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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.
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.
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..."
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.
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.