XDR Tuberculosis Has "Likely Spread" From SA Hospital - 52/53 Patients Killed By Strain - NYT

JOHANNESBURG, Jan. 27 — More than a year after a virulent strain of tuberculosis killed 52 of 53 infected patients in a rural South African hospital, experts here and abroad say the disease has most likely spread to neighboring countries, and some say urgent action is essential to halt its advance. Several expressed concern at what they called South Africa’s sluggish response to a health emergency that, left unchecked, could prove hugely expensive to contain and could threaten millions across sub-Saharan Africa.

The director of the government’s tuberculosis programs called those concerns unfounded and said officials were doing everything reasonable to combat the outbreak. The form of TB, known as XDR for extensively drug-resistant, cannot be effectively treated with most first- and second-line tuberculosis drugs, and some doctors consider it incurable.

Since it was first detected last year in KwaZulu-Natal Province, bordering the Indian Ocean, additional cases have been found at 39 hospitals in South Africa’s other eight provinces. In interviews on Friday, several epidemiologists and TB experts said the disease had probably moved into Lesotho, Swaziland and Mozambique — countries that share borders and migrant work forces with South Africa — and perhaps to Zimbabwe, which sends hundreds of thousands of destitute refugees to and from South Africa each year.

But no one can say with certainty, because none of those countries have the laboratories and clinical experts necessary to diagnose and track the disease. Ominously, none have the money and skills that would be needed to contain it should it begin to spread.

EDIT

http://www.nytimes.com/2007/01/28/world/africa/28tuberculosis.html?_r=1&oref=slogin

then isolating everyone who is infected from the general population is the only thing that will slow it down. Nothing will stop it because the mycobacteria are so stable and will live in the environment forever. There will be new cases from time to time, but they need to establish procedures NOW for testing and isolation of those cases, too.

Yes, it's horrible from a civil rights standpoint, but consider that Boston has had one of the lowest rates of drug resistant TB in the country despite the large HIV and shelter populations. It's because the old confinement laws were never overturned, and infected people who were unreliable at taking their medication every day could be confined to a locked ward in a hospital partially dedicated to TB until their course of medication was complete. Once they were non contagious, they were allowed out on organized day trips, but the infectious people were kept confined.

TB is one of the most horrible killers out there. The disease ultimately kills when it eats through an artery within the lung and the person drowns in his or her own blood, conscious and terrified.

Why do these diseases always seem to start in Africa, the one place that is least capable of dealing with them?

It is probably the reason why the potentially fatal cystic fibrosis gene has survived amongst the indigeneous people of that continent for so long.

http://www.newscientist.com/article/dn10013-cystic-fibrosis-gene-protect