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- 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.
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- 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.
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- "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.
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- "As some of my
colleagues have noted, upgrading
yourself to first class will not
necessarily protect you."
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- 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.
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- "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."
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- 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.
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- 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.
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- Those with the drug-resistant form were more likely to
have been homeless.
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- The DOTS-Plus regimen recommended in Thursday's report
requires patients to take more drugs over a longer period of time.
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- 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.
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- 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.
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- 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.
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