Tuberculosis: Old disease, new danger
By, Tuscaloosa News, June 14, 2007
Last month, health officials quarantined an Atlanta man infected with a type of tuberculosis that resists multiple antibiotics.
Most people probably thought the days of quarantine were over. After all, we have highly effective antibiotics, vaccinations and other public health measures to prevent and treat infectious diseases.
This is the government’s first quarantine in more than 40 years. And it’s not a previously unknown infection. The man has an age-old disease about which we know plenty.
TB is a historic scourge of humankind. Even now, it is the leading infectious cause of death in the world, accounting for more than 2 million deaths a year.
We have been luckier in the United States than in developing countries. Starting in about 1900, improved living standards led to a decline in the disease, which dropped further after the discovery of anti-TB drugs in mid-century. But in 1984, a rise was fueled by HIV and homelessness. We also saw the first cases of multidrug-resistant TB.
Ordinary TB responds to a combination of four drugs for the first two months, followed by two drugs for four more months.
But MDR strains resist the first-line drugs, so treatment requires a complex cocktail of multiple second-line drugs.
In the United States, the risk of both forms of TB plateaued in 1992. The risk has declined steadily since, to an all-time low of about 14,000 cases a year, because of aggressive diagnosis and strict isolation of cases. Most deaths from TB occur when the condition is not diagnosed promptly or because the proper antibiotics are not started in time.
In some ways, the current case is a product of advances in science and technology.
When antibiotic use becomes widespread, bacteria may mutate into a form that resists antibiotics. When drugs for TB were first introduced, drug-resistant strains of the germ were rare. No more. And global travel can spread tough bugs, putting more people at risk.
Most people in the United States probably don’t have to take special precautions to avoid infection with TB.
Experts believe the risk to public health in the United States posed by XDR TB remains quite low.
— Harvard Medical School
Source: http://www.tuscaloosanews.com/apps/pbcs.dll/article?AID=/20070614/NEWS/706140306/1002/NEWS04
Last month, health officials quarantined an Atlanta man infected with a type of tuberculosis that resists multiple antibiotics.
Most people probably thought the days of quarantine were over. After all, we have highly effective antibiotics, vaccinations and other public health measures to prevent and treat infectious diseases.
This is the government’s first quarantine in more than 40 years. And it’s not a previously unknown infection. The man has an age-old disease about which we know plenty.
TB is a historic scourge of humankind. Even now, it is the leading infectious cause of death in the world, accounting for more than 2 million deaths a year.
We have been luckier in the United States than in developing countries. Starting in about 1900, improved living standards led to a decline in the disease, which dropped further after the discovery of anti-TB drugs in mid-century. But in 1984, a rise was fueled by HIV and homelessness. We also saw the first cases of multidrug-resistant TB.
Ordinary TB responds to a combination of four drugs for the first two months, followed by two drugs for four more months.
But MDR strains resist the first-line drugs, so treatment requires a complex cocktail of multiple second-line drugs.
In the United States, the risk of both forms of TB plateaued in 1992. The risk has declined steadily since, to an all-time low of about 14,000 cases a year, because of aggressive diagnosis and strict isolation of cases. Most deaths from TB occur when the condition is not diagnosed promptly or because the proper antibiotics are not started in time.
In some ways, the current case is a product of advances in science and technology.
When antibiotic use becomes widespread, bacteria may mutate into a form that resists antibiotics. When drugs for TB were first introduced, drug-resistant strains of the germ were rare. No more. And global travel can spread tough bugs, putting more people at risk.
Most people in the United States probably don’t have to take special precautions to avoid infection with TB.
Experts believe the risk to public health in the United States posed by XDR TB remains quite low.
— Harvard Medical School
Source: http://www.tuscaloosanews.com/apps/pbcs.dll/article?AID=/20070614/NEWS/706140306/1002/NEWS04
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