BEIJINGNews (Updated
April 5, 2009)
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By GILLIAN WONG,
Associated Press Writer Gillian
Wong, Associated Press Writer
Wed Apr 1,
10:57 am ET
BEIJING
One of the world's oldest and deadliest infectious
diseases, TB has mutated into hardier forms that withstand some of the
most commonly used medicines. Left unchecked, people with drug-resistant TB
could spread the disease to others, creating a widespread epidemic in the highly
mobile global economy.
At a meeting of health ministers in Beijing,
software magnate Bill Gates'
foundation and the Chinese
government announced a $33 million project that initially covers 20
million people in six provinces and will be expanded to 100 million people over
five years.
New approaches being tried include tests
that diagnose drug-resistant TB in hours instead of weeks and drug
combinations that at least halve the number of pills patients have to
take. Mobile phone text messages will be used to track patients and their
treatments.
WHO Director-General Margaret
Chan told health ministers and senior officials from 27 countries
worst-affected by the new drug-resistant strains of TB that they must make
dramatic improvements in detecting infections and build stronger health
care systems.
"Call it what you may — a time bomb
or a powder keg," Chan said at the opening of a three-day meeting on
drug-resistant TB in
Countries attending the meeting said
Wednesday they would draw up national plans to provide drug-resistant TB
patients with access to treatment by 2015, ensure a sufficient supply of anti-TB
drugs, better train health workers and other measures aimed at controlling the
spread of drug-resistant strains.
The disease is caused by germs that spread
when a person with active TB coughs, sneezes or speaks. It's ancient and
treatable but now has evolved into stronger forms: multidrug-resistant TB, which
does not respond to two top drugs, and extensively drug-resistant TB, which is
virtually untreatable.
The problem has been partly blamed on health
care systems that lose track of patients who do not complete their courses of
treatment, allowing the TB bacteria to develop resistance to normally potent
medicines.
In 2007, 1.75 million people died of tuberculosis.
Of the more than 9 million people around the world who contract the disease
every year, about 500,000 get multi-drug resistant TB. The WHO estimates that
150,000 people die of drug-resistant TB every year worldwide.
Nearly a quarter of those who contract the
drug-resistant strains are in
It is also a problem in
The Bill
& Melinda Gates Foundation chose to fund the TB project in
"Because of its skill, its scale, its
TB burden, its love of innovation, and its political commitment to public
health, China is a perfect laboratory for large-scale testing of new tools and
delivery techniques to fight TB," Gates said at a news conference.
Medecins Sans Frontieres, also known as Doctors Without Borders, welcomed the Gates project but
said
"It's a big pilot project but the
question is what happens to all the other patients who need treatment now and
what will be provided to them while this project is ongoing in the next five
years," said MSF's Tido von Schoen-Angerer.
TB is usually treated in six months with a $20 cocktail of four antibiotics, but its drug-resistant form takes up to two years and is at least 100 times more expensive to fight.
By GILLIAN WONG,
Associated Press Writer Gillian
Wong, Associated Press Writer
Mon Mar 30,
1:36 am ET
BEIJING
It's not only his health at stake. If Wang
stops treatment prematurely, his tuberculosis is likely to morph into one of the
new, hardier strains that resist the drugs he has been using and that pose a
growing threat to global public
health. Countries as diverse as
"TB is now taking on a deadly new form
— one that will spread further," said Cornelia Hennig, the World
Health Organization's TB program coordinator for
The WHO is trying to bring renewed vigor to
the fight with a three-day meeting of health ministers from the worst-affected
countries in
TB is caused by germs that spread when a
person with active TB coughs, sneezes or speaks. It's ancient and treatable but
now has evolved into stronger forms: multidrug-resistant TB, which does not
respond to two top drugs, and extensively drug-resistant TB, which is virtually
untreatable. TB is usually treated in six months with a $20 cocktail of four
antibiotics, but its drug-resistant form takes up to two years to fight.
One of the culprits: health
care systems that lose track of patients who do not complete their
courses of treatment, allowing the TB bacteria to develop resistance to normally
potent medicines.
