- *Following are recently published quotes by Dr Anthony
Moll, who heads the Church of Scotland Hospital at Tugela Ferry in the
province of Kwa-Zulu Natal, South Africa -- the site of the first out-of-control
outbreak of XDR-TB in October 2006 which has now become a countrywide
epidemic. Dr Moll first had to ask for special ANC-government permission
before he was even allowed to test his seriously-ill patients for resistance
- CBS News Reports -- May 31 2007 - "In most instances,
HIV/AIDS positive patients being treated with both anti-retrovirals and
tuberculosis drugs improved, Dr. Moll explained, but not these two. "They
were getting worse by the hour." With a lack of testing facilities
in his rural hospital in South Africa's Kwazulu-Natal province, Dr. Moll
asked for special permission to have the sputum samples of 45 patients
sent to Durban (one of SA's eight state-run health laboratories) and tested
for resistance to TB drugs ('DST- testing').
- "Nurses collected samples from the two very ill
patients, as well as 43 others being treated with TB and anti-retroviral
drugs, and sent them off. By the time the results came back eight weeks
later, 10 of the patients were dead, including the two who had been very
ill. Of the 45 samples, 10 were resistant to all six TB drugs they tested
- "I got a cold shiver, with such fear in my heart,"
Moll said. "I thought, 'This is airborne.Could I be infected? Could
my staff be infected?' To go into a new realm of XDR-TB, which is basically
untreatable, was almost unthinkable," he said, using the acronym
for Extremely Drug-Resistant Tuberculosis.
- Moll's worst fears were realized: Four of the hospital
nurses died in those first few months. From that point on, the hospital
began identifying more and more patients - and in almost all cases, the
patients with XDR-TB were dead before the lab results were back. Most
die within 16 days of being identified as a possible XDR-TB case. The
mortality rate of XDR-TB is 84 percent.
- Since the first two cases, close to three years ago,
doctors at the Church of Scotland Hospital have identified 266 people
with XDR-TB. That is just one small hospital. Across South Africa, doctors
in all nine provinces have reported XDR-TB cases.
- "It seems to be simmering, with increasing numbers
each month," says Moll said. "It's not explosive, but it's slow,
insidious, increasing numbers."
- With recent U.S. fears of tuberculosis being stoked by
a Georgia man's trans-Atlantic travels while infected with XDR-TB, South
Africa's struggles serve as an ominous reminder of how deadly the disease
can be, reports CBS-news.
- "The South African government has installed extractor
fans in all TB wards and hospital staff use surgical face masks, but doctors
claim there is a lack of good isolation facilities available. Small rural
clinics and hospitals can sometimes wait for up to three weeks with an
XDR-TB patient in a general ward before a bed is available in one of the
few urban hospitals better equipped to deal with the disease.
- Currently, a small group of XDR patients have been treated
for more than five months in a Durban hospital, but their results have
fallen short of doctors' expectations. "Ultimately we need prevention,
as the current treatment regime just isn't the way to go," Moll said.
"The bulk of the (XDR-TB) patients just die so quickly."
- LINK TO ORIGINAL STORY ON CBS NEWS:
- ** DST: Drug Sensitivity Testing:
- LINK TO DRUG-SENSITITY TESTING METHODS: