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More on the kids , school , high school and prep and TB .
TUBERCULOSIS, STUDENTS - USA (FLORIDA) ************************************** A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> Date: Thu 8 Feb 2007 From: ProMED-mail <promed@promedmail.org> Source: News4Jax [edited] <http://www.news4jax.com/news/10965577/detail.html> For the 2nd day in a row, a Jacksonville student has been diagnosed with tuberculosis. On Thu 8 Feb 2007, a student at an Eastside school, RL Brown Elementary School, was diagnosed with TB. School officials sent letters home to parents about the case. According to officials, the student is an 11-year-old who has been treated and released from the hospital. School officials said next week they plan to test 25 classmates and others who have come into contact with the 11-year-old. The health department said it's not clear if the latest case is connected to the TB case confirmed the day before at Stanton College Preparatory School. A student there also has active TB, which was confirmed less than a year after an outbreak at a daycare center located directly across the street from the high school. Stanton College Preparatory School is less than a one-tenth of a mile from Stanton Pre-School, the daycare center that closed shortly after a TB outbreak there in April 2006 left 4 young children sick. The 2 schools are not affiliated. The health department tested 180 students and faculty at the Stanton College Preparatory as a precaution, and found that 16 of them had come in contact with the disease. Testing on the 16 students and adults exposed to TB continued on Thu 8 Feb 2007. "We've evaluated a number of them today, and we're continuing that evaluation. The ones I've seen today have been started on therapy," said Dr. Jeff Lauer of the Duval County Health Department. The health department said it is taking the proximity of both schools into consideration as they look into the high school's TB case. Doctors with the health department said Duval County is the 5th highest in the state for active TB cases, and that there are currently 86 active cases of the disease in the county. -- ProMED-mail <promed@promedmail.org> [Except for issues relating to drug-resistant tuberculosis, ProMED has not posted extensively on _Mycobacterium tuberculosis_ disease. The proximity of the cases mentioned here, however, is interesting and suggests the possibility of common exposure, which can be determined microbiologically by DNA fingerprinting the isolates from the recent cases and from the daycare center from 2006. Time-wise, the interval from exposure with conversion of the TB skin test to positive and the development of active tuberculosis can be years to decades. Statistically, only about 10 percent of those exposed significantly enough to develop tuberculin skin test reactivity will develop active infection in their lifetime. It is important to note, however, that about half of these will manifest within the first 2 years. It is also important to be aware that treatment of individuals who have recently become reactive to the tuberculin skin test can decrease the risk of the development of active TB by about a factor of 10. Treatment is classically administered with a single drug, isoniazid. Treatment of the active disease, however, involves the use of 4 agents. The success of either of these depends on adherence to the treatment and the preexisting resistance profile of the infecting organism. The classical acid-fast staining characteristics of the tubercle bacillus can be seen at: <http://www.textbookofbacteriology.net/acid-fastbacilli.jpeg>. A map showing the location of Jacksonville, Florida in the northeastern corner of the state can be found at: <http://pics2.city-data.com/city/maps/fr13.gif>. - Mod.LL] [see also: 2005 ---- Tuberculosis, nosocomial - USA (NY) 2003 20051223.3672 Tuberculosis, school - Sweden (Stockholm) 20051028.3140 Tuberculosis, hospital exposures - USA (MA) 20050616.1702 Tuberculosis, nursery school - Spain (Catalonia) 20050523.1416 Tuberculosis, supermarket exposure - Netherlands (Zeist)(03) 20050225.0602 Tuberculosis, supermarket exposure - Netherlands (Zeist) 20050207.0411] ..............................ll/mj/mpp |
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They don't screen Healthcare workers?
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Date: Fri, 23 Dec 2005
From: ProMED-mail <promed@promedmail.org> Source: New York Times [edited] <http://*********/2005/12/23/nyregion/23tb.html> A New York City maternity ward nurse who had infectious tuberculosis exposed as many as 1500 patients to the disease over 2 months in 2003, and most likely infected at least 4 infants, according to a joint investigation by the city's health department and the CDC. More than 1000 of the patients the nurse came in contact with could not be found, the CDC said. It is not clear whether any of them contracted the disease, but city health officials say they have all the patients' names and are watching TB registries to see if they appear. The CDC says it believes that transmission was limited. So far, the only patients known to have been infected are the 4 infants, who were treated and are now healthy, city health officials said. So is the nurse, whose identity was not revealed. While the agency declined to name the hospital, health officials confirmed that it was the Bronx-Lebanon Hospital Center. Dr. Kenneth G. Castro, director of the Division of Tuberculosis Elimination at the CDC, said New York was fortunate to have a health department with an active tuberculosis control program, because if the infection of the 4 infants had not been detected, the number of those who caught the disease could have grown exponentially. Still, the case underscores the difficulty of providing appropriate follow-up care for patients exposed to TB in hospitals and other health-care settings. |
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http://www.sabcnews.com/south_africa/health/0,2172,143693,00.html
Eastern Cape health is giving XDR-TB drugs February 13, 2007, 14:45New drugs to fight extreme drug-resistant tuberculosis (XDR-TB) have been administered in the Eastern Cape since November, the health department said. They were being supplied at Jose Pearson Tuberculosis Hospital in Port Elizabeth, said Sizwe Kupelo, a department spokesperson. |
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As time goes by ...
