Friday, March 24, 2006
Tuberculosis - News Updates
It is surprising to hear that the outbreak of tuberculosis (TB) has been steadily increasing here in recent years. To our regret, Korea’s outbreaks of tuberculosis and resulting death rate are said to be the highest among the Organization of Economic Cooperation and Development (OECD) member nations.
An alarming fact is that the number of new patients which stood at 30,000 in 2003, increased to 31,500 in 2004 and jumped to 35,000 last year, marking an 11.6-percent increase over previous year. Tuberculosis has long been considered almost conquered here by virtue of effective drugs. But, the disease is rebounding with an added intensity.
According to a statistics, nearly one-third of the world’s population is infected with tuberculosis, which kills almost 2 million people each year. Tuberculosis causes more deaths than any other infectious disease in the world. Though widely considered to be a curable disease thanks to the effective medicines, tuberculosis still remains the leading cause of death.
Though not confirmed, tuberculosis may not be the only disease that has made a comeback here with an added potency. According to health authorities, the disease is spreading rapidly particularly among young people. Of course, the resurgence of the disease is not limited to our country but is also a global problem.
Troublesome is the fact that the disease that used to be easily controlled with standard drugs are getting difficult to treat because the microbes causing it have developed a resistance to these drugs. What we have to pay particular attention to is the fact that the widespread use of these antibiotics is responsible for this resistance.
It is time for us to enhance our awareness of the danger the random use of antibiotics poses. Medical experts warn that the situation, if allowed to grow unchecked, could return the world to the pre-antibiotic era, setting the stage for a worldwide return of such an infectious disease.
Another major cause of its resurgence is rampant dieting among the people as part of their efforts to stay slim and healthy. An unreasonable diet is feared to cause serious nutritional imbalances, doctors said. Even young people with strong physical strength can easily be infected with tuberculosis when they lose their physical balance.
The doctors also pointed out that many people don’t seem to regard it seriously and think that tuberculosis is a disease of the old days and easily curable. But, reality is that as many as 3,000 people here die from tuberculosis every year. The death rate is four times higher that for AIDS.
Super TB strain rekindles fearsHealth officials say number of cases ebbing, drug-resistant disease emerging
By Rebecca Vesely, STAFF WRITER
Tuberculosis cases in California and nationwide are dropping to record lows, but a super-strain of TB resistant to antibiotics is emerging, health officials warned in advance of World TB Day today.
Meanwhile, some counties throughout California — including Alameda and San Mateo — saw an uptick in TB cases last year.
California has the highest number of TB cases of any state, with a total of 2,900 cases in 2005, down from 2,989 the previous year. Although the state saw a record low total cases last year, 10 of the 20 cities nationwide with the most TB cases are in California, including Oakland, Stockton, Vallejo, San Francisco and San Jose.
"The notion remains that TB is a disease of the past but it is anything but," said Dr. Robert Benjamin, medical director of Alameda County's TB control program.
Worldwide, TB kills 1.7 million people each year. Most cases occur in Africa, and global health officials are warning of a rise in what is being called "extensively drug-resistant" TB, especially in the former Soviet states.
In these cases, patients do not respond to the first-line antibiotics or three out of six of the second-line antibiotics available for treatments, according to a study released Thursday by the Centers for Disease Control and Prevention.
One in 50 TB cases throughout the world are "drug-resistant," meaning they do not respond to top-line antibiotics and so are more difficult to treat. These new cases are so drug-resistant that they can mean a death sentence.
"These are individuals who are virtually untreatable with available drugs," said Dr. Kenneth Castro of the CDC.
Even for patients with multidrug-resistant TB that can be controlled, the cost of treatment is far higher than typical TB and take much longer. A typical course of treatment costs
$3,000 for six months. Multidrug-resistant cases cost about $250,000 for two years of treatment, Benjamin said.
In California, about 80 multidrug-resistant TB patients undergo treatment today, according to the American Lung Association of California.
Two-thirds of all TB cases in California are among foreign-born. In Alameda County,
85 percent of TB cases occur among immigrants, Benjamin said.
"TB is coming to us on the wings of an airplane," he said, cautioning that victims should not be blamed, but instead TB programs worldwide should be enhanced.
