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The Patient Predator
This article is an extremely interesting one; However, I will only post the beginning of it due to it length. The link is posted below the article if you wish if finish reading it. This was written some time ago but the historical information about TB is worth reading.
The Patient Predator
Dr. Lee Reichman is alarmed by the public's indifference to the peril posed by multidrug-resistant strains of TB. <!--end caption-->
<!--deck-->News: Tuberculosis is back, and thanks to globalization and slipshod treatment, it's deadlier than ever. <!--end deck-->
<!--byline--><SCRIPT language=Javascript type=text/javascript><!--byline_title_by_url('/news/feature/2003/03/');//--></SCRIPT>By Kevin Patterson
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The creature arrived in the arctic as it had spread itself around the world. It lay dormant in the lungs of someone apparently healthy enough to undertake such a journey, and then, when he was weakened, perhaps by hunger, or cold, or simple loneliness, it revived itself explosively. The sailor, or the missionary, or the trader found himself coughing paroxysmally and febrile, in some little iglu or tent, the bacterium streaming through his blood, to all his organs, and then a local Inuk had the misfortune to enter the shelter and leave. In Arviat, one of the Inuit communities that hug the shore of Hudson Bay, lives a woman I will call Therese Oopik, who carries the descendants of the creature within her. I visit Arviat in my work as an internist and she is my patient. We have been acquainted for a decade. Mostly we have had quiet conversations about contraception and bladder infections; these days we talk about this infection that seems likely to claim her.
She was beautiful when I first knew her, with a full-faced smile and glowing from the cold, but for two years now she has lost weight steadily and she looks as emaciated as a New York City fashion model. We joke about this. When I next visit there, she suggests, I might find a job for her.
Arviat is populated by 1,800 people, almost all Inuit, and it clings to the low rocks that stretch into the Arctic water like a collection of brightly painted aluminum-sided mollusks. The wind scours this place. Everyone knows everyone else and most of their problems. There have been episodic outbreaks of tuberculosis here, as in all the little communities in this part of the Canadian Arctic, ever since that first coughing sailor or missionary arrived. Tuberculosis has smoldered on notwithstanding the advent of antibiotics. The disease is primarily an expression of poverty and its consequences, especially overcrowding, and in the Arctic, these are usual. Latent infection endures in almost everyone older than 40. It revives itself regularly and seeps through the community; by the time a new outbreak is recognized there are usually dozens of new infections, some apparent, most already gone dormant.
Therese is 27 and does not know from whom she caught her illness. There are nearly as many possibilities as there are people around her. Half her left lung is taken up by a giant cavity full of the organism. Every time her sputum has been analyzed in the last two years, it has been found to be packed with the little rods of Mycobacterium tuberculosis that stain crimson when examined under the microscope. She coughs constantly and is so thin she is cold even inside, wrapped in blankets. After months of unsuccessful treatment in Arviat, she spent much of last winter in a hospital in southern Canada, but she continued to lose weight steadily. Her sputa remain resolutely positive. Finally, she insisted on going home, to her children, and to the tundra.
She has the cachectic facies of a painting of a Victorian consumptive, Munch's Sick Child, perhaps. It is an uncomfortable feeling to find in her sickness the conventions of beauty -- boniness and pallor. She is suspicious of doctors and nurses and takes her medication only episodically. People worry aloud about her children. This is a catastrophe in formation. A slow-moving freight train.
This catastrophe threatens to erupt on a vastly larger scale than Arviat, to involve the entirety of North America. For the past 12 years I've treated patients in TB hot zones such as the Arctic, the Pacific Islands, inner-city America. What I and others on the front lines have to report is that TB is migrating out of these geographically remote or economically isolated communities and into the mainstream.
Continued at :http://www.motherjones.com/news/feat...ma_311_01.html
<!--end date--></NOINDEX>
The Patient Predator
Dr. Lee Reichman is alarmed by the public's indifference to the peril posed by multidrug-resistant strains of TB. <!--end caption-->
<!--deck-->News: Tuberculosis is back, and thanks to globalization and slipshod treatment, it's deadlier than ever. <!--end deck-->
<!--byline--><SCRIPT language=Javascript type=text/javascript><!--byline_title_by_url('/news/feature/2003/03/');//--></SCRIPT>By Kevin Patterson
<!--end byline-->
<!--date-->
The creature arrived in the arctic as it had spread itself around the world. It lay dormant in the lungs of someone apparently healthy enough to undertake such a journey, and then, when he was weakened, perhaps by hunger, or cold, or simple loneliness, it revived itself explosively. The sailor, or the missionary, or the trader found himself coughing paroxysmally and febrile, in some little iglu or tent, the bacterium streaming through his blood, to all his organs, and then a local Inuk had the misfortune to enter the shelter and leave. In Arviat, one of the Inuit communities that hug the shore of Hudson Bay, lives a woman I will call Therese Oopik, who carries the descendants of the creature within her. I visit Arviat in my work as an internist and she is my patient. We have been acquainted for a decade. Mostly we have had quiet conversations about contraception and bladder infections; these days we talk about this infection that seems likely to claim her.
She was beautiful when I first knew her, with a full-faced smile and glowing from the cold, but for two years now she has lost weight steadily and she looks as emaciated as a New York City fashion model. We joke about this. When I next visit there, she suggests, I might find a job for her.
Arviat is populated by 1,800 people, almost all Inuit, and it clings to the low rocks that stretch into the Arctic water like a collection of brightly painted aluminum-sided mollusks. The wind scours this place. Everyone knows everyone else and most of their problems. There have been episodic outbreaks of tuberculosis here, as in all the little communities in this part of the Canadian Arctic, ever since that first coughing sailor or missionary arrived. Tuberculosis has smoldered on notwithstanding the advent of antibiotics. The disease is primarily an expression of poverty and its consequences, especially overcrowding, and in the Arctic, these are usual. Latent infection endures in almost everyone older than 40. It revives itself regularly and seeps through the community; by the time a new outbreak is recognized there are usually dozens of new infections, some apparent, most already gone dormant.
Therese is 27 and does not know from whom she caught her illness. There are nearly as many possibilities as there are people around her. Half her left lung is taken up by a giant cavity full of the organism. Every time her sputum has been analyzed in the last two years, it has been found to be packed with the little rods of Mycobacterium tuberculosis that stain crimson when examined under the microscope. She coughs constantly and is so thin she is cold even inside, wrapped in blankets. After months of unsuccessful treatment in Arviat, she spent much of last winter in a hospital in southern Canada, but she continued to lose weight steadily. Her sputa remain resolutely positive. Finally, she insisted on going home, to her children, and to the tundra.
She has the cachectic facies of a painting of a Victorian consumptive, Munch's Sick Child, perhaps. It is an uncomfortable feeling to find in her sickness the conventions of beauty -- boniness and pallor. She is suspicious of doctors and nurses and takes her medication only episodically. People worry aloud about her children. This is a catastrophe in formation. A slow-moving freight train.
This catastrophe threatens to erupt on a vastly larger scale than Arviat, to involve the entirety of North America. For the past 12 years I've treated patients in TB hot zones such as the Arctic, the Pacific Islands, inner-city America. What I and others on the front lines have to report is that TB is migrating out of these geographically remote or economically isolated communities and into the mainstream.
Continued at :http://www.motherjones.com/news/feat...ma_311_01.html
<!--end date--></NOINDEX>