One third of the world’s population lives with tuberculosis (TB), and new infections occur at a rate of about one per second. Also, the number of people who become ill with tuberculosis each year continues to grow. The World Health Organization estimates that there are currently 13.7 million chronic active cases of TB, 9.3 million new cases each year, and 1.8 million annual deaths. In 2012, tuberculosis (TB) is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. The symptoms of TB include a chronic cough, fever, night sweats, and weight loss. Diagnosis relies on a tuberculin skin test, blood tests, X-rays of the lungs as well as microscopic examination and microbiological culture of bodily fluids.
About 10 to 20% of all diagnosed cases of tuberculosis infect the skeleton. Bone tuberculosis can occur at any age and can infect virtually any bone within the body. Evidence of human tuberculosis has been obtained from a 9000-year-old skeleton. Thus, TB is an ancient disease and there has not been evolutionary change of the TB genome.
Professor Robert Koch (1843–1910) received the Nobel Prize in Physiology or Medicine in 1905 for his discovery in 1882 of Mycobacterium tuberculosis, the bacterium that causes tuberculosis. The concept of use of a sanatorium for treatment of patients with tuberculosis was included by Professor Koch in his 1905 Nobel lecture.
The standard TB medical therapy for decades in the pre-antibiotic era was based on rest in a sanatorium at an elevation where UV light was amply prevalent. In retrospect, this suggested a linkage between vitamin D status and the disease of TB. In the 1940s a high dose vitamin D supplementation was introduced for patients with TB. In the past decade epidemiological studies have linked inadequate vitamin D levels [low serum concentrations of 25(OH)D] to a higher susceptibility of immune-mediated disorders, including chronic infections and autoimmune diseases. In 2006 new data supported a link between tuberculosis and vitamin D-deficiency as determined by the blood levels of 25(OH)D and by activation of the innate immunity system via production of antimicrobial pep tides (AMPs) which can kill the Mycobacterium tuberculosis.
