Africa: Drug Resistant TB Goes Airborne

[Snowy Owl]

Africa: Red Alert as Drug Resistant TB Goes Airborne
http://allafrica.com/stories/200609260509.html

Vanguard (Lagos)
September 26, 2006
Posted to the web September 26, 2006
Sola Ogundipe


Medical institutions throughout the world are drawing attention to the pandemic of the new drug resistant strain of tuberculosis which has since become airborne, even as the World Health Organization warned in Switzerland that the strain capable of further spreading in the African continent.


Amongst countries at risk of the deadly strain are Djibouti, Egypt, Ethiopia, Ghana, Ivory coast, Kenya, Mauritania, Niger, South Africa and Nigeria. No response to the threat has been issued by health authorities over the development.

The new strain of extremely resistant TB known as XDR-TB is currently rapidly spreading in the United States, Eastern Europe and parts of Africa.


Reports quoting Paul Nunn, Head of the WHO TB resistance team, said the organization estimates that about 180,000 of the million cases of TB in the world could be XDR-TB.

"This is raising the specter of something that we have been worried might happen for a decade -- the possibility of virtually untreatable TB."


Meanwhile experts are worried about the major implications for the antiretroviral drug treatment programme being rolled out for HIV and AIDS patients across Africa, where a great number of those patients die from TB.


It is known that any one exposed to the contagion can easily become infected as it easily spreads through the air.


Already, International health experts have met in Johannesburg, South Africa to discuss stronger preventative measures against this deadly form of the disease.


The XDR-TB strain,is virtually untreatable and has an alarmingly high mortality rate.


In a recent outbreak in the Kwazlul-Natal province of South Africa, it killed 52 of 53 patients infected. Most of the victims were HIV-positive.


Health officials warn that people infected with HIV are particularly susceptible to XDR-TB because of their already weakened immune systems.


WHO officials said drug-resistant tuberculosis could have a severe impact on mortality in Africa, given the underlying HIV epidemic.


It noted that the strain has been found in all regions of the world, most frequently in the countries of the former Soviet Union and in Asia.


The Extensively Drug-Resistant" strain (EDR-TB) and "multi-drug resistant" strain (MDR-TB), set annual TB death at 2 million people, mostly in Africa and south east Asia.


EDR-TB affects those who stop treatment or remain unaware of their condition.



MDR-TB is almost impossible to cure because it overpowers the best first- and second-line TB drugs.



South Africa reported 50 dead to EDR-TB and the US 74 since 1993.

[AlaskaDenise]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne


(there are no words for how I feel about this)

[Niko]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne

(there are no words for how I feel about this)

I copied this thread to "Breaking News" - it needs visability.

[Marcie]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne

OK, so which do you suppose is going to get us first, the BF or the TB!

[Sally Furniss]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne

I thought all TB was airborne.

Does any one know?

[Niko]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne

I took the significance of the article to mean that it is spreadly rapidly, not just the fact that TB is airborne.

How is TB spread?

TB is spread through the air from one person to another. The bacteria are put into the air when a person with active TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected.

When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.

TB in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.

People with active TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers.

http://www.cdc.gov/nchstp/tb/faqs/qa_introduction.htm#Intro3

[NOK]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne

Alright what catagory does this put it in in the pandemic alert system.

[Marcie]

Re: Africa: Red Alert as Drug Resistant TB Goes Airborne

These are the points that stood out to me in the article:


The XDR-TB (extremely drug resistant TB) strain is virtually untreatable and has an alarmingly high mortality rate.

"This is raising the specter of something that we have been worried might happen for a decade -- the possibility of virtually untreatable TB."

The new strain of extremely resistant TB known as XDR-TB is currently rapidly spreading in the United States, Eastern Europe and parts of Africa.

[AlaskaDenise]

Re: Africa: Drug Resistant TB Goes Airborne

I wonder if prior exposure to TB resulting in positive TB test will confer some immunity?

The apparent increased virulence may mean it is not well handled by a normally healthy person.

As a child, I was exposed to TB (from aunt), never got TB, but have a positive TB test from the experience. Here, it may mean that in that same situation, I would have contracted TB.

.

[Marcie]

Re: Africa: Drug Resistant TB Goes Airborne

I wonder if prior exposure to TB resulting in positive TB test will confer some immunity?

The apparent increased virulence may mean it is not well handled by a normally healthy person.

As a child, I was exposed to TB (from aunt), never got TB, but have a positive TB test from the experience. Here, it may mean that in that same situation, I would have contracted TB.

