Drug-Resistan TB

[Kanastrous]

Drug-resistant TB could lead to global disaster

Crisis could occur if killer strains are not contained, WHO official says

updated 12:51 p.m. PT, Thurs., Nov. 8, 2007

CAPE TOWN - The world is at risk of a tuberculosis crisis if killer drug-resistant strains of the disease are not contained, a senior World Health Organization official warned on Thursday.

"Scenarios of apocalyptic nature are not, let's say, likely, but they might happen. They are not ... impossible," said Mario Raviglione, director of the World Health Organization's Stop TB department.

"Globally speaking about 96 percent of all TB cases are still treatable with the four drugs that we use in the standard regimen, 4 percent are multi-drug resistant ... but the worst case scenario is when this 4 percent becomes 50, 60, 70, 80 percent," he told reporters at a conference in Cape Town.

Raviglione said a worst-case scenario would see multi- and extensively drug-resistant TB overtake cases of ordinary TB, which can still be cured with older but effective drugs.

Multi- and extensively drug-resistant TB (MDR-TB and XDR-TB) are mutations of common TB virtually immune to all treatments.

Raviglione said some countries in the former Soviet Union were showing an MDR-TB incidence of up to 20 percent, while some European states showed resistance to all second-line TB drugs — the most powerful in an increasingly ineffective drug arsenal.

Outlining the seriousness of the emerging drug resistance, Raviglione said the situation in some European countries reminded health officials of the "pre-antibiotic era" of 1943.

He said Russia, China, India and South Africa were the four countries worst-hit with MDR-TB and XDR-TB, accounting for up to 60 percent of the world's cases.

The emergence of drug-resistant TB strains, coupled with a deadly co-infection of TB and HIV, has alarmed health authorities who are uniting to head off a global TB crisis.

On Thursday, hundreds of activists and TB experts attending the 38th Union World Conference on Lung Health marched through Cape Town's city center to draw attention to the disease, easily spread during close personal contact.

Experts agree that underfunding, outdated drugs, a lack of new vaccines and poor diagnostics for TB are hampering treatment, leading to higher and faster mortality rates, especially among those infected with both TB and HIV.

"The XDR epidemic has simply exposed the limitations of the current tools used to control TB ... New diagnostics and hopefully a new vaccine are fundamental items that we have to push through as a global community," Raviglione said.


http://www.msnbc.msn.com/id/21694145/

[Mayabird]

There's a TB vaccine already in existence and another one on the way.

Could someone who knows more about it tell me why it can't be widely used as a childhood immunization so we don't have to worry about this at all?

[Kanastrous]

If you're thinking of the BCG vaccine, it's unpopular for kids in the US because (a) having been vaccinated with it interferes with testing for TB exposure, and because its effectiveness against adult pulmonary TB is unpredictable. Also, the (presently) low incidence of TB in the US means there isn't much drive to use it, here (yet).

Don't know why it's not in more widespread use, elsewhere.

[Knife]

Not that much different than the thread a bit ago about MRSA. The first world nations have been spoiled and have a terrible habbit of not doing what needs to be done in reguards to medication and dangerous and contageous diseases.

Virulent strains get a grip because people don't finish their meds to kill all of the pathogens. They take their pills long enough to feel good, which means they kill off the easy to kill versions of the bug and leave the nasty ones.

That said, even a 'drug resistent' version of a pathogen doesn't mean it's immune to the drug, rather it just takes longer and perhaps a bigger does to off the little critter.

So, for me, its either another fearmongering bit or a wake up call for the spoiled first world countries who think taking one or two pills in two days will cure anything.

[PainRack]

If you're thinking of the BCG vaccine, it's unpopular for kids in the US because (a) having been vaccinated with it interferes with testing for TB exposure, and because its effectiveness against adult pulmonary TB is unpredictable. Also, the (presently) low incidence of TB in the US means there isn't much drive to use it, here (yet).

Don't know why it's not in more widespread use, elsewhere.

This may be due to the fact that people often require repeated boosters every decade or so. The mandatory vaccination programme here for example only offers booster shots up to the age of 16-18.

However, this is worse than other diseases. The drugs one historically use to treat TB require months to work and come with quite a package of side effects including tea coloured urine. Considering such a lengthy regime, it isn't unusual for people to forget. That's why modern countries now require a Drug Observed Therapy where patients in the non infectious stages must travel to a clinic and take their meds, as opposed to home dosing. Needless to say, such a program is hard to institute in the countries most badly hit by resistant TB such as Russia, China and India.

[Broomstick]

That said, even a 'drug resistent' version of a pathogen doesn't mean it's immune to the drug, rather it just takes longer and perhaps a bigger does to off the little critter.

Yeah, but it sucks if the "critter" is so resistant that it has a chance to kill you before the drugs kill it.

[Knife]

That said, even a 'drug resistent' version of a pathogen doesn't mean it's immune to the drug, rather it just takes longer and perhaps a bigger does to off the little critter.

Yeah, but it sucks if the "critter" is so resistant that it has a chance to kill you before the drugs kill it.

Indeed; however just saying 'resistant' isn't a death sentence. That was the problem I had with the tone of this article and the other article about MRSA a while back.

Is it a concern and is it dangerous? Hell yeah. But not the end of the world sweeping plague doom and gloomers would have you think.

[Fingolfin_Noldor]

Wasn't there an incident in Russia or something about drug resistant TB? It was an old outbreak many years ago.