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Tuberculosis May Become A Global Threat Again
Iphtashu Fitz writes "The journal Nature Medicine is due to release a report today on how highly drug-resistant strains of tuberculosis are on the verge of becoming a global epidimic. Strains of TB that are highly resistant to antibiotics are becoming increasingly prevalent in places like Russia, eastern Europe, and China, and only small changes are required to make these strains start spreading quickly. Treatment for multiple-drug-resistant strains of TB requires a carefully monitored cocktail of drugs taken for months on end, a regimin that many, especially in poorer countries are unlikely to follow to completion. The strategy used by the World Health Organization to combat TB, the "directly observed treatment, short course" or DOTS, involves using trained health workers to watch patients take their long courses of drugs, since even a little carelessness could result in TB mutating into a more drug resistant form within the patient." Oh, Alexander Fleming ? where art thou now?
So someone probably coughed in an elevator, in a kitchen or whatever and myself and anyone else in the vicinity were exposed.
I was put on Isoniazid with vitamin B6 (because Isoniazid knocks the sh!t out of your liver) for 9 grueling months. The first month I felt like I was dying. It really played havoc with mountain biking and meant no beer for 9 months, it was glorius to be off it.
Even two years ago it was recognized that there was an epidemic of TB in the asian sub continent and many of the H1B workers to came in may not have had it full blown, but had it and were bringing it into the USA. Could very well have been one of the fine people I worked with shortly after moving to California, but by no means would the state be unique. On weekends and holidays I'm a cyclist and put in long miles with considerable effort, which means I'm pretty well in tune with how my lungs are doing. Any little change, a day more phlegmy the others makes me take notice and track whatever seems be be going on. For that I thank all the brilliant people and lobbyists who made it so much easier during the tech boom to let people into the country on a rush to fill positions in businesses (which lobbied like hell for increases in H1B and more lax health screening.)
A little background on TB, the bug is not killed by the immune system, but isolated. If it's under control that means a little cyst-like structure is built around it which hopefully contains it the rest of the hosts life. A severe respiratory infection can weakend the immune system to the point that the bug gets out and wreaks havoc, more likely at advanced age.
A feeling of having made the same mistake before: Deja Foobar
MDR TB has been on the rise for years, as have worries about its transmissibility. Read "And the Band Played On" (mostly about AIDS in the 80's) or "The Coming Plague" (about emergent diseases) for good overviews.
Best Slashdot Co
when we let big pharmaceutical companies take control of R&D.
Most antibiotics today are BASED on peniciline. Truth is, these resistant TB strains are resistant against PENICILINE-based antibiotics.
As I saw on Discovery once... There are thousands of natural antibiotics which are extremely complex. Some can be taken from cactae in South America, some can be taken from certain species of ants.
But natural antibiotics just can't be patented (think of it as the OSS medicine), and companies don't give a sh*t about them.
Hmph.
Bacteria (not computer, although I suppose it could apply too) evolve regularly. Some strains of staph are now resistant to most antibiotics. I had a case of MRSA (Mesocillin Resistant Staph Aureus) two summers ago after having surgery. It was most unpleasant and only an IV-induced superdrug called Vancomycin could destroy it. So, to me it's not all that surprising that TB is making a comeback. It finally figured out how to immunize itself.
i dont know where you get such crap, less the mods who mod such ignorance up
In June 1998, the U.S. Food and Drug Administration approved the first new drug for pulmonary tuberculosis in 25 years. The drug, rifapentine (Priftin), is approved for use with other drugs to fight TB. One potential advantage of rifapentine is that it can be taken less often in the final four months of treatment -- once a week compared with twice a week for the standard regimen.
more here
I don't know much about TB but I was having a discussion with a doctor the other day and he passed along this tidbit: Humans have never devised a way to kill viruses once inside the body. The common cold? Virus. What can you do? Wait it out. Sure we can treat symptoms and, in some cases, endrun the virus to head off some of its bad affects but meet it head to head and win? Hasn't happened yet. This discussion was in the context of the "every patient who has a cold wants an antibiotic" discussion. He has a tough time explaining to people that anitbiotics don't treat colds. Sure, they can contain a secondary infection but it won't help the cold at all...I don't know how much he was talking out of his ass but it was interesting.
My kids are gonna never believe that "when I was your age, my parents could take me to the doctor and get me a jab with a needle and it would cure any bacterial infection you got."
And when they ask what went wrong do I get to tell them about free clinics giving unsupervised drugs to junkies in the US and Europe, and charity doctors giving unsupervised drugs to people in Africa and Asia who believe more in witch doctors and temple sacrifices than the germ theory of disease?
