Marshall Islands: Drug Resistant Tuberculosis health emergency declared

[Shiloh]

Source: http://topnews.us/content/210458-tb-...rshall-islands

TB health emergency in Marshall Islands
Submitted by Anjali Singh on Sat, 01/30/2010 - 11:38

Tuberculosis in Marshall Islands, a public health emergency has been declared. This has happened following an outbreak of drug-resistant tuberculosis. The government is thinking of calling upon special powers of quarantine.

In less than two months the number of people with the drug-resistant disease has risen from six to 10 in the western Pacific nation. Everyone now fears that the situation would escalate and will reach to 500.

Majuro Hospital chief of staff Marie Lanwi-Paul, said, "We are in the process of doubling the bed capacity" in the TB isolation unit.?

Rachel Powel who is working with the World Health Organisation said, "Drug resistance poses a serious threat to our ability to treat and control TB.?

Marshall Islands Health Minister Amenta Matthew said she was in the process of forming legislation that would give power to the director of health to quarantine people who were not complying with TB prevention requirements.

Mathew felt that the drug-resistant TB evoloved because of people not following advice of taking medicines despite physicians counseling them.

It was reported that one patient was taken to the court by health authorities for failing to take treatment and remain in isolation.

[alert]

Re: Marshall Islands: TB health emergency declared

http://www.promedmail.org/pls/otn/f?p=2400:1001:7837084919229897::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,81142

Archive Number 20100131.0335
Published Date 31-JAN-2010
Subject PRO/EDR> Tuberculosis, drug resistance - Marshall Islands: RFI


TUBERCULOSIS, DRUG RESISTANCE - MARSHALL ISLANDS: REQUEST FOR INFORMATION
************************************************** ***********************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 30 Jan 2010
Source: Top News [edited]
<http://topnews.us/content/210458-tb-health-emergency-marshall-islands>


A public health emergency has been declared in Marshall Islands. This
has happened following an outbreak of drug-resistant tuberculosis
(TB). The government is thinking of calling upon special powers of quarantine.

In less than 2 months the number of people with the drug-resistant
disease has risen from 6 to 10 in the western Pacific nation.
Everyone now fears that the situation would escalate and will reach
to 500. Majuro Hospital chief of staff Marie Lanwi-Paul, said, "We
are in the process of doubling the bed capacity" in the TB isolation unit."

Rachel Powel who is working with the World Health Organisation said,
"Drug resistance poses a serious threat to our ability to treat and
control TB." Marshall Islands Health Minister Amenta Matthew said she
was in the process of forming legislation that would give power to
the director of health to quarantine people who were not complying
with TB prevention requirements. Matthew felt that the drug-resistant
TB evolved because of people not following advice of taking medicines
despite physicians counseling them. It was reported that one patient
was taken to the court by health authorities for failing to take
treatment and remain in isolation.

[Byline: Anjali Singh]

--
Communicated by:
M. Randolph Kruger
<memphisservices@bellsouth.net>

[It is stated in the news release that the outbreak of drug resistant
TB in the Marshall Islands is secondary to improper management of the
TB cases, i.e., the TB drugs were not taken by patients as
recommended by the physicians. However, the exact drugs to which the
_Mycobacterium tuberculosis_ isolates are resistant and the extent of
the drug resistance is not specified in the above news release. Also
it is not specified if there is any epidemiological linkage among the
patients, if the isolates have similar drug resistance patterns, or
if they have been genotyped. Detailed discussions of drug-resistant
TB can be found in prior ProMED posts below.

The Marshall Islands is an island nation with a population of about
62 000 in the middle of the Pacific Ocean, just west of the
International Date Line and just north of the Equator
(<http://en.wikipedia.org/wiki/Island_nation>). From 1946 to 1958,
the USA tested 67 nuclear weapons in the Marshall Islands.
Independence was completed in 1990, when the UN officially ended its
Trusteeship status. In 1986, the Compact of Free Association with the
USA provides for aid and USA defense of the islands in exchange for
continued USA military use of a missile testing range
(<http://en.wikipedia.org/wiki/Island_nation>). The location of the
Marshall Islands in relation to other countries in the South Pacific
can be found on a map at
<http://www.lonelyplanet.com/maps/pacific/>. - Mod.ML]

[Shiloh]

Re: Marshall Islands: Tuberculosis health emergency declared

Source: http://www.guampdn.com/article/20100...1/2060313/1002

Interior gives Marshall Islands $1.4M to help allay TB outbreak
By Gaynor Dumat-ol Daleno ? Pacific Daily News ? February 6, 2010

The Department of the Interior is giving $1.4 million to help the Republic of the Marshall Islands mitigate an outbreak of multiple-drug-resistant tuberculosis in the island nation.

"This disease needs to be stopped in its tracks for the health of the Marshallese people," said Assistant Secretary of the Interior for Insular Areas Tony Babauta. "If left unchecked, it would burden the community -- not just with expensive medical care -- but with lives lost prematurely."

"In the recent past, there has been a similar outbreak in the Federated States of Micronesia and I anticipate that the lessons learned will provide an excellent model for the Marshalls to follow and provide a similar outcome of success," Babauta said in a press release.

During a 2008 outbreak of drug-resistant tuberculosis in the FSM, the U.S. government provided similar assistance to successfully stem the spread of the disease, according to Interior.

