- TORONTO (CP) -- Tuberculosis, once thought a disease of the past in Canada,
is growing increasingly resistant to the drugs used to treat it, suggests
a new Ontario government study.
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- The analysis of TB cases over the last
10 years confirms what many scientists have been warning: there are more
and more instances where the infection doesn't respond to certain medication.
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- A few people have died as a result.
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- The "ominous" problem exists
mainly among immigrants from some countries in Africa and Asia, said Dr.
Frances Jamieson of Ontario's public health laboratories, the study's author.
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- But drug-resistant strains could spread
if doctors and public health officials aren't vigilant about detecting
and aggressively treating cases, she said.
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- "We must remain vigilant ... It's
not something we can ignore," said Jamieson.
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- "If you don't do it, the risk of
spreading resistant tuberculosis is there."
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- An outbreak such as occurred in New York
a few years ago could lead to "an escalating situation," she
said.
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- While Jamieson's study dealt with Ontario,
she said the problem also exists in other cities with large concentrations
of immigrants, such as Vancouver and Montreal.
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- Experts at a conference on tuberculosis
in Toronto this week debated whether Immigration Canada's complex rules
allowing for some screening of the immigrants for TB need to be tightened,
she said.
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- Jamieson's study looked at 6,655 TB patients
from 1987 to 1997 and their reaction to five different drugs.
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- It found the proportion of cases resistant
to isoniazid, one of the most effective treatments, more than doubled to
12.9 per cent over that period.
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- Resistance to another medication, streptomycin,
jumped to eight per cent in 1997 from five per cent in previous years.
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- About 16 per cent of TB cases occurring
in Ontario are now resistant to at least one of the drugs commonly used
to treat the infection, she said.
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- The usual treatment of the disease lasts
six months.
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- Those with resistance to one or more
drugs must be treated with a blend of medication. It takes longer for those
people to be cured and the cocktail of pills can have unpleasant side effects,
Jamieson said.
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- Resistance has built in certain poor
countries because patients go untreated, can afford only one drug or fail
to keep taking the pills until the disease is eradicated, said Jamieson.
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- Others simply won't admit they have it,
she said.
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- "TB has quite a stigma for a lot
of cultures so they don't want to say they have TB."
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- Jamieson said similar problems exist
among Toronto's homeless population, where tuberculosis has been spreading
lately.
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- Doctors can keep the problem in check
if they're sure to examine patients from high-risk countries for TB, and
prescribe the appropriate treatment, she said.
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