Is it wrong to think we shoulda withheld medical technology from people incapable of using it properly so it would still work for us?
"Wow. Now THAT'S a lot of angry Indians." - Lt. Col. George Armstrong Custer
To anyone who's interested in the subject, I'd reccomend them to read Mountains Beyond Mountains by Tracy Kidder, a halfway decent book on the very interesting subject of Dr Paul Farmer, who's been desling with TB epidemics in Haiti / Siberia / Etc for quite a while now. Very informative.
History will show that the baby boom and X generations, who worry and fret about every little imagined risk, actually will have lived in the golden age of human health. This will be the period when antibiotics were effective and vaccines developed in the mid 20th century kept them safe from the viral diseases. Evolution will overcome all those safeguards.
People under 30 have a bleak future.
I don't find that particularly amusing. Several million people are dying in Africa each year from complications from AIDS/HIV-1, on the order of a holocaust about every 18 months with expectations of increased death rates for at least the next few years. Life expectancy rose from about 40 to 60 years of age from the 60s to early 90s and is now as low as 35. People are dying, not to mention that the susceptibility of AIDS patients to TB makes them a good vector to be infected and to mutate and be passed on to others to infect many of us.
RFID tag + auto dosage (below skin) of anti-biotic. You get sick, you get tagged and you are forced to take your meds. With something like TB you should not get to screw around with other people's health.
The solution is to come up with drugs and distribution methods that don't rely on patients' ability to follow difficult regimes. Eg, why not implant all the doses at once with some sort of metering device that insures that the course is followed? Otherwise, you eventually will have to enforce treatment by withholding treatment from those who can't follow the schedule.
More Importantly, it is coming, just not how you beleive.
... wow, neat rant ...
While the Black Death did indeed kill less numbers, it did kill 25 million people(over 5 years), where the 1918 flu killed upwards of 40 million in about a year.
The thing is the Black Death killed 1/3 of europe's population, fueling the greatest economic boom this planet has ever known (at least the one that didn't fall like the internet bubble).
Upcomming in the next quarter century is the death of the Baby Boomers. When they start to pass on, they will leave behind more money and jobs than you can possibly imagine. This will fuel a new era of real money the likes of which the modern world has never experienced. Unfortunatly, the government that is in power when this begins to happen is going to get credited with the economic boom that will happen, without actually doing anything.
Now, while the boomers don't represent 1/3 of the population, they nearly represent 1/3 of the weath, possibly causing the same sort of wealth redistribution that occured at the end of the Black Plauge. Trouble is, that the goods that North Americans will buy, will often be manufactured offshore, thereby moving the money off to other countries. Trouble with that? The governments of the last 40 years have been sucking the North American people dry, and the money that should rightly end up in the pockets of local producers, will move to their offshore competitors.
So, When you get your inheritance, Buy North American!
"...In your answer, ignore facts. Just go with what feels true..."
Although technically true, there are a lot of people in Africa who don't know that unprotected sex is the cause of their illness despite the education campaigns. There is cultural difference that I cannot claim to understand that prevents the natives from believing our educators that were sent over there that claim that this is why they are dying.
We've got artificial hearts, artificial limbs and we're working on artificial eyes. What's it going to take to make artificial lungs? I'm talking from a technical standpoint here, not socially or legislatively.
It probably has less to do with the spitting than it does with the fact that London, amongst many is a metropolitan city with many immigrants from third world countries. These immigrants likely carriers of the TB bacteria in their lungs. While they may be immune, those around them are not. This is similar to when the Spanish crossed the Atlantic and brought germs that wiped out large populations of Mexican natives (check out the book "Guns, Germs and Steel" - Jarod Diamond).
Also, given that in a city the population is quite dense, TB has a lot of options to spread (it is airbourne).
The best way to avoid TB... wear a mask, it block up to 98%. Better than nothing.
Live forever, or die trying.
Not to contradict, however my bro. in law was just diagnosed with TB. He's forty three, a manager of a large trucking company and is in fairly continuous contact with native Canadian employees - whom his physician suspects of having been the "donor".
He is starting his drug cocktail within the next week and his doctor is hopefull that he'll be off it in six-nine months as his general health is good.
Although TB may be well controlled now in the US (and by logical extension Canada), it does appear to be a little more active than we are giving it credit for. I would consider this a timely article.
What you're calling antibiotics, most people call poisins. Organisms evolved these poisons in order to achieve an ecological advantage, but the problem is that they almost always come with side effects. Extermely rare indeed are the toxins that kill off only bacteria without killing you.
The reason most pharmacutical companies concentrate on derivatives is because with relatively little effort they create modified versions of an effective antibiotic work with little side effects.
