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Tuberculosis (TB) was once dreaded in Japan, with fatalities reaching a peak of 171,474 in 1943. Recent news about new TB cases, including a midwife in Takatsuki, Osaka Prefecture, and Ms. Haruka Minowa of the popular female comic duo Harisenbon, has reminded people and medical professionals that TB is not a disease of the past.

In Japan, the number of new TB cases detected stood at 25,311 in 2007, a drop of 1,073 from the previous year. TB took the lives of 2,188 people in 2007, 81 fewer than in 2006. But it must be remembered that TB is still a serious infectious disease in this country in terms of the number of new cases. Japan’s TB incidence — 19.8 cases per 100,000 people in 2007 — is the highest among developed countries: 4.5 times more than in Canada, 4.4 times more than in the United States and 3.7 times more than in Sweden.

Most TB cases in Japan involve people aged 70 and above, who were infected when young. They tend to be senile or suffer from other diseases like diabetes. A system should be developed to detect and treat such TB cases at an early stage.

Historically, the industrial revolution increased the number of TB cases in Europe. In Japan, TB became rampant as industrialization proceeded during the Meiji Era and onward. The concentration of the population in urban areas, harsh labor conditions, bad nutrition, stress and unsanitary housing contributed to the spread of TB.

TB remains largely a disease of the poor and the socially weak. Nowadays congested locations in urban areas like Internet cafes and cheap inns have been linked to the spread of TB. Young people with low-paying jobs and no fixed abodes, homeless people and people on welfare are at a higher risk of contracting TB. A system is needed to carry out regular health checks on such people.

It is imperative to enlighten people about TB at schools and in communities, and to train TB specialists. The World Health Organization reports that some 9.27 million new TB cases were detected worldwide in 2007, about 80 percent of them in Asia and Africa. Japan and other developed countries should do more to assist countries of these regions in their struggle against TB.

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