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This article raises alarm to Public Health officials as TB has been on the rise worldwide. Something that sometimes we don't think about, that we are invincible and the likes, but with how small our global world has become, it only takes one person on a plane to start a pandemic (SARS).
New strains of TB raise alarm
By Elisabeth Rosenthal International Herald Tribune
Published: September 5, 2006
PARIS The spread of a new, highly resistant form of tuberculosis that is "virtually untreatable" is causing alarm among international health officials who say that it has now been identified in "all regions of the world," according to the World Health Organization.
For two decades, health officials have been concerned about the steady rise in drug resistant tuberculosis, which has forced them to rely on more expensive and prolonged treatments in order to achieve a cure, increasing the cost of treatment 100-fold.
But the new strains, called extremely drug resistant (XDR) TB, cannot be treated at any cost. In many patients, particularly those with HIV/AIDS, the emergence of such strains has transformed tuberculosis, generally a slow, chronic lung disease, into a rapid assassin.
"With XDR-TB we have very few options left - all we can even try are very old, very ineffective drugs that we stopped using in the '50s and '60s," said Dr. Karin Weyer, director of the TB Unit at the South African Research Council. "For many people, there is no option."
Later this week, international experts from the World Health Organization and the U.S. Centers for Disease Control and Prevention will meet in Johannesburg to plot strategies to contain this new killer. Officials from the World Health Organization declined to discuss the topic until after the conference.
In one recent TB outbreak among 544 people in the South African province of Kwazulu-Natal, most of whom were HIV positive, 221 had resistant TB, and 53 of those cases involved XDR strains. Of those 53 cases, 52 patients have died, including many who were otherwise getting the most advanced therapy for AIDS.
And the problem of extreme resistance is not limited to Africa or to patients with HIV/AIDS. When the U.S. Centers for Disease Control last year asked tuberculosis labs worldwide to take a look at specimens for XDR TB, the results were alarming.
In a paper published this summer in Morbidity and Mortality Weekly, researchers reported that 15 percent of samples in South Korea had extreme drug resistance, 19 percent in Latvia, as well as 14 percent in the East European/ West Asia region. In the United States, 4 percent of sample were XDR.
"XDR TB has emerged worldwide as a threat to public health and TB control, raising concerns of a future epidemic of virtually untreatable disease," the researchers said. Extreme drug resistance is defined as strains of tuberculosis that are impervious to at least 3 of the 6 second-line drugs available to treat TB, and some are impervious to all 6.
Effective treatment of TB often requires the simultaneous administration of more than 3 drugs.
Extremely drug-resistant TB arises when a strain of tuberculosis with a less severe form of resistance is unrecognized, or is otherwise treated inadequately or incompletely.
Even standard TB needs to be treated for six months for a cure. Multidrug resistant strains required patients to take multiple drugs for two years, a treatment plan that is, for many patients, particularly those in poor countries, difficult to afford and comply with.
In South Africa, the cost of the six- month treatment is about 50, or $64, while the cost of the two-year course is 4,000, Weyer said.
If that treatment is not adhered to, the patient is not cured though his condition may improve. But most worrying, the tuberculosis bacterium that remain in his body learn to defy those drugs. These germs can then be passed to others setting off untreatable epidemics, like that in South Africa.
PARIS The spread of a new, highly resistant form of tuberculosis that is "virtually untreatable" is causing alarm among international health officials who say that it has now been identified in "all regions of the world," according to the World Health Organization.
For two decades, health officials have been concerned about the steady rise in drug resistant tuberculosis, which has forced them to rely on more expensive and prolonged treatments in order to achieve a cure, increasing the cost of treatment 100-fold.
But the new strains, called extremely drug resistant (XDR) TB, cannot be treated at any cost. In many patients, particularly those with HIV/AIDS, the emergence of such strains has transformed tuberculosis, generally a slow, chronic lung disease, into a rapid assassin.
"With XDR-TB we have very few options left - all we can even try are very old, very ineffective drugs that we stopped using in the '50s and '60s," said Dr. Karin Weyer, director of the TB Unit at the South African Research Council. "For many people, there is no option."
Later this week, international experts from the World Health Organization and the U.S. Centers for Disease Control and Prevention will meet in Johannesburg to plot strategies to contain this new killer. Officials from the World Health Organization declined to discuss the topic until after the conference.
In one recent TB outbreak among 544 people in the South African province of Kwazulu-Natal, most of whom were HIV positive, 221 had resistant TB, and 53 of those cases involved XDR strains. Of those 53 cases, 52 patients have died, including many who were otherwise getting the most advanced therapy for AIDS.
And the problem of extreme resistance is not limited to Africa or to patients with HIV/AIDS. When the U.S. Centers for Disease Control last year asked tuberculosis labs worldwide to take a look at specimens for XDR TB, the results were alarming.
In a paper published this summer in Morbidity and Mortality Weekly, researchers reported that 15 percent of samples in South Korea had extreme drug resistance, 19 percent in Latvia, as well as 14 percent in the East European/ West Asia region. In the United States, 4 percent of sample were XDR.
"XDR TB has emerged worldwide as a threat to public health and TB control, raising concerns of a future epidemic of virtually untreatable disease," the researchers said. Extreme drug resistance is defined as strains of tuberculosis that are impervious to at least 3 of the 6 second-line drugs available to treat TB, and some are impervious to all 6.
Effective treatment of TB often requires the simultaneous administration of more than 3 drugs.
Extremely drug-resistant TB arises when a strain of tuberculosis with a less severe form of resistance is unrecognized, or is otherwise treated inadequately or incompletely.
Even standard TB needs to be treated for six months for a cure. Multidrug resistant strains required patients to take multiple drugs for two years, a treatment plan that is, for many patients, particularly those in poor countries, difficult to afford and comply with.
In South Africa, the cost of the six- month treatment is about 50, or $64, while the cost of the two-year course is 4,000, Weyer said.
If that treatment is not adhered to, the patient is not cured though his condition may improve. But most worrying, the tuberculosis bacterium that remain in his body learn to defy those drugs. These germs can then be passed to others setting off untreatable epidemics, like that in South Africa.
This article raises alarm to Public Health officials as TB has been on the rise worldwide. Something that sometimes we don't think about, that we are invincible and the likes, but with how small our global world has become, it only takes one person on a plane to start a pandemic (SARS).
