Gert van der Hoek
In Memoriam - Editor, Senior Moderator
First "XDR" TB cases found in Myanmar migrants
Mon Jun 11, 2007 4:41AM EDT
By Gill Griffith-Jones
MAE SOT, Thailand (Reuters) - Aid workers have discovered the first cases of "extensively drug resistant" TB among migrants from Myanmar, intensifying fears about untreatable infectious diseases propagating in the army-ruled former Burma.
French aid agency Medecins Sans Frontieres (MSF) said it had confirmed two cases of "XDR" tuberculosis in the Thai border town of Mae Sot last week, and had two other suspected cases of the hard-to-treat strain.
One of the infected patients was a refugee, the other a migrant worker, MSF said.
MSF's discovery made no headlines, unlike the furor in the United States over bungled attempts to isolate an XDR-infected 31-year-old lawyer who flew halfway round the world despite requests not to travel.
However, as an indicator of the growth of drug-resistant killer diseases in Myanmar due to a combination of simmering civil war, a non-existent health service and the widespread availability of fake drugs, it is arguably far more serious.
"We cannot treat XDR here. There is no treatment for them," said Janne Krause, one of the MSF doctors responsible for dealing with the growing numbers of TB patients flocking across the border.
MSF, which sees between 50 and 80 new TB patients from Myanmar every month, started treating "multi-drug resistant" patients in 2005.
Throughout an arduous treatment course in a special "TB village" in a refugee camp, patients are under careful monitoring to ensure they do not deviate from prescribed dosages.
Allowing them to miss doses, take half doses or doses with fake pills that contain only a fraction of the correct drugs is a sure way to let the TB bacterium mutate and start to build up immunity, experts say.
Unfortunately, among refugees and the desperately poor migrant workers flooding into Thailand, ad hoc self-treatment is the norm.
"They don't take their drugs regularly. They take them every second day because they want to save drugs. They stop taking them then start again after some weeks. They take all kinds of drugs in different combinations," she said.
Some patients have even managed to get hold of "second-line" drugs used to treat the multi-drug resistant strain.
"This is how they become finally XDR," Krause said.
The World Health Organization has confirmed 269 cases of XDR TB in 35 countries, with 85 percent of patients expected to die. Myanmar has not had any confirmed cases.
Long-term treatment with strong antibiotics can cure patients but in the United States the costs exceed $250,000 per patient.
http://www.reuters.com/article/healthNews/idUSBKK2176820070611
Mon Jun 11, 2007 4:41AM EDT
By Gill Griffith-Jones
MAE SOT, Thailand (Reuters) - Aid workers have discovered the first cases of "extensively drug resistant" TB among migrants from Myanmar, intensifying fears about untreatable infectious diseases propagating in the army-ruled former Burma.
French aid agency Medecins Sans Frontieres (MSF) said it had confirmed two cases of "XDR" tuberculosis in the Thai border town of Mae Sot last week, and had two other suspected cases of the hard-to-treat strain.
One of the infected patients was a refugee, the other a migrant worker, MSF said.
MSF's discovery made no headlines, unlike the furor in the United States over bungled attempts to isolate an XDR-infected 31-year-old lawyer who flew halfway round the world despite requests not to travel.
However, as an indicator of the growth of drug-resistant killer diseases in Myanmar due to a combination of simmering civil war, a non-existent health service and the widespread availability of fake drugs, it is arguably far more serious.
"We cannot treat XDR here. There is no treatment for them," said Janne Krause, one of the MSF doctors responsible for dealing with the growing numbers of TB patients flocking across the border.
MSF, which sees between 50 and 80 new TB patients from Myanmar every month, started treating "multi-drug resistant" patients in 2005.
Throughout an arduous treatment course in a special "TB village" in a refugee camp, patients are under careful monitoring to ensure they do not deviate from prescribed dosages.
Allowing them to miss doses, take half doses or doses with fake pills that contain only a fraction of the correct drugs is a sure way to let the TB bacterium mutate and start to build up immunity, experts say.
Unfortunately, among refugees and the desperately poor migrant workers flooding into Thailand, ad hoc self-treatment is the norm.
"They don't take their drugs regularly. They take them every second day because they want to save drugs. They stop taking them then start again after some weeks. They take all kinds of drugs in different combinations," she said.
Some patients have even managed to get hold of "second-line" drugs used to treat the multi-drug resistant strain.
"This is how they become finally XDR," Krause said.
The World Health Organization has confirmed 269 cases of XDR TB in 35 countries, with 85 percent of patients expected to die. Myanmar has not had any confirmed cases.
Long-term treatment with strong antibiotics can cure patients but in the United States the costs exceed $250,000 per patient.
http://www.reuters.com/article/healthNews/idUSBKK2176820070611