[Shiloh]

Re: Marshall Islands: Drug Resistant Tuberculosis health emergency declared

Source: http://www.yokwe.net/index.php?name=...ticle&sid=2525

TB Threat in Marshall Islands Requires More Action

# MIJ: TB Threat - Public Health Emergency - three of 10 Marshallese with drug resistant TB have died
# TB challenge gets a parliamentary focus in the Marshall Islands - frustration with the current law that requires them to go to court to quarantine patients
# Moves to forcibly quarantine TB patients in Marshall Islands - few people who could contract drug resistant TB have refused to take their medication
# Marshalls Seeks Quarantine in TB Outbreak Minister of Health is asking the parliament to amend a law

MORE:
* U.S. Interior Gives Marshall Islands 1.4M to Fight TB - Tony Babauta, Assistant Secretary of the Interior for Insular Areas, signed yesterday a $1,456,932 grant that will be used to combat an outbreak of multiple drug resistant tuberculosis in the Marshall Islands.


THREAT: Underlining the health threat of drug resistant TB, three of 10 Marshallese with drug resistant TB have died, including one of two discovered in recent months, according to a recent report from the US Centers for Disease Control. The report, based on a CDC investigation conducted in November at the request of the Ministry of Health, shows six patients were on Ebeye and four on Majuro. The drug resistant problem first developed in 2004. CDC?s investigation estimated there are 480 people who had contact with the active drug resistant TB patients, and of those, 168 were ?anticipated? to be infected.
CDC describes the outbreak of drug resistant TB as ?a public health emergency.? ?This threat is an emergency,? said Assistant Attorney General Rosania Bennett at Tuesday?s hearing on a TB-related bill. ?It can impact us all as it?s hard to monitor and cure.?

HEARING: The threat of drug resistant tuberculosis in the Marshall Islands has prompted Parliament?s health committee to consider a law ammendment to allow public health officials to order the quarantine of patients.The recommendation was made during a public hearing on Thursday, considering legislation to increase the authority of health officials to detain people who are a threat to public health and prevent the spread of communicable diseases.During the meeting, Public Health Director Dr Kennar Briand said in other countries, people who pose a public health risk can be detained in jail, and asked why not take the next step if a person refuses treatment.

TREATMENT: The country?s TB-Leprosy Director, Dr Kennar Briand says three patients have died from the disease, three are still receiving treatment, there is one suspected case, and two unconfirmed historical cases. He says they are also trying to interview several-hundred people who may have been in contact with TB patients. Dr Briand says a few people who could contract drug resistant TB have refused to take their medication for a variety of reasons. ?Same reasons why people in the Pacific don?t want to take drugs. They believe its magic, they believe they can use local medicines, same reasons, some people don?t want to bother taking it.?

QUARANTINE: Introducing the legislation, Health Minister Amenta Matthew said the current system requiring public health officials to take a person to court requires a lengthy and difficult process that does not adequately prevent spread of contagious diseasesThe Marshall Islands has confirmed 10 drug-resistant TB cases, and overall has the highest rate of TB in the Pacific at over 190 per 100,000 population. The rate in the United States is four per 100,000. Drug resistant TB has developed as a "result of non-compliance to medications due largely to patients? refusal to take their medicines regardless of efforts by the Public Health physicians to conduct home visits and counseling," she said. "Currently, there are patients who continuously move around the community with TB disease posing the threat of exposing others to the disease."

GRANT: Babauta pointed out that this is not the first occurrence of drug resistant TB in the Freely Associated States. ?I am increasingly concerned that given the free migration privileges of FAS citizens to the U.S., outbreaks such as this demands quick and immediate action by FAS leaders, the federal government and U.S. jurisdictions most visited by FAS citizens,? he said. ?Containment and cure should be our priority to ensure that FAS and U.S. citizens are protected. In the recent past there has been a similar outbreak in the Federated States of Micronesia and I anticipate that the lessons learned will provide an excellent model for the Marshalls to follow and provide a similar outcome of success."

[Sally Furniss]

Re: Marshall Islands: Drug Resistant Tuberculosis health emergency declared

Officials will now forcibly quarantine people TB patients who have failed to follow prevention guidelines. Parliament has allowed officials to do this in Marshall Islands.

The country's TB-Leprosy Director, Dr Kennar Briand said, "Three patients have died from the disease, three are still receiving treatment, there is one suspected case, and two unconfirmed historical cases."

There are attempts being made to interview people who might have been in any kind of contact with people having TB.

Dr Briand said that people with drug resistant TB have denied taking any medication. He added, "They believe its magic, they believe they can use local medicines, same reasons, some people don't want to bother taking it."

He however added that there were resources available to handle the situation if needed.

TB rate in the Marshall Islands is the highest at 190 per 100,000 population.

http://topnews.us/content/210635-officials-quarantine-tb-patients-forcibly

[AlaskaDenise]

Re: Marshall Islands: Drug Resistant Tuberculosis health emergency declared

Dealing with TB in the Marshall Islands has its challenges.

The Marshallese working for the US military missle test range live on Ebeye, crammed into a mile-long and quarter of a mile-wide islet, supporting a population of about 12,000, in hardship conditions.

(http://yokwe.net/index.php?name=News...ticle&sid=2236)

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