Virulent new Tuberculosis strain

Virulent new Tuberculosis strain are raising fears of a pandemic

A virulent strain of tuberculosis resistant to most available drugs is
surfacing around the globe, raising fears of a pandemic that could
devastate efforts to contain TB and prove deadly to people with
immune-deficiency diseases such as HIV-AIDS.

Known formally as extensively drug-resistant TB, or XDR-TB, the strain
has been detected in 37 countries. It arises when the bacterium that
causes TB mutates because antibiotics used to combat it are carelessly
administered by poorly trained doctors or patients don't take their
full course of medication. Rather than being killed by the drugs, the
microbe builds up resistance to them. At least 50% of those who
contract this strain of TB will die of it, according to medical
experts.

In trying to stop the spread of the disease, which can be transmitted
through coughing, spitting or even speaking, health officials have
imposed sometimes extreme controls on infected people. Robert Daniels,
a 27-year-old dual Russian-US citizen, underwent months of treatment
for TB in Russia, where he often led a homeless existence. After
telling people he was feeling better, he flew from Moscow to New York
on January 14 last year, then on to Phoenix, Arizona. In fact, his
disease had not disappeared.

The microbe causing it had mutated, apparently helped by his failure
to complete a drug regimen in Russia. Weeks after arriving in Phoenix,
Daniels was again coughing, feeling weak and losing weight. Doctors in
Phoenix diagnosed his illness as the new resistant strain of TB.
Daniels again failed to follow doctors' orders, authorities say. So
health officials got a court order, and he was locked up in the prison
wing of a Phoenix hospital, where he has spent the past nine months in
hermetically sealed isolation. It's not right," Daniels said in a
telephone interview. I'm not a criminal."

Daniels has become a case study in the bleak choices society faces in
dealing with the new strain and attempting to balance protection of
individual rights with protection of the public. Evidence of TB has
been found in ancient skeletons and mummified remains. From the 17th
century to the 20th, it was a major killer in the United States and
Europe, taking the lives of such notable people as the poet John
Keats, the composer Frederic Chopin, the writer Stephen Crane and the
actress Vivien Leigh. Even in the antibiotics age, TB has remained a
scourge in poorer countries and communities. Today, one in three
people globally is estimated to be infected with dormant TB, according
to the World Health Organization (WHO).

Most will never get sick, but in one in 10 cases the bacterium becomes
active when the host's immune system is compromised. Worldwide, an
estimated 1.7 million people die every year of the disease. Two events
last year alerted the medical community to a frightening new version
of the disease. The Centers for Disease Control and Prevention,
drawing on a survey of TB labs on six continents, reported that the
prevalence of the super strain of TB increased from 3% of patients to
11% between 2000 and 2004. It reached 15% in South Korea and 19% in
Latvia. There are no statistics yet about the new strain in Russia,
China or Africa, areas with major TB populations.

In the United States, 13,767 TB cases were recorded in 2006, the
lowest rate of infection since reporting began in 1953. A
retrospective analysis by the CDC found 49 cases of the new strain in
the country since 1993. The CDC survey was followed by a report from
Yale University researchers that the superbug had raged through a
rural hospital in South Africa in 2005 and early 2006, killing 52 of
53 who contracted it, including six health care workers. The victims,
apparently infected by airborne transmission of the virus, died on
average just 16 days after diagnosis; most of them also had HIV. We
have to come to grips with this quickly," said Vladislav Yerokhin,
director of the Central Tuberculosis Research Institute in Moscow.
This is not just a threat for TB patients. This is a serious threat
for the general population."

Budapest Business Journal
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