This is also a problem in
An estimated half a million people in the
world are already infected with drug-resistant TB, nearly a quarter of them in
Less than 5 percent of people suffering from
drug-resistant TB worldwide are properly treated, said Mark Harrington,
executive director of Treatment
Action Group, a U.S.-based health
advocacy group.
"So most of the people are going around
coughing and spreading multidrug-resistant
TB," he said. "But most countries have not yet started to take
it seriously."
Though the problem is mainly confined to
developing countries, health experts warn the risk is widespread as people and
their diseases cross the globe. An intercontinental scare was set off two years
ago when an American lawyer with drug-resistant TB flew to several countries and
back to attend a wedding.
In the U.S., even as TB rates fall, drug
resistant strains are showing up in California and other states with large
immigrant communities, because many people come from or travel frequently to
countries such as Mexico, India and China where TB is a greater risk.
International experts recommend that TB
treatment centers monitor their patients rigorously, supplying them with
medication and watching them swallow every dose.
In the past decade, China made marked
progress in fighting tuberculosis,
which until last year was the most fatal infectious disease. Once a person tests
positive for TB at a hospital, an Internet-based reporting system helps health
officials channel the infected patients to special TB facilities run by the communicable
diseases agency.
The Health Ministry says more than 90
percent of new infections are cured every year. But China still has 112,000
people with drug-resistant TB, according to the WHO. Experts say only a few
thousand of them are receiving proper treatment.
An underfunded health
care system means many TB facilities can't closely track every patient,
while most of the 130 million highly mobile migrants from rural China don't
qualify for free treatment given to urban residents. Guangdong province, where
most of China's export factories are located and home to many migrants, has more
TB infections than any other province.
China is developing an electronic system to
track infected migrants, the WHO's Hennig said. The government has also promised
revamping of health care with a $124 billion investment over the next three
years.
The Health Ministry says it is working on a
national survey of drug-resistant TB patients and plans to roll out treatment to
them, but did not say when. It said treating drug-resistant TB is a hundred
times more expensive than normal TB.
Aid agency
Doctors Without Borders, also known as Medecins
Sans Frontieres, said it was trying for two years to start a
drug-resistant TB program in Inner
Mongolia but gave up because China wanted too much control over the
operation's finances and other issues. The Health Ministry had no immediate
comment.
"We are rather frustrated about it ...
and the patients continue to go untreated," said MSF's operational
coordinator in Brussels, Luc van Leemput, who was involved in the negotiations.
"I hope that the Chinese
government is going to get its act together and provide access to
treatment for those patients who need it."
Thu Apr 2,
3:46 am ET
The infections were discovered in September
after a patient who had received a transfusion during an operation tested
positive for the disease, the Xinhua
News Agency reported Wednesday.
The hospital in the southwestern city of
Further tests showed that by Tuesday, 64
patients had been infected with hepatitis C through blood
transfusions from the donor, who was a hepatitis C carrier, the report
said.
Xinhua said director Li Changhe was detained
on suspicion of illegally collecting and providing blood.
A woman who answered the phone at the
hospital on Thursday said no one was available to comment. Police in Pingtang
said they were not authorized to speak to the media and referred questions to
the county government, where calls rang unanswered.
Hepatitis C results in the swelling of the
liver and can cause stomach pain,
fatigue and jaundice. It may eventually result in liver
failure. Even when no symptoms occur, the virus can slowly damage the
liver.
Last year,
By BETH DeFALCO,
Associated Press Writer Beth
Defalco, Associated Press Writer
Thu Apr 2,
5:20 pm ET
TRENTON, N.J. – New
Jersey officials have advised nearly 3,000 people who share a doctor to
get tested after five cancer
patients who visited the physician were found to have hepatitis
B.
Two cases of hepatitis B were confirmed in
late February as connected with the office of Dr. Parvez Dara, an oncologist
with offices in
Health officials recently learned of three
more cases, all in
"These were older adults who didn't
have other risk factors, so
that is what raised a red flag," Riley said.
