- WASHINGTON (UPI) -- The
lung disorder tuberculosis poses a major global health threat, even in
the United States where strains of the deadly disease that are resistant
to treatment persist, experts said Tuesday.
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- More than 9 million people worldwide will contract tuberculosis
this year and 2 million will die from the bacteria-caused disease. To raise
awareness, the Journal of the American Medical Association published a
special theme issue on the disease this week.
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- "It will take the will and resources of the entire
world to eradicate this global problem," JAMA Editor in Chief Dr.
Catherine DeAngelis and Managing Deputy Editor Annette Flanagin wrote in
an editorial.
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- The bacteria that causes tuberculosis -- Mycobacterium
tuberculosis -- is spread through the air and typically affects the lungs.
Antibiotics usually can clear up the infection, but the treatment regimen
can take up to a year. Consequently, some patients fail to complete the
full course of treatment, which can lead to TB strains that are resistant
to the medications and are more difficult to treat.
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- Eighty percent of new TB cases occur in 23 countries,
with more than half concentrated in just five: Bangladesh, China, India,
Indonesia and Nigeria.
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- Although the United States has reported declining numbers
of TB cases in recent years, the disease continues to affect the country
because it is often brought in by infected immigrants.
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- For California, this presents a significant threat. The
state leads the nation in TB cases, and according to a study by the Centers
for Disease Control and Prevention in Atlanta, strains that are resistant
to two or more drugs have continued to persist over the decade from 1994
to 2003. These strains can be life-threatening and require at least 18
months of treatment, which can cost from $28,000 to more than $1 million
per patient.
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- The CDC researchers found that 83 percent of the multi-drug-resistant
TB strains occurred in foreign-born individuals from 30 different countries,
with many of Asian-Pacific Islander ethnicity.
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- "Our findings are of concern," CDC's Dr. Reuben
Granich and colleagues wrote in the journal. "Although (multi-drug-resistant)
TB may be curable at a great individual and societal cost, the implementation
of both local and global TB control strategies is needed to prevent the
further development and spread of (multi-drug-resistant) TB."
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- CDC spokeswoman Jessica Frickey told United Press International
some of the California trends also hold nationwide.
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- "Foreign-born individuals accounted for about half
of TB cases reported in 2004," Frickey said.
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- On a national level, multi-drug-resistant TB strains
were down in 2003 (the most recent year for which data are available) 76.5
percent from 1993, but "it's still a concern because it's so much
more difficult to treat," she said.
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- Globally, the problem is a lot worse. The World Health
Organization has estimated that as many as 50 million people worldwide
may be infected with drug-resistant strains of TB.
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- Strains of bacteria resistant to antibiotics have long
been a concern of healthcare professionals and are an increasing problem
with other diseases as well. Antibiotic-resistant bacteria kills tens of
thousands of Americans each year, and infectious-disease experts say an
epidemic of a "super bug" strain that is resistant to the strongest
available antibiotics could harm millions.
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- The potential problem could be exacerbated by the lack
of development of new antibiotic drugs, the Infectious Diseases Society
of America warned in a report last year. The pharmaceutical industry is
not investing in developing new antibiotics because they are not as profitable
as drugs that treat chronic conditions and lifestyle problems, IDSA argued
in a report last July entitled, "Bad Bugs, No Drugs."
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- Tuberculosis is of particular concern because no new
antibiotics have been approved to treat it for 30 years, IDSA said.
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- Help may be on the way. The Project Bioshield II Act
of 2005, which was introduced in the Senate in April, is aimed at developing
new medications against bioterrorism threats, but it also provides incentives
to industry to develop new medications to combat antibiotic-resistant bacterial
infections.
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- IDSA has endorsed the legislation.
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- Jeff Trewhitt, spokesman for the Pharmaceutical Research
and Manufacturers of America, a trade group for the pharmaceutical industry,
told UPI there are a number of new antibiotic and related medications in
development.
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- "Pharmaceutical and biotechnology research companies
at this point have 185 medicines in human clinical testing for a range
of infectious disease, including 34 potential new medicines in development
for antibiotics," Trewhitt said. This includes "nine anti-fungals,
23 anti-infectives and 39 antivirals and others, so there is still a commitment
to this field," he said.
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- Steve Mitchell is UPI's Medical Correspondent. E-mail:
sciencemail@upi.com
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