Control of Tuberculosis: An Agent Carter & Captain America Size Task

The popular culture infectious diseases references continue.

On last night's premiere of ABC's new 1940s-era show, Marvel's Agent Carter a character who sneezes exclaims that she likely has tuberculosis. (For those of who might not know, in the Marvel universe, Agent Carter was an associate of Captain America.) 

In the 1940s tuberculosis was a serious fear in the US and pre-streptomycin (1944) there was no effective treatment available. Despite this, deaths had been declining due to improving socioeconomic and health conditions in the US. However, in 1945 the incidence rate was still was at an alarming 87 per 100,000. For comparison, it was 3 per 100,000 in 2013--a 96% reduction.

Though, as I've written before, there are vulnerabilities in our control of tuberculosis including drug resistance and the fact that the bulk of tuberculosis cases in the US occur in foreign-born individuals, who may present special challenges with respect to case identification, contact tracing, and treatment. 

With those caveats, a 96% reduction in tuberculosis cases in 70 years, in the absence of a vaccine program, was a Captain America seized feat.