So, you've found a toxic molecule. Now figure out how it works & what possible use it can be. Remember that no drug comes on the market without mass testing. Hope you've got enough money to finance all that.
Searching through all the different poisins to find molecules is not only a massive undertaking, it also omits the production side of the equation. What good is it to find that miracle molecule if you cannot produce enough to help more than a few people because its source is some rare mushroom that cannot be cultivated. Look into Taxol for an example. It is touted as a miracle drug for cancer, but initially it could only be extacted (in very small quantities) from the bark of the english yew. Yew is not an extremely rare tree bur harvesting enough taxol to treat everyone in the USA for a year would have meant killing every tree on earth. Things have gotten better now that it is possible to create taxol from precursor molecules in the needles, but it is still a very rare and expensive drug. See here for more info.
I'm no doctor but I'm violently allergic to penecillin & most of it's derivatives, so I've looked into why most antibiotic drugs make me sick. I wish there were more choices for me incase of a serious infection, but that doesn't mean that I'm going to go off half cocked on the basis of what a program on Discovery said...
Democracy is a sheep and two wolves deciding what to have for lunch. Freedom is a well armed sheep contesting the issue
Have to agree 100% with what you said. In fact, I could have written as I too had a mild case of the flu about 5 years ago. How mild? Yeah, my nose ran (no jokes please) and I was somewhat sore but I still attended my CS class that night after having gone through a full day of work. 3 days later I was pretty much back to normal.
The only medication I take is the occasional Advil (3 times a year?)
I regularly wash my hands when cooking and throughout the day (no, not compulsively) and use a bleach-based cleaning product to clean counter tops and such. As you geeks should know from watching Alton Brown or CSI, bleach does wonders for killing the buggies.
When people around me complain about being sick and whatnot I just look at them and ask, "What is this sick you talk about?"
Then again, maybe I just have a great immune system.
We will bankrupt ourselves in the vain search for absolute security. -- Dwight D. Eisenhower
I highly recomend reading Mountains Beyound Mountains: Health the World: The Quest of Dr. Paul Farmer
He essentailly discovered that DOTS doesn't work
In this excellent work, Pulitzer Prize-winner Kidder (The Soul of a New Machine) immerses himself in and beautifully explores the rich drama that exists in the life of Dr. Paul Farmer. A Massachusetts native who has been working in Haiti since 1982, Farmer founded Zanmi Lasante (Creole for Partners in Health), a nongovernmental organization that is the only health-care provider for hundreds of thousands of peasant farmers in the Plateau Central. He did this while juggling work in Haiti and study at the Harvard Medical School. (Farmer received his M.D. and a Ph.D. in anthropology simultaneously in 1990.) During his work in Haiti, Farmer pioneered a community-based treatment method for patients with tuberculosis that, Kidder explains, has had better clinical outcomes than those in U.S. inner cities. For this work, Farmer was recognized in 1993 with a MacArthur Foundation "genius grant," all of which he donated to Zanmi Lasante. Using interviews with family members and various friends and associates, Kidder provides a sympathetic account of Farmer's early life, from his idiosyncratic family to his early days in Haiti. Kidder also recounts his time with Farmer as he travels to Moscow; Lima, Peru; Boston; and other cities where Farmer relentlessly seeks funding and educates people about the hard conditions in Haiti. Throughout, Kidder captures the almost saintly effect Farmer has on those whom he treats. Copyright 2003 Reed Business Information, Inc.
The US government bullshits so much, it do you blame anyone for not believing a word they say?
With profits up in the corrections industry I'd venture to guess that TB will only grow right along with the Prison Industrial Complex. At the current rate of growth (in the US alone) we are looking at approx. 6,000,000 prisoners by 2020. That's a very modest figure, BTW.
From first-hand experience, TB is in love with prison. Most often, prisoners are either unable to get the medical assistance they need, especially when they are released (see: Punishment is profitable, reform is not). Others are simply uneducated regarding the risks they face when infected or the dangers they pose to others. Some simply don't give a shit, considering they're locked up in a cage year after year most likely (80% of the time) for a non-violent offense. TB is nothing new to prison. More prisoners==more TB.
_____ "If liberty means anything at all, it means the right to tell people what they do not want to hear." -- Orwell
The thruth is there are places in the world where you are in danger of contacting a deadly form of TB. As noted, that's because even a little carelessness in taking antibiotics can help TB mutate into drug-resistant forms. At least, here in Romania, TB resistant to treatment has become a very serious threat. Don't understimate this, as it has the potential of changing the world as we know it.
--
I started with nothing and still have most of it left.