TB Fight Hits a Wall in India - making more resistant strains through poor public policy
 

http://online.wsj.com/article/SB1...71954.html

Okay, this is just sad. India is now giving a 6 drug cocktail to anyone with drug resistant TB - However, you must NOT be resistant to 4 of the 6 drugs for the program to work. Guess what? Most folks on the program ARE RESISTANT TO THE DRUGS AND MAKING A MORE VIRULENT FORM OF TB. Will India stop? Nope, they are pushing ahead and probably going to create a form of TB that is completely resistant to drug therapy. The only option left (after drug treatment fails) is to quarantine the patients and isolate them so others don't get infected. You can also collapse one of the lungs in the hopes of protecting the other.

Idiots, they are going to create a super TB that can't be contained.

Here's some of the article (even more depressing)

"MUMBAI—Here on center stage in the global crisis of drug-resistant tuberculosis, top doctors are sounding a new alarm: India's emergency strategy to defeat the disease may be having the opposite effect—encouraging TB instead to mutate into more deadly and unstoppable strains. In its new strategy, India is treating some, and perhaps many, drug-resistant TB patients with drugs that they are already resistant to. That can allow the bacteria to build resistance to new drugs as well.

On Friday, a prominent specialist described research to The Wall Street Journal showing that the government's treatment plan wouldn't work on fully two-thirds of the 300 patients analyzed at one major Mumbai hospital. The results suggest India's plan is "a futile exercise" that will "serve to amplify resistance," said the researcher, Dr. Zarir Udwadia. "It is morally and medically disastrous."

Shown the findings, Mario Raviglione, director of the World Health Organization's Stop TB Department, called India's approach to treating drug-resistant TB "complete nonsense."

Greed is Good™

On the brightside it will be a form of population control which India is badly in need of, but clearly at the cost of people eventually dying prematurely from TB. However, I don't know how much you can expect from a country as backwards as India.

Unfortunately, it's not like the TB knows not to venture outside of India.

I'd kill for some lamb biryani and naan right now....

True true, but you'd likely see the worst of it isolated to India with an occasional case popping up here.

This sort of thing speaks volumes for why we need to take special care to control immigration into this country. If we do not control our borders, how can we prevent epidemics arising in other countries from spreading here?

So you believe that we should prohibit U.S. citizens infected with the super TB strain from reentering the country until they are cured?

Except I don't think you would be cured. Also how do you test for it? The current test most US doctors use is the PPD test which gives false positives for anyone who got the vaccine, mostly foreign born people. The QFT test is better, but most doctors are either too stupid or ignorant to use it. That being said, both tests require time to either process or wait for results, way more time than someone could reasonably be held in customs. Also I think the ACLU and everyone else out there would have a hard time allowing them to draw blood at customs.

Actually, the U.S. Customs can demand anything of anyone before allowing them to enter the country, including but not limited to, drawing of blood.

Really? Perhaps back in the day before air travel but not so much anymore...

I believe that US citizens should be quarantined pending a cure, and non citizens denied access until they find a cure.

I am not sure how many of you read this article in the actual Wall Street journal paper. The very next day after this was published, there was a strong reply from the same WHO director stating that the statements made in the article about him are completely wrong. He has written that India complies with the recommendation of WHO and fully cooperating to eradicate TB.

Now as a subscriber and regular reader to Wall Street journal myself am not able to understand whether the contents of this article is fully genuine.

Population control? Wow...

Uh oh here we come leper colonies...

While it may be a heartless statement, disease, along with war and many other things, are a form of population control. In many cases the disease is fomented by the overpopulation.

And what would you offer as an alternative? Alter their disposition, or allow them to infect everyone around them?

I can't disagree more. Look at Africa. It's the perfect storm there. TB and HIV. "The emergence of MDR and its even more dangerous cousin, XDR (extremely drug-resistant TB), have pushed tuberculosis cure rates in the country from a high of 73 percent in 2008 down to 53 percent in 2010." And the cure rates of TB will continue to decrease as more HIV patients contract drug resistant (or totally drug resistant) TB. Here's the article. http://www.usnews.com/news/articl...uth-africa Doctors Struggling to Fight "Totally Drug-Resistant" TB in South Africa.

It will have to get bad first. When you have enough people contract TB, then you will see proper testing and eventually quarantine. I think with better funding the CDC could come up with a quicker way to test for TB. You could have chest X-rays and upgrade the sputum smear test. At least you could have the results in a few hours, instead of 24 hours. The blood test is the best but you have to test the blood quickly, longer wait time for results, and can be more expensive. Most people might agree to an x-ray and a sputum test vs. a blood test. You could screen individuals at the border. Those individuals from countries with high TB rates could be assessed by a nurse. If TB symptoms are suspected, the person would be tested using x-rays and sputum smear. Then take blood if needed.

I think that is fair. If you have an untreatable form of TB, should be allowed to walk around just because you are a US citizen. The risk to the rest of society is too great. If you have untreatable TB and not a citizen of the US, you should be returned to your country of origin.

Agreed. It seems a bit harsh. TB is a communicable and sometimes deadly disease that has one form (XDR-TB) that can't be treated (almost totally resistant to antibotics). We don't need to see this as a form of population control but as a threat we need to address. India is making a bad situation worse and killing its own people. They are also helping mutate and make the disease more deadly by misusing the antibotics that treat it.

The people most at risk are the families of the person with untreatable TB. Prolonged exposure (especially to those with lower immunities, like children and the elderly) puts them at risk. Unfortunately TB is transmitted through the air. You can't stop breathing and most people don't want to wear a mask 24/7. The best solution would be to isolate and treat those with untreatable or drug resistant TB as best you can. If the TB is under control (the person is no longer contagious) or cured, they should be allowed to return back to society.