TB was first identified in 460 BCE by 1882 Hippocrates and initially named Robert Koch “phthisis,” which means “consumption” discovered TB in Greek. Throughout history, using the microscope 1895 TB has had many names, including Development “white plague.” However, since Dr. of chest x-ray diagnostic 1907 Koch’s discovery, “tuberculosis” became Tuberculin skin the more common medical term. test developedp 1921 BCG vaccine BCG initially proved iintroducedntr a resounding success, reducing mortality from TB 1936 Solid culture first by in vaccinated 90% used to identify TB children. However, BCG does not prevent primary infection or reactivation 1943 of latent TB. First anti-TB drug discovered: Streptomycin 1952 First anti-TB regimen used: Streptomycin, PAS, isoniazid Monotherapy- (single-drug regimen) 19631963 resistant mutations began to Rifampin and appear within a few months of Capreomycin discovered the introduction of the drug Streptomycin. It was soon demon- 19741974 strated that this problem could British Medical Research be overcome by treating TB with Council trials added Rifampin and Pyrazinamide a combinationcom of twtwo or three drugs. Emergence Emergence 19801980 of TB-HIV of MDR-TB* Liquid culture developed co-infection* 19941994 Directly Observed Treatment, David Rochkind Short-course (DOTS) uberculosis Progra USAID’s T m Began 19981998 In Rifapentine c re approved d a ia s g in Emergence n g o p s of XDR-TB* 20092009 t ip ic e iLED microscope, line s l in probe assay developed a e n d fo v a r c n c ew 20102010 in e d GeneXpert XpeXpert MTB/RIF rapid test for c ru TB rreceives CE IVD marketing an g d s, MTB/RIF®M assay id at is a newne molecular test that es can detdetect TB and mutations 20112011 associassociated with Rifampicin New drug development approach: CPTR (critical path to TB [drug] regimens) <2hrs resistresistance in fewer than 2 hoursho with far greater aaccuracycc than smear 20122012 microscopy. FDA approves Bedaquiline, the first new anti-TB drug since Rifapentine in 1998 APPROVED 20142014 Clinical trials begin on PaMZ, the 3-drug cocktail that could shorten treatment for TB, including MDR-TB One Day We Hope to Have... A tool that can diagnose TB and MDR TB within 24 hours for children, adults, and HIV-infected individuals A shorter treatment regimen that can cure TB in 10 days or less that will also work with antiretroviral drugs A vaccine that can prevent new TB infections or recurrences of the disease *NOTES: MDR-TB: Multidrug-resistant tuberculosis, TB-HIV: Tuberculosis and HIV Co-infection, XDR-TB: Extensively drug-resistant tuberculosis.