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Unless you work in or around the public health field you may not know that today, March 24th, is World Tuberculosis Day.
This observance marks the anniversary of the discovery, in 1882 by Dr. Robert Koch, of the bacterium that causes Tuberculosis.
TB is a mostly forgotten disease here in the United States, but when I was a young paramedic, we still had TB sanitariums, where people infected with the disease would spend months `taking the cure’.
My Grandmother had TB as a young adult in the 1920’s.
It was still common enough in the early 1970’s that I saw several TB cases each month. But by the end of the 1970’s it appeared that newer, better drugs were going to eradicate this scourge . . . hopefully forever.
But it didn’t turn out that way.
Tuberculosis is on the rise again, and this time, there are new drug resistant TB strains in circulation. Today, the World Health Organization released the news that XDR (extensively drug resistant) TB has spread to 55 countries and territories around the world.
This from Reuters:
Q+A-What can be done about drug-resistant TB?
24 Mar 2009 14:00:17 GMT
Source: Reuters
March 24 (Reuters) - The World Health Organisation on Tuesday reported that extensively drug-resistant tuberculosis (XDR-TB), a lethal strain of the contagious lung disease, has spread to 55 countries and territories worldwide. ]
The emergence and spread of drug-resistant germs makes it harder and more expensive to treat, and increases the likelihood that people infected with tuberculosis will die.
Here are the main public health issues involved.
WHAT IS XDR-TB AND WHAT CAUSED IT?
Although antibiotics can cure "normal" tuberculosis, many patients have failed to take the full six- to nine-month treatment course of existing drugs, leading germs to develop resistance. Doctors prescribing the wrong medicines and shortages of drugs in low-income countries have exacerbated these problems.
Multi-drug-resistant tuberculosis fails to respond to two or more of the most potent tuberculosis drugs, and can take two years or more to treat. Extensively-drug-resistant -- or XDR -- strains are even less responsive, defying nearly all existing tuberculosis drugs. A recent South Korean study found that half of the people infected with XDR-TB die as a result. [ID:nN05313913]
WHERE HAS XDR-TB BEEN FOUND?
While tuberculosis is found predominantly in developing countries, the XDR-strain has been reported in both rich and poor nations, partly because developed economies have better screening and diagnostic technology to identify it.
To date, XDR-TB has been found in: Argentina, Armenia, Austria, Azerbaijan, Bangladesh, Botswana, Brazil, Canada, Chile, Colombia, Czech Republic, Ecuador, Estonia, France, Georgia, Germany, Hong Kong, India, Iran, Ireland, Israel, Italy, Japan, Kenya, Latvia, Lesotho, Lithuania, Mexico, Moldova, Mozambique, Myanmar, Namibia, Nepal, Netherlands, Norway, Oman, Peru, the Philippines, Poland, Portugal, Qatar, Romania, Russia, Slovenia, South Africa, South Korea, Spain, Swaziland, Sweden, Thailand, Ukraine, United Arab Emirates, United Kingdom, United States, Uzbekistan, and Vietnam.
Today, the NIH (National Institutes of Health) issued this statement on World TB Day.
This year, as we commemorate World TB Day, we renew our resolve to stop tuberculosis. Although mindful of the substantial challenges that confront us in the ultimate goal of eliminating tuberculosis, we are encouraged by recent progress in fighting this lethal infection. The theme of this year’s World TB Day, "I Am Stopping TB," is enthusiastically embraced by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, as we continue working side by side with our international partners, other government agencies, communities and individuals affected by TB to stop this deadly disease.
TB is an ancient disease; however, it remains one of the major causes of disability and death throughout the world. Today, one-third of the world’s population is thought to be infected with Mycobacterium tuberculosis (Mtb), the microbe that causes TB. An estimated 13.7 million people have the active form of the disease. In 2007, approximately 9.27 million people developed TB, of whom 1.37 million were HIV positive, and 1.75 million died, including 456,000 individuals co-infected with HIV.
With Mtb infection among people with HIV/AIDS rapidly on the rise, the two largest infectious disease pandemics of modern times are heading for a perilous collision. This threat is heightened by the rapid rise and spread of multidrug-resistant (MDR) TB, which is unresponsive to the first-line drugs isoniazid and rifampin, and extensively drug-resistant (XDR) TB, which resists most existing TB antibiotics. Although the true extent of drug resistance is unknown, estimates from the World Health Organization (WHO) suggest that an average of approximately 5 percent of all TB cases are MDR. Currently, the prevalence of XDR TB can only be inferred, because relatively few countries are able to test for XDR TB. While drug-sensitive TB comprises the largest burden of the disease globally, the continued emergence of drug-resistant Mtb strains raises serious concerns that gains in TB control may be rapidly reversed and treatment options reduced to what was available in the pre-antibiotic era.
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