Linda Bradford of Bayville said she's
worried about her husband's health after hearing news of the outbreak.
"The first thing I did was call my
husband,"
Hepatitis B is transmitted through exposure
to infected blood, often by sexual contact or infected needles. Dara's office
treats patients with blood
disorders and cancer, some of whom receive chemotherapy there.
"The evidence that's available suggests
the infections could be linked to the method the clinical staff used to
administer injectable medications," such as chemotherapy, Riley said.
"There's no evidence to suggest the medications were a problem."
Dara faces suspension of his medical
license in connection with the outbreak and for other alleged health code
violations. A hearing is scheduled for Friday before the state
Board of Medical Examiners.
Until then, he is performing only patient
consultations, not procedures, said his lawyer, Robert Conroy. Neither of Dara's
offices were open Thursday.
According to a report by the state
epidemiology division, Dara has infection
control violations dating to 2002, including violations of standards of
the federal Occupational Safety
and Health Administration.
Conroy said that there is no proof the
patients got the disease from Dara's office and that other factors aren't being
considered. All five patients
were also seen at
Health officials said they ruled the
hospital out as a possible source of the infection.
Hepatitis B
is transmitted through exposure to infected blood, often by sexual contact or
infected needles.
Conroy said three patients were found to
have dormant hepatitis infections that might have been noticed only after they
started cancer treatments,
which can suppress the body's
immune system.
Because the patients live in the same area,
he said, there could be another possible source.
"Absent any evidence, it is just as
likely that those patients were infected (at) ... a common eatery," he
wrote in a letter to the Medical Examiners Board.
Meanwhile, Conroy said Dara has received
only support from his patients.
"The doctor has never felt more
appreciated by his patients than he does right now," he said.
Ocean County Health Department
spokesman Edward Rumen said no new cases
have been reported since the alert was issued.
02 Apr 2009 18:08:00 GMT
Source: SciDev.Net
Sharon Davis
Reuters and AlertNet
are not responsible for the content of this article or for any external internet
sites. The views expressed are the author's alone.
[
The US$30 million KwaZulu-Natal
Research Institute for Tuberculosis and HIV (K-RITH) to be built at the
university's Nelson Mandela School of Medicine in Durban, will also train a new
generation of African scientists in tuberculosis (TB) and HIV research.
K-RITH will initially
focus on developing more rapid and effective tests for TB, characterising
strains of TB and immune system responses to the infection, particularly in HIV
positive patients, and studying recurrent TB infections.
The US-based Howard Hughes
Medical Institute (HHMI) will collaborate with K-RITH on research and is
contributing US$20 million to the construction of the centre, which will include
two floors of high-level biosafety laboratories for TB research.
The research will be led
by two investigators from HHMI, William Jacobs from the Albert Einstein College
of Medicine and Bruce Walker of the Massachusetts General Hospital and two
investigators from UKZN, Willem Sturm, dean of the medical school and K-RITH's
interim director and Salim Karim, director of the Centre for AIDS Programme of
Research in South Africa.
HHMI has also committed a
further US$40 million to the initiative over the next ten years to provide K-RITH
with research funding.
To build up capacity for
the centre, the HHMI distributed more than US$1.1 million in grants in 2008 to
South African and US scientists. It will also provide US$3 million this year to
construct temporary laboratory facilities for the TB research programme.
The K-RITH initiative
offers an unusual opportunity for a comprehensive approach to research, says
Karim. "Usually research is very focused, but K-RITH incorporates the
entire spectrum of research. There is the laboratory side, the clinical side and
the community or public health implications," he told SciDev.Net.
HHMI's vice-president
Peter Bruns says that Durban was chosen as the venue not only because it is the
epicentre of the intertwined epidemic of multi-drug resistant TB and HIV but
also because the UKZN scientists involved have been extensively involved in
international research collaboration.
Construction of the
six-story centre, which will be integrated into the existing Doris Duke Medical
Research Institute, is expected to start towards the end of September this year.