- THE NETHERLANDS -- When reading
the abstract "XDR-TB as a cause of death in patients co-infected with
tuberculosis and hiv in a rural area of South Africa" on the website
of the Centres for Disease Control" in the USA, I noted that
only those infected patients with extreme-drug-resistant tuberculosis who volunteered
for testing at this Pongola rural hospital in KZN were actually tested
for this study: no-one was tested from outside this setting i.e. no contacts
of these infected patients were chased down for testing and quarantine.
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- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=
Retrieve&db=PubMed&list_uids=17084757&dopt=Abstract
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- My first question is:
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- A) How are totally unknown XDR-TB cases being tracked
down in the South African community at the moment if they fail to present
for testing themselves?
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- B) Is there any legal mechanism in place and are medical
personnel given police backup in which contacts of these XDR-TB cases can
be forced to undergo testing and quarantined to prevent this XDR-TB strain
from spreading?
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- Left: the TB-outpatients clinic in Pongola, KwaZulu-Natal:
this recent photograph in the New York Times shows TB patients and their
family members wait in these crowded corridors for testing and treatment...How
many of these people were infected while just waiting here?
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- It has also been reported in the SA news media that all
53 of these particular patients in Pongola have since died, making the
mortality rate 100%. The cure rate for the 'lesser evil" -- MDR-TB
- in the Western Cape's excellent TB-prevention programme is 70.3% but
their far eight identified XDR-TB patients in 2007 also have a mortality
rate of 100%. Judging from the photograph of the Pongola clinic which I
post here, it is pretty obvious that these patients are not placed in any
kind of quarantine, and indeed are closely packed together when they visit
the clinic to get medication - small wonder that this has become an epidemic
so rapidly that 1,054 people per 100,000 of the population are now infected
with it...
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- I thus am growing ever-worried about the poor management
of these outbreaks in South Africa -- especially because the SA health
department is still publicly proclaiming that XDR-TB "only occurs
among hiv-infected patients" when actually only co-infected people
were tested in this particular study on which some of the ANC-regime's
recent statements must presumably be based.
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- Travellers to SA still believe they are safe from XDR-TB
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- Their misleading official advice is also given to European
travellers to South Africa -- and who now are therefore led to believe
that they could not be infected with XDR-TB as long as they are not immune-deficient
-- and who are moreover encouraged to take a TB-vaccine before departure
to SA which clearly would have no effect on XDR-TB whatsoever, with its
100% mortaility rate...
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- I know of at least one private hospital case in Klerksdorp
from the Afrikaans-language news media where the patient, Mrs Petro Nel,
41, had died on 17 September 2006 of identified XDR-TB even though she
was a completely healthy person and had indeed tested hiv-negative. Her
life-partner Mr Ken Nelson has since filed a formal complaint of negligent
culpible homicide through the Klerksdorp police against the SA minister
of health over Mrs Nel's death.
- http://152.111.1.251/argief/berigte/rapport/2006/11/06/RH/12/lpmantomoord.html
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- My second question is:
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- A. Was Mrs Nel infected with some other kind of XDR-TB
strain which can also infect healthy people?
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- B. I understand that such a strain unique to South Africa,
identified as SA-1, was identified by Dr Tommie Victor and his health team
at the university of Stellenbosch medical faculty in 2003 and again in
2004, and was at that time successfully isolated after they had even traced
patients as far afield as Zambia.
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- So which XDR-TB strain is infecting healthy people in
SA such as Mrs Nel - and why are all the XDR-TB patients and all their
contacts not being tracked down and isolated so that they can't pass on
the infection to the rest of the community?
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- Should the SA government not put out an emergency call
to the rest of the world to come and help isolate these patients - in military
field hospitals if necessary -- so that this new epidemic can be stopped
in its tracks before even more damage is done? The USA had a similar outbreak
and proved that only a rigid enforced quarantine regimen was able to stop
it.
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- I am indeed deeply concerned over these mixed signals
we are receiving from South African government in this regard. Could anyone
tell us the truth please?
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- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=
PubMed&list_uids=17084757&dopt=Abstract
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