Multi-Drug Resistant TB
Racing Around The Globe -
A Deadly Harvest 9/z-tb.sml
NEW YORK - Six years after health officials declared tuberculosis a global crisis, deadly strains that are resistant to various drugs are spreading faster than anticipated, Harvard Medical School researchers said Thursday.
In a report released in New York entitled, The Global Impact of Drug Resistant Tuberculosis, doctors said the phenomenon was a "man-made problem" unknown five decades ago. They said "multidrug-resistant tuberculosis" has been reported in 104 countries " mostly in the developing world but threatening to spread to Western Europe and North America.
"There is debate about quantifying infectiousness but there are a number of experiences now from airplanes so that someone with active pulmonary tuberculosis on an airplane can readily infect other passengers," the report's primary author, Dr Paul Farmer, said at a news conference.
"As some of my colleagues have noted, upgrading yourself to first class will not necessarily protect you."
In 1993, the World Health Organization (WHO) warned the world that the airborne bacteria that can afflict almost any tissue in the body but especially the lungs, was a global emergency. The disease infects about eight million people worldwide a year and kills up to two million.
"The rapid rise of multidrug-resistant tuberculosis is a public-health catastrophe of the first order," Farmer said in a statement accompanying the report. "When patients stop taking or don't take enough of the right medications, they develop resistance to the drugs, and then spread new drug-resistant strains of the bacteria."
The Harvard doctors recommended that health agencies immediately carry out WHO's Directly Observed Therapy Shortcourse (DOTS) to all tuberculosis patients and urged a more intensive treatment called DOTS-Plus in areas where the bacteria resistant to drugs is already prevalent.
In August, researchers from the U.S. Centers for Disease Control and Prevention said that even DOTS, the best-known strategy for treating TB " making patients take a cocktail of drugs and watching them swallow them " had failed to stop an epidemic in one Russian district. The researchers said cases of multidrug-resistant TB even rose during their experiment.
Those with the drug-resistant form were more likely to have been homeless.
The DOTS-Plus regimen recommended in Thursday's report requires patients to take more drugs over a longer period of time.
The intensified treatment was successful in New York City during the early 90s and for the past three years in Peru, said Farmer, professor of the Harvard Medical School's Infectious Disease and Social Change program. He also said the treatment was cheaper per patient in the South American country.
Harvard's study was financed by the New York-based Open Society Institute, a foundation backed by international financier George Soros. It stemmed from the Institute's assistance to Russian prisoners, who are among the highest carriers with some 100,000 diagnosed with active TB.
Researchers said that without at least $1 billion in new funding for tuberculosis treatment, strains of the bacteria resistant to drugs "will spread to all corners of the earth." The development of new drugs was also needed, they said.