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Extremely Drug Resistant TB Surfaces In US, Authorities Concerned

by Gopalan on  December 30, 2009 at 1:39 PM Respiratory Disease News   - G J E 4
 Extremely Drug Resistant TB Surfaces In US, Authorities Concerned
The identification of the first case of an extremely drug-resistant TB in US has made public health authorities nervous.
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XXDR-TB, the strain detected in 19-year-old Peruvian, Oswaldo Juarez, who was visiting the country, TB is virtually impervious to all the drugs that are used to treat the disease.  Somehow he contracted the diseases TB without ever having had tuberculosis before.

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The  boy  was treated for two years and finally released from the A.G. Holley State Hospital in Lantana, Florida. He was released with inactive TB. However, others who have had this XXDR-TB have not survived. So far there have only been a few cases of XXDR-TB worldwide.

This strain of TB is described by ABC News as contagious, aggressive, and especially drug-resistant. WebMD reports that TB is a bacterial infection that is transmitted through the air and very contagious. However, one must be exposed to TB intensely by one who has active disease. Many people do not show signs and symptoms of active disease, indeed, their cases of TB are often inactive and only 10% of those infected will ever develop the disease. TB will spread to the lymph nodes, to the bloodstream, and to any organ in the body, most commonly in the lungs.

Elsewhere, scientists have identified a strain of antibiotic-resistant tuberculosis that is resistant to rifampin, the front-line antibiotic to treat TB. The rifampin-resistant strain was identified in a patient in China and is described in a study that will appear in the January 2010 issue of The International Journal of Tuberculosis and Lung Disease.

Meanwhile, physicians and researchers around the world are expressing growing alarm over the disturbing escalation of a variety of antibiotic-resistant diseases they say are rapidly mutating. Some are worried because they fear these diseases will evolve into dominate  strains for which we have no new antibiotics to treat the level of resistance that we are now witnessing.

Once quite treatable, TB has slowly evolved resistance to first- and second-line antibiotics, throwing the wisdom of employing antibiotics to treat TB into doubt. 

According to some experts, the unprecedented increase in drug-resistant strains of otherwise lethal diseases could be because patients have taken far too many antibiotics or failed to take the full course of their antibiotic treatment, thereby allowing the diseases to naturally evolve into a drug-resistant form.

Indeed. The World Health Organization (WHO) says multidrug-resistant TB (MDR-TB) is becoming an especially dangerous problem in many parts of the world expressly because patients who do not adhere to their six-month TB treatments.

WHO says about five percent of all TB cases are MDR-TB that's resistant to rifampin and isoniazid, the primary drugs used to combat the disease. There are about 40,000 new cases of extensivelydrug-resistant TB (XDR-TB) every year, WHO reports.

The XXDR strain of TB is so rare that only a handful of other people in the world are thought to have had it.

According to WHO, there have only been a handful of cases of XXDR TB worldwide. The strain is resistant to all tuberculosis drugs and is almost always fatal.

According to WHO, two cases have been diagnosed in Europe, and two cases are suspected to have appeared in Italy in 2003, both of which were fatal.

Ironically a former  Surgeon General of the US William H. Stewart had once declared that it was "time to close the book on infectious diseases and declare the war against pestilence won."

Today, all the leading killer infectious diseases on the planet — TB, malaria and HIV among them — are mutating at an alarming rate.

"Drug resistance is starting to be a very big problem. In the past, people stopped worrying about TB and it came roaring back. We need to make sure that doesn't happen again," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, who was himself infected with tuberculosis while caring for drug-resistant patients at a New York clinic in the early '90s. "We are all connected by the air we breathe, and that is why this must be everyone's problem."

Source: Medindia
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