The World Health Organization will hold an urgent meeting this week to seek ways to deal with deadly strains of tuberculosis that are virtually untreatable with standard drugs.
The meeting, in Johannesburg on Thursday and Friday, comes in response to recent reports from a number of the world’s regions about a small but growing number of cases of the deadly strains, known as extreme drug-resistant tuberculosis, or XDR-TB.
“XDR-TB poses a grave public health threat, especially in populations with high rates of H.I.V.” and few health care facilities, the health organization, a United Nations agency, said Tuesday.
This strain of TB already has worldwide distribution (including the United States, but it’s been a relatively small percentage of cases. What’s brought it to attention currently is a highly deadly outbreak in South Africa [bonus points to whoever spots the giant gaffe in the article]:
A new, deadly strain of tuberculosis has killed 52 of 53 people infected in the last year in South Africa, the World Health Organisation said on Friday, calling for improved measures to treat and diagnose the bacteria.
The strain was discovered in Kwazulu-Natal, and is classified as extremely drug-resistant. Drugs from three of the six second-line medicines, used as a last line of defence against TB, proved useless against the new strain.
“We are extremely worried about the issue of extreme drug resistance,” said Paul Nunn, coordinator of the WHO’s drug resistance department. “If countries don’t have the diagnostic capacity to find these patients, they will die without proper treatment.”
And it certainly has killed quickly:
Drug resistance is a common problem in TB treatment, but the new strain appears particularly virulent: 52 of the 53 patients infected all died within about three weeks of being tested for drug resistance.
Of course, the fear is that, if this strain spreads more widely and becomes increasingly common (overtaking even the MDR-TB strains), this could essentially send us back to the pre-antibiotic era as far as treatment for TB goes:
The lack of effective drugs brings doctors back to the era before antibiotics, when the limited treatment measures included chest surgery. For patients whose tuberculosis was confined to one lung, surgeons could remove a portion or whole lung, but without assurance of cure.
If the strain keeps spreading, it could exceed by “hundreds of times” the outbreak of drug-resistant tuberculosis in New York City in the 1990′s, Dr. Raviglione said. That outbreak was brought under control by adopting strong measures, including observation of infected patients to make sure they took their drugs properly.
Over at Time’s Global Health blog, they note that new TB drugs may be on the horizon, but of course, that just keeps us one step ahead of the game, and only lying in wait for the bacteria to develop resistance to the new drugs as well. This is a strategy we can’t win in the long term.
Image from http://www.futura-sciences.com//img/tuberculose_cnrs.jpg