Interface of Private/Public Interface of Private/Public Entities in TB CareEntities in TB Care

Dr. Yossef AelonyDr. Yossef Aelony

TB: History of Contagion TB: History of Contagion Hypothesis 1/Public HealthHypothesis 1/Public Health

Ancient Brahmins: “Do not marry”Aristotle: person to person spread1609: scrofula pronounced

contagious1699: Republic of Lucca requires

Notice1751: Spain; Naples in 1782:

failure of doctor or family member to notify TB punished by Exile.

TB: History of Contagion TB: History of Contagion Hypothesis 2/Public HealthHypothesis 2/Public Health

1800: 20% of all deaths due to TB1800: introduction of private hospital

beds19th century: progressive recognition of

need to protect public; specialized TB hospitals & sanitariums; TB ‘resorts’ contain the most expert physicians in TB

Sanitariums supported by state or charity

Brompton in London; Saranac Lake NYLa Vina in Pasadena

TB: History of Contagion TB: History of Contagion Hypothesis 3/Public HealthHypothesis 3/Public HealthRobert Koch postulates1880 prove

AFB origin of TB, reducing resistance to protecting the public.

Public attitudes had retarded support for public protection until then.

Remember Verdi’s La Traviata (‘one who went astray’): Violetta

20th century saw widespread public institutions against TB. (1929 in Palestine)

Increase TB in NYC with HIV epidemic demonstrated relation of Pub Health $ to TB

Single BedsSingle Beds

Isolated SanatoriumIsolated Sanatorium

TB Fund Raising StampsTB Fund Raising Stamps

Fresh Air for TBFresh Air for TB

Brompton Hospital LondonBrompton Hospital London

Public/Private Cooperation Public/Private Cooperation 20102010

I surveyed 10 pulmonologists in LA, all of whom indicated they were pleased with our relationship, EXCEPT they often don’t get a follow up at the end of Rx.

We are in the process of trying to rectify this & would welcome any other suggestions from the audience