girlfriend stuck to her drug therapy. Tuberculosis is caused by an organism known as Mycobacterium tuberculosis. In the past, it was thought to be the result of genetics, bad climate, uncontrolled emotions, and insufficient light. Treatments through the centuries have included bloodletting, exercise and milk, smoking cow dung, removing ribs, injecting gold salts, going for carriage rides, and injecting extracts of red roses and honey. Then, in 1882, Robert Koch identified M. tuberculosis, cultured the organism, and proved that it caused the disease by inoculating animals with it. People spread the germ by sneezing, coughing, speaking, even singing; it is very easily transmitted and can travel across a room on airborne particles. The current treatment for tuberculosis is a combination of drugs taken every day to kill off all the bacteria before they have a chance to become immune to the treatment. The most common medicines in use are isoniazid (INH), rimpapin, pyrazinamide, ethambutol, and streptomycin. Usually, people have to take three or more of these drugs for anywhere from six months to a year. People who have TB in the lungs or throat should stay home for the first few weeks to avoid spreading the infection to others. After that initial period, they can go out and lead a normal life. If people take these drugs as directed, they are not contagious. And furthermore, if people take the therapy for the recommended length of time, using the proper dosages, it will cure the disease. Tuberculosis was nearly wiped out in developed countries by the late 1970s, with drugs first discovered in the l940s. Then, in the United States and elsewhere, in the mid-1980s the incidence began to rise. Over the past five years, active cases have increased by more than 20 percent - and in some urban areas TB has become epidemic. Epidemiologists attribute the problem to an increase in populations at high risk, including homeless people, intravenous drug users, and people with HIV, as well as cuts in public health budgets. People without adequate medical support systems have not followed the drug regimens. Some stop as soon as they start to feel better. This has not only contributed to the spread of TB but has also encouraged the development of drug-resistant strains. Drug-resistant tuberculosis is now a major medical and social concern. Three-quarters or more of those who contract a multidrug-resistant strain die in 4 to 16 weeks. The only recourse available is isolation and treatment with experimental antibiotics. At the moment, most cases of TB are still quite treatable - if you follow the recommended therapy for the recommended length of time. Tomorrow: Am I a chocoholic?