Drug-Resistant “White Plague” Lurks Among Rich and Poor

Kate Kelland, Yahoo! News, March 19, 2012

On New Year’s Eve 2004, after months of losing weight and suffering fevers, night sweats and shortness of breath, student Anna Watterson was taken into hospital coughing up blood.

It was strange to be diagnosed with tuberculosis (TB)—an ancient disease associated with poverty—especially since Watterson was a well-off trainee lawyer living in the affluent British capital of London. {snip}

But when Watterson’s infection refused to yield to the three-pronged antibiotic attack doctors prescribed to fight it, her relief turned to dread.

After six weeks of taking pills that had no effect, Watterson was told she had multi-drug resistant TB, or MDR-TB, and faced months in an isolation ward on a regimen of injected drugs that left her nauseous, bruised and unable to go out in the sun.

{snip}

Tuberculosis is often seen in the wealthy West as a disease of bygone eras—evoking impoverished 18th or 19th century women and children dying slowly of a disease then commonly known as “consumption” or the “white plague”.

But rapidly rising rates of drug-resistant TB in some of the wealthiest cities in the world, as well as across Africa and Asia, are again making history.

London has been dubbed the “tuberculosis capital of Europe”, and a startling recent study documenting new cases of so-called “totally drug resistant” TB in India suggests the modern-day tale of this disease could get a lot worse.

“We can’t afford this genie to get out of the bag. Because once it has, I don’t know how we’ll control TB,” said Ruth McNerney, an expert on tuberculosis at the London School of Hygiene and Tropical Medicine.

{snip}

TB is a bacterial infection that destroys patients’ lung tissue, making them cough and sneeze, and spread germs through the air. Anyone with active TB can easily infect another 10 to 15 people a year.

{snip}

Little surprise, then, that the apparently totally untreatable cases in India have raised international alarm.

{snip}

Non-prescription and over-the-counter antibiotic use is rife in India and it may be no coincidence that the country now has one of the highest burdens on MDR-TB in the world, with more than 100,000 cases.

Udwadia’s team conducted a recent study in Mumbai, home to more than 12 million people often living in harsh and overcrowded conditions, and found in one district only five out of 106 doctors in the unregulated private sector could give a correct prescription for a hypothetical patient with MDR-TB.

Most of the prescriptions were “inappropriate” and would only have made the patient worse—driving the conversion of MDR [multi-drug resistant] tuberculosis to XDR [extensively drug resistant] and then to TDR [totally drug resistant] tuberculosis.

The Mumbai findings show that totally drug-resistant TB “was an accident waiting to happen,” Udwadia said.

“To get to this stage, you have to have amplified resistance over years, with loads of misuse of (antibiotic) drugs. And no other country throws around second-line drugs as freely as India has been doing.”

{snip}

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  • IstvanIN

    This article is obviously racist.  Everyone knows that Indians are among the most intelligent and civilized people the world has ever seen.  Their doctors are the world’s best and wouldn’t make such elementry mistakes, that is why the US imports them, because they are the best.

    • The_Bobster

      (/sarcasm)

  • Bon, From the Land of Babble

    London has been dubbed the ‘tuberculosis capital of Europe.’

    Is this because England no longer has a First-Class Western-Style medical system?

    From the Daily Telegraph:

    Muslim staff escape NHS hygiene rule 

    Female staff who follow the Islamic faith will be allowed to cover their arms to preserve their modesty despite earlier guidance that all staff should be ‘bare below the elbow.’

    The Department of Health has also relaxed rules prohibiting jewellery so that Sikh members of staff can wear bangles linked with their faith, providing they are pushed up the arm while the medic treats a patient.

    Rules (such as hand washing) were drawn up to reduce the number of patients who were falling ill, and even dying, from superbugs such as MRSA and Clostridium difficile.

    It seems patient safety comes in second to the demands of Muslim health care workers.

    The US is not far behind.

    Bon

    • AvidReaderSometimePoster

       But wearing a crucifix is illegal and forbidden. 

  • Imported from the the third world, another diversity gift.

  • Celebrate that lung-shredding diversity. Breathe it in deep and drop dead in London, the tuberculosis capital of the world. Pip pip cheerio and all that lung rot.

  • JJ

    Is this God’s way of telling us that multiculturalism is a stupid idea?  

    As I remember from Sunday school, one of the first attempts at multicultural cooperation involved building a giant tower.  God squashed that one by making people speak different languages. 

    If you believe in God then doesn’t it make sense that he INTENDED people to be different and live apart? 

    If he had wanted us to crowd into London, all living like pigs on top of one another, coughing germs on each other, subjecting each other to various interpretations of “sanitation” . . . wouldn’t it have been like that from the beginning?   Would it really require a bunch of non-believing, liberal progressive hippie throwbacks to institute suicidal social policies that work against the magic of medical science?

    I’m not a religious man but I accept there is much I don’t know.  God is one of those mysteries.  

    I just always assumed that is He exists, He is far more intelligent than we are.

  • haroldcrews

    As a practical matter in the US only go to large hospitals that are frequented by immigrants under extraordinary circumstances.  Hospitals that have emergency services generally have many immigrants come through the emergency services.  But more importantly avoid doctor’s offices that accept Medicaid and Medicare.  These are generally high volume providers and are also frequented by immigrants.  The best bet is to see only those doctors that accept cash payment.  They are lower volume and are less likely to have many immigrant patients.