# Totally drug resistant TB found in South Africa



## kejmack (May 17, 2011)

As I posted before, I think TB and Smallpox will be the next plagues. It is a 3 page article, I only posted the first part.

http://www.usnews.com/news/articles...ally-drug-resistant-tuberculosis-south-africa

Doctors Struggling to Fight 'Totally Drug-Resistant' Tuberculosis in South Africa

TB kills more people annually than any other infectious disease besides HIV

By JASON KOEBLER
February 11, 2013 RSS Feed Print

Patients of the TB center in Khayelitsha, South Africa, wait to see doctors, March 23, 2009. Tuberculosis is a contagious lung disease that spreads through the air, including through coughing and sneezing.
In a patient's fight against tuberculosis-the bacterial lung disease that kills more people annually than any infectious disease besides HIV- doctors have more than 10 drugs from which to choose. Most of those didn't work for Uvistra Naidoo, a South African doctor who contracted the disease in his clinic. For those who contract the disease now, maybe none of them will.

A new paper published earlier this week in the Centers for Disease Control and Prevention's Emerging Infectious Diseases journal warns that the first cases of "totally drug-resistant" tuberculosis have been found in South Africa and that the disease is "virtually untreatable."

Like many bacterial diseases, tuberculosis has been evolving to fend off many effective antibiotics, making it more difficult to treat. But even treatable forms of the disease are particularly tricky to cure; drug sensitive strains must be treated with a six-month course of antibiotics. Tougher cases require long-term hospitalization and a regimen of harsh drugs that can last years.

Naidoo, then an avid runner, says he continued training for months with the disease, which affects more than 389,000 South Africans annually (about one fourth of Africa's cases), according to the World Health Organization. It wasn't until he went to visit his family in Durban (he had been working with TB patients in a pediatric clinic in Cape Town) that his family noticed he had lost more than 30 pounds.

"I had flu symptoms and chest pains, but I was still running so I didn't think anything was wrong," he says. But when he went in for an X-ray, doctors found that his entire right lung had filled with fluid. Within weeks, he was on his deathbed as his body wasn't responding to the most commonly prescribed antibiotics.

"One night I nearly passed away-it didn't look good," he says.

His father, also a physician, suggested that he may have had an emerging MDR, or a multi drug-resistant strain of TB. The emergence of MDR and its even more dangerous cousin, XDR (extremely drug-resistant TB), have pushed tuberculosis cure rates in the country from a high of 73 percent in 2008 down to 53 percent in 2010.

[OPINION: African Health Ministers on How to Wipe Out TB]

Naidoo survived the night and doctors eventually found a treatment regimen that worked, but he was in and out of the hospital for three years, and the drugs' side effects were almost unbearable, he says. He developed Stevens-Johnson Syndrome, a complication that causes layers of skin to separate from each other and can be deadly. He regularly bled from his eyes. He fell into a deep depression.

"The TB doesn't feel like it's killing you, but the drugs do. I am a doctor and was informed that the drugs you take make you feel worse," he says. "My case was three years long. I don't think the average patient has that kind of patience."

At King George V hospital in Durban-one of South Africa's most popular TB clinics, which specifically treats XDR patients-the 200 beds are always full, and there's a four- to six-week waitlist for new patients.

William Bishai, of the Johns Hopkins Center for TB Research Laboratory and head of the KwaZulu-Natal Research Institute for Tuberculosis and HIV in South Africa, works with Naidoo and says his commitment to getting better is uncharacteristic in South Africa. TB is particularly easy to contract among people who have compromised immune systems due to HIV infection-a group that makes up about 12 percent of the country's population.

"There's a co-infection problem with HIV-a lot of XDR patients also have HIV and have to take eight TB drugs in addition to their HIV retrovirals," he says. "The average uneducated person would be prone to giving up. There have been a number of suicides at King George V."


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## CrackbottomLouis (May 20, 2012)

I really hope this stays in Africa. If not that's exactly why we should all prep for a bug in scenario. No treatment equals quarantine. I need more books and cooking fuel. And ammo of course.


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## ras1219como (Jan 15, 2013)

I agree...hope it stays there but with the ease of travel that's not likely. All it would take is one infected person on a plane. Hope the docs/scientists come up with something soon.


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## cnsper (Sep 20, 2012)

Part of the problem is that doctors hand out prescriptions like they were PEZ dispensers. Penicillin is not what it used to be and the same now for it's replacements.

People that take their children to the doc because of some sniffles or a fever are making things worse for their children later. The doc can not do anything except treat the symptoms and you can do that yourself. Unless the bone is protruding, I do not go to the doc. And then only if I can not treat it. I don't need an xray to tell me when a bone is broken and I can put a cast on myself.

The key is to get the docs to quit dispensing drugs like candy. Hell in the old days they used to hand out sugar pills to hypochondriacs.


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## ras1219como (Jan 15, 2013)

cnsper said:


> Part of the problem is that doctors hand out prescriptions like they were PEZ dispensers. Penicillin is not what it used to be and the same now for it's replacements.


Another issue is people that do not complete their drug therapy. Stopping antibiotics before the entire course is done can also allow the infection to become resistant.

And I completely agree with you that people go to the dr too frequently!


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## swjohnsey (Jan 21, 2013)

Good news and bad news. Good news is the TB is not easy to catch. Bad news is that most of the mechanisms used to battle TB in the past have been dismantled. You can no longer force folks into sanitarium/treatment facilities. The identities of folks who have TB is kept secret by public health officials. I taught in a school where a student had advanced TB, spitting up blood. The only way teachers found out was through the grapevine.


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## Woody (Nov 11, 2008)

cnsper said:


> Part of the problem is that doctors hand out prescriptions like they were PEZ dispensers. Penicillin is not what it used to be and the same now for it's replacements.


Not all doctors. My Dad was an MD and way back in the late 60's early 70's they knew that pumping antibiotics into folks for every ailment was a bad idea. I remember him talking about it with Mom one time at the dinner table. They were already finding resistant strains and needed to use different antibiotics to get rid of them.

But I do agree that recently things are different. Not so much with antibiotics but with other drugs. High blood pressure, here's a pill for that. Tired? Here's a pill for that. Can't sleep? Here's a pill for that. That pill gives you side effects? Here is a pill to take care of them.


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## ras1219como (Jan 15, 2013)

swjohnsey said:


> I taught in a school where a student had advanced TB, spitting up blood. The only way teachers found out was through the grapevine.


That's not only dangerous but irresponsible! Kids that have lice or chicken pox can't go to school (at least not when I was a kid) but someone with advanced TB can go?! If I had a child in that school I would be pissed. Of course you are correct that TB is difficult to catch but still...it's the principle.


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## swjohnsey (Jan 21, 2013)

Things have change since we were in school. Kids with lice are no longer set home, they just get a letter to take home to mom and maybe some lice treatment if they are poor. Most of this came about with the advent of AIDS.


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## ras1219como (Jan 15, 2013)

So many times I find things out and all I can do is shake my head and sigh. Looks like my future children will be going to private school...


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