Sunday, May 13, 2007

This Is Not Good

Before the AIDS-HIV epidemic, we were anticipating the arrival of a drug resistant form of Tuberculosis, Typhoid, Diphtheria or other ancient disease. Most of these once ravaged humanity killing thousands at go, before retreating for a few years only to rise and attack again. We knocked them down with better diet, health care, water treatment, hygiene and personal habits.

The ready-steady-frequent use of antibiotics to cure -EVERYTHING- demanded by patients and given by doctors has produced a new strain that we do not have a drug for. The Anthrax scares showed that we have limited numbers of proven, tested, safe anti-biotics available.... And now from the SF Chronicle,
Sacramento Bee and S-J Merc News we get the following reports of a drug resistant for of TB in our midst. What would we do if this turned into an epidemic? 1,000 or 10,000 cases suddenly appearing with more coming?

This is a disease of opportunity. It is easily transmitted. It can lie dormant for years.

SAN FRANCISCO - Virulent TB strain linked to 7 cases in SoMa

Sabin Russell, San Francisco Chronicle, 05/12/07
A San Francisco man is hospitalized in critical condition with a highly drug-resistant strain of tuberculosis that killed a patient last year and is responsible for a string of cases linked to a South of Market residency hotel catering to the poor. The...
Drug-resistant TB poses pandemic risk - Rapidly spreading virus will kill half of sufferers, experts say

Peter Finn, San Francisco Chronicle, 05/04/07
A virulent strain of tuberculosis resistant to most available drugs is surfacing around the globe, raising fears of a pandemic that could devastate efforts to contain TB and prove deadly to people with immune-deficiency diseases such as HIV-AIDS. Known...

Bay City News Service

San Francisco health officials are struggling with a drug-resistant strain of tuberculosis that since late 2005 has killed one person and sickened six others.

Health investigators believe the strain came from the former Soviet Union and infected tenants in a Tenderloin residential motel, said Dr. Masae Kawamura, director of the tuberculosis control section of the San Francisco Department of Public Health.

Federal budget cuts threaten progress against TB in state, officials say

By Dorsey Griffith - Bee Staff Writer

Published 7:50 pm PDT Friday, March 23, 2007

California - the nation's leader in tuberculosis cases and deaths - logged its lowest TB rate in history last year, but health officials say federal budget cuts are undermining efforts to keep the infectious disease from spinning out of control.

The state's case rate dropped by 4.2 percent last year, to 2,781 cases, but California continues to experience the highest number of TB cases and deaths in the country, including among children.

In addition, California has a significant share of cases that are resistant to one or more first-line drugs that can otherwise cure the disease if taken as directed.

A 12 percent cut in TB control funds from the federal government - with additional cuts expected - can only make matters worse, said Dr. Sarah Royce, chief of the state's Tuberculosis Control Branch.

WHAT IS TUBERCULOSIS-? (see for almost TMI)

The following is from
Science and Technology Encyclopedia

An infectious disease caused by the bacillus Mycobacterium tuberculosis. It is primarily an infection of the lungs, but any organ system is susceptible, so its manifestations may be varied.

Mycobacterium tuberculosis is transmitted by airborne droplet nuclei produced when an individual with active disease coughs, speaks, or sneezes. When inhaled, the droplet nuclei reach the alveoli of the lung. In susceptible individuals the organisms may then multiply and spread through lymphatics to the lymph nodes, and through the bloodstream to other sites such as the lung apices, bone marrow, kidneys, and meninges.

The development of acquired immunity in 2 to 10 weeks results in a halt to bacterial multiplication. Lesions heal and the individual remains asymptomatic. Such an individual is said to have tuberculous infection without disease, and will show a positive tuberculin test. The risk of developing active disease with clinical symptoms and positive cultures for the tubercle bacillus diminishes with time and may never occur, but is a lifelong risk. Only 5% of individuals with tuberculous infection progress to active disease. Progression occurs mainly in the first 2 years after infection; household contacts and the newly infected are thus at risk.

Many of the symptoms of tuberculosis, whether pulmonary disease or extrapulmonary disease, are nonspecific. Fatigue or tiredness, weight loss, fever, and loss of appetite may be present for months. A fever of unknown origin may be the sole indication of tuberculosis, or an individual may have an acute influenzalike illness. Erythema nodosum, a skin lesion, is occasionally associated with the disease.

The lung is the most common location for a focus of infection to flare into active disease with the acceleration of the growth of organisms. There may be complaints of cough, which can produce sputum containing mucus, pus- and, rarely, blood. Listening to the lungs may disclose rales or crackles and signs of pleural effusion (the escape of fluid into the lungs) or consolidation if present. In many, especially those with small infiltration, the physical examination of the chest reveals no abnormalities.

The principal methods of diagnosis for pulmonary tuberculosis are the tuberculin skin test (an intracutaneous injection of purified protein derivative tuberculin is performed, and the injection site examined for reactivity), sputum smear and culture, and the chest x-ray. Culture and biopsy are important in making the diagnosis in extrapulmonary disease.

A combination of two or more drugs is used in the initial therapy of tuberculous disease. Drug combinations are used to lessen the chance of drug-resistant organisms surviving. The preferred treatment regimen for both pulmonary and extrapulmonary tuberculosis is a 6-month regimen of the antibiotics isoniazid, rifampin, and pyrazinamide given for 2 months, followed by isoniazid and rifampin for 4 months. Because of the problem of drug-resistant cases, ethambutol can be included in the initial regimen until the results of drug susceptibility studies are known. Once treatment is started, improvement occurs in almost all individuals. Any treatment failure or individual relapse is usually due to drug-resistant organisms. See also Drug resistance.

The community control of tuberculosis depends on the reporting of all new suspected cases so case contacts can be evaluated and treated appropriately as indicated. Individual compliance with medication is essential. Furthermore, measures to enhance compliance, such as directly observed therapy, may be necessary. See also Mycobacterial diseases.

If you're coming to San Fran Cisco, be sure to pack some anti-biotics in your bags... It is a disease of opportunity. It is easily transmitted. If a person coughs straight up in an elevator the bacteria can float for up to 30 minutes. Once infected a person may live without symptoms for years until the body is weakened by starvation, disease, injury or wound, or stress.... We Californi-Os don't have any stress...

No comments: