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Tuberculosis and World War I.

Consumption (or “phthisis”), later renamed tuberculosis, ravaged Europe in the sixteenth, seventeenth, and eighteenth centuries. Some say more than 1 billion people died of the disease during that 300-year epoch of extraordinary mortality. To compound the problem, deaths from consumption climbed even higher during the first half (1760 to 1810) of the Industrial Revolution. But by 1800, or somewhat before, a remarkable about-face took place: the scourge peaked and then began a nearly steady decline that lasted for more than a century (1). Note that the reduction in mortality was underway well before Robert Koch announced his discovery of Mycobacterium tuberculosis in 1882, and without significant change mortality kept falling for another 32 years. But then the downward trend abruptly ceased—on July 28, 1914—the start of World War I (WWI): the greatest cause of death and destruction to that time in history. And the carnage didn’t stop until November 11, 1918, nearly four and one-half years later. The purpose of this essay is to examine what actually happened to tuberculosis during WWI: (1) why did mortality rates suddenly escalate so strikingly at the outset of hostilities, (2) increase considerably higher during wartime, (3) decrease precipitously shortly after peace was declared, and (4) end up at virtually the same level of mortality that would have been expected if the war never happened?