.

It's a new strain of TB, a drug resistant strain, with a very high CFR, especially for those people with compromised immune systems. The strain is virtually untreatable. All TB is airborne.

[AlaskaDenise]

Re: Africa: Drug Resistant TB Goes Airborne

It's a new strain of TB, a drug resistant strain, with a very high CFR, especially for those people with compromised immune systems. The strain is virtually untreatable. All TB is airborne.

My question pertains to possible cross-reactive immunity. Just as Robert Webster, et al, is proposing a pre-pandemic H5N1 VAX could offer limited protection against pandemic H5N1, perhaps early TB strain "A" could offer limited protection against high-CFR TB strain "B".

BTW, compromised immune systems could also mean people undergoing chemotherapy.

.

[Marcie]

Re: Africa: Drug Resistant TB Goes Airborne

My question pertains to possible cross-reactive immunity. Just as Robert Webster, et al, is proposing a pre-pandemic H5N1 VAX could offer limited protection against pandemic H5N1, perhaps early TB strain "A" could offer limited protection against high-CFR TB strain "B".

BTW, compromised immune systems could also mean people undergoing chemotherapy.

.

Re cross-reactive immunity - don't know, but I'll be you can find the answer somewhere on FT or on the web somewhere.

Yes, hadn't thought of chemotherapy.

I've always taken my perfect health for granted. Don't think I will anymore.

[Niko]

Re: Africa: Drug Resistant TB Goes Airborne

My question pertains to possible cross-reactive immunity. Just as Robert Webster, et al, is proposing a pre-pandemic H5N1 VAX could offer limited protection against pandemic H5N1, perhaps early TB strain "A" could offer limited protection against high-CFR TB strain "B".

BTW, compromised immune systems could also mean people undergoing chemotherapy.

.

In my unexpert opinion, no. Well, maybe. I think you need to differentiate between Latent TB and Active TB.

From the CDC:

http://www.cdc.gov/nchstp/tb/faqs/qa_introduction.htm#Intro4

Questions and Answers About TB
2005

What is TB?

Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. The bacteria usually attack the lungs. But, TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. TB disease was once the leading cause of death in the United States.

TB is spread through the air from one person to another. The bacteria are put into the air when a person with active TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected.

However, not everyone infected with TB bacteria becomes sick. People who are not sick have what is called latent TB infection. People who have latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB to others. But, some people with latent TB infection go on to get TB disease.

People with active TB disease can be treated and cured if they seek medical help. Even better, people with latent TB infection can take medicine so that they will not develop active TB disease.


What is latent TB infection?

In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. People with latent TB infection

* have no symptoms
* don't feel sick
* can't spread TB to others
* usually have a positive skin test reaction
* can develop active TB disease if they do not receive treatment for latent TB infection

Many people who have latent TB infection never develop active TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active and cause TB disease.

Back to Top of Page

What is active TB disease?

TB bacteria become active if the immune system can't stop them from growing. The active bacteria begin to multiply in the body and cause active TB disease. The bacteria attack the body and destroy tissue. If this occurs in the lungs, the bacteria can actually create a hole in the lung. Some people develop active TB disease soon after becoming infected, before their immune system can fight the TB bacteria. Other people may get sick later, when their immune system becomes weak for another reason.

Babies and young children often have weak immune systems. People infected with HIV, the virus that causes AIDS, have very weak immune systems. Other people can have weak immune systems, too, especially people with any of these conditions:

* substance abuse
* diabetes mellitus
* silicosis
* cancer of the head or neck
* leukemia or Hodgkin's disease
* severe kidney disease
* low body weight
* certain medical treatments (such as corticosteroid treatment or organ transplants)
* specialized treatment for rheumatoid arthritis or Crohn?s disease

Symptoms of TB depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs. TB in the lungs may cause symptoms such as

* a bad cough that lasts 3 weeks or longer
* pain in the chest
* coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of active TB disease are

* weakness or fatigue
* weight loss
* no appetite
* chills
* fever
* sweating at night

Well, maybe. There is this from the American Lung Association

http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=35804

It is important to understand that there is a difference between being infected with TB and having TB disease. Someone who is infected with TB has the TB germs, or bacteria, in his/her body. The body's defenses, though, are protecting them from the germs, and they are not sick. Someone with TB disease is sick and, if not properly treated, can spread the disease to other people. A person with symptoms of TB disease or evidence of infection needs to be seen by a physician.

Is that about as clear as mud?

Any HCW or Docs want to weigh in?