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December 28, 2009

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Drug-resistant TB case found in the US

IT started with a cough, a cool-season hack that refused to go away.

Then came the fevers. They bathed and chilled the skinny frame of Oswaldo Juarez, a 19-year-old Peruvian visiting Florida to study English. His lungs clattered, his chest tightened and he ached with every gasp. During a wheezing fit, Juarez felt a warm knot rise from his throat. He ran to the bathroom sink and spewed a mouthful of blood.

"I'm dying," he told himself, "because when you cough blood, it's something really bad."

It was really bad, and not just for him.

Doctors say Juarez's incessant hack was a sign of what they have both dreaded and expected for years - first case of a contagious, aggressive, especially drug-resistant form of tuberculosis in the United States.

Extremely rare

Juarez's strain - so-called extremely drug-resistant XXDR TB - has never been seen in the US, according to Dr David Ashkin, one of the nation's leading experts on tuberculosis. XXDR tuberculosis is so rare that only a handful of other people in the world are thought to have had it.

"These are the ones we really fear because I'm not sure how we treat them," Ashkin said.

Forty years ago, the world thought it had conquered TB and any number of other diseases through the new wonder drugs: antibiotics. US Surgeon General William H. Stewart announced 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, hitchhiking their way in and out of countries.

The reason: Overuse and misuse of the very drugs that were supposed to have saved us.

Just as the drugs were a man-made solution to dangerous illness, the problem with them is also man-made. It is fueled worldwide by everything from counterfeit drug makers to the unintended consequences of giving drugs to the poor without properly monitoring their treatment.

"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 US Centers for Disease Control and Prevention.

"We are all connected by the air we breathe, and that is why this must be everyone's problem," he said.





 

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