There were 152 TB cases in Alameda County last year, up from 144 cases the previous year. That is still below a high of 242 cases in 2001.
TB is a contagious disease transmitted when a person with active TB coughs or speaks. TB symptoms include a cough lasting more than two weeks, coughing up blood, weakness, fatigue, weight loss or lack of appetite.
About one in 10 people in California have inactive TB, which can remain dormant for years before making the person sick or contagious, according to the state Department of Health Services. About 10 percent of people with inactive TB eventually become sick at some point in their lives if they are not treated.
"Finding and treating these infected Californians is essential to preventing future TB outbreaks," said Dr. Mark Horton, the state's public health officer, in a statement.
Next week, Sen. Barbara Boxer, D-California, and other lawmakers plan to introduce a bill that would triple United States aid to help control TB, with the goal of cutting international TB deaths in half by 2015. The bill would authorize $225 million for 2007 to combat TB worldwide.
Contact Rebecca Vesely at firstname.lastname@example.org. The Associated Press contributed to this report.
Inside Bay Area
TB still a scourge for Canada's poor, homeless, natives, refugeesProvided by: Canadian
PressWritten by: SUE BAILEYMar. 24, 2006
OTTAWA (CP) - Tuberculosis is still very much a disease of the poor in Canada and around the world, warn experts who say a global scourge could spread here unless more is done to stop it.
Native people, the homeless and refugees face much greater risk of infection, and rates have soared in developing countries plagued by AIDS. Canada has a choice, observers say: do more to stem a growing flood of cases overseas or grapple with the inevitable import and spread of the illness here.
That reality may shock those who assume the lung-attacking sickness once known as consumption has been all but wiped out.
Most Canadians take for granted one of the lowest infection rates in the world. But outside North America and most other industrialized regions, the developing world is caught in a TB outbreak.
"We're kind of like little islands," Dr. Michael Gardam, medical director of the University Health Network's tuberculosis clinic in Toronto, said Friday - World TB Day.
"We're surrounded by a worldwide epidemic.
"In fact, most of the deaths that are occurring in HIV-positive people in Africa are due to tuberculosis.
"Most people have no idea that this is happening."
In Canada, about 1,600 cases of active TB are diagnosed each year - five for every 100,000 people.
The rate for latent TB is many times higher. Gardam estimates that at least 10 per cent of the Toronto population is likely infected but not aware.
Latent TB only flares into the actual disease in about 10 per cent of otherwise healthy people. But those weakened by HIV or other conditions develop potentially deadly symptoms at a much higher rate.
Those who plan extended stays in developing countries should be tested before and after, Gardam said. Annual tests are also recommended for those having close contact with those at higher risk for infection.
There is no vaccine. Antibiotics offer a 97 per cent recovery rate if used properly but are often unavailable in countries where they're most needed, Gardam said.
Reasons for a tragic lack of basic care range from complete breakdowns of public-health services to global indifference.
An estimated two million people die around the world each year from TB, while another nine million become sick.
Improper use of antibiotics has also created an alarming spike in cases of multidrug resistance, Gardam said.
It's crucial that patients complete a six-month course of treatment without mixing antibiotics, he explained.
In Canada, rates of infection are 10 times higher on native reserves, said Phil Fontaine, national chief of the Assembly of First Nations.
"In some northern communities, up to half of the population is infected," he said. "This is simply unbelievable and unacceptable in any community in Canada in the 21st century."
He urged the Conservatives to make good on $870 million in health funding promised to aboriginal Canadians by the former Liberal government.
"TB is a preventable, treatable, curable disease," Fontaine said. "But it will persist for as long as our people continue to suffer in poor living conditions."
On the Northlands First Nation, a fly-in Dene community in northern Manitoba, more than 120 people have been treated for latent TB in the last year to ensure it doesn't become full-blown.
There are just 144 run-down houses for almost 1,000 people, said Chief Joseph Danttouze. Over-crowding is a factor widely blamed for the spread of tuberculosis.
"We've been asking for more money to build more homes . . . but it hasn't worked out for us yet," said Danttouze.
Unemployment on the remote reserve hovers at about 85 per cent.
"I think Indian Affairs should look at what's happening in our community. Why aren't they helping us to resolve some of these problems? We have our treaty rights."
Body and Health