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Extreme drug resistant tuberculosis, or XDR-TB, has killed at least 183 people in South Africa since September.
SA alters Aids plan after extreme TB threat February 15, 2007, 14:45South Africa is overhauling its Aids strategy in a bid to counter the rise of extreme drug resistant tuberculosis which is proving a serious threat to those suffering HIV/Aids, a senior official said today. Extreme drug resistant tuberculosis, or XDR-TB, has killed at least 183 people in South Africa since September. |
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tony m
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Perhaps then, South African health officials are finally waking up to the reality that you cannot solve "HIV" without coming to grips with all forms of TB including MDR TB. Of course traditional belief calls for the fact that since "HIV" causes AIDS, TB hops on board afterwards. Oh, is that so?!! At the risk of being repetitive: WHICH IS MDR-TB AND WHICH IS HIV? (.........or....which came first, the chicken or the egg) WHO: "At least two in three South African TB sufferers are H.I.V. positive." Although it seems comforting, for those of us who do not have HIV to believe this, there are many reasons to question this notion that most world-based active TB, including MDR and XDR strains need "HIV" to explain "AIDS": It was in this very same Africa that HIV faced its first and most serious challanges. Not only were over 65% of African AIDS patients not HIV positive (Lancet, Oct. 17, 1992) but, of those that tested positive, data suggested that the antigens in HIV-1 Elisa and Western Blots, initially claimed to belong solely to HIV, were in fact cross-reacting with tuberculosis and the mycobacteria, which includes leprosy. (Kashala,O Infection with human immunodeficiency virus type 1 (HIV-1) and human T-cell lymphotropic viruses among leprosy patients and contacts: correlation between HIV-1 cross-reactivity and antibodies to lipoarabinomannan. J. Infectious Diseases 169(2):296-304. 1994 Feb) Mycobacterial cell wall components, found in all strains of TB, such as phenolic glycolipid (PGL) and lipoara-binomannan (LAM) were noted not only to strongly cross- react with p24, the sacred cow of 'HIV' isolation, but p31, also favored in the detection of HIV in the blood (Kashala, 1994). Even the most prominent and persistently detected antiben in AIDS tests (Veronese, 1985), p41, could be found in bacteria such as tuberculosis. The take home message, at the end of the day, is just this: Just how many of these positive AIDs tests are being caused by TB and the mycobacteria? |
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TonyM just how your post said it which comes first the chicken or the egg == Dr. Keith Cloete, director of TB for the province, said a 23-year-old
Cape Town woman had died in the Brooklyn Chest Hospital on 5 Feb 2007, but XDR TB had only been diagnosed after death.
TUBERCULOSIS, XDR - SOUTH AFRICA (04) ************************************* A ProMED-mail post <http://www.promedmail.org> ProMED-mail is a program of the International Society for Infectious Diseases <http://www.isid.org> Date: Tue 20 Feb 2007 From: ProMED-mail <promed@promedmail.org> Source: Independent Online [edited] <http://www.iol.co.za/index.php?set_id=14&click_id=125&art_id=vn20070220112202862C923242> The deadly drug-resistant strain of tuberculosis has claimed its 1st life in the Western Cape and 5 new sufferers have been diagnosed. This brings to 8 the number of people identified with "extensively drug-resistant" tuberculosis -- XDR TB -- in the province so far. Dr. Keith Cloete, director of TB for the province, said a 23-year-old Cape Town woman had died in the Brooklyn Chest Hospital on 5 Feb 2007, but XDR TB had only been diagnosed after death. In 2006, this strain killed more than 50 people in KwaZulu-Natal and more than 300 cases have been confirmed countrywide. Four of the 5 new local cases have been admitted to Brooklyn Chest Hospital, where they are being treated in isolation along with the 1st 2 cases, an 11-month-old baby from Khayelitsha and a 43-year-old woman from the Eastern Cape, who fell ill while visiting Cape Town over Christmas. -- ProMED-mail <promed@promedmail.org> [Many of the initial cases described in KwaZulu-Natal also died before the diagnosis of XDR TB was made. This reflects the rapid progression of the disease when not treated properly and the co-infection (in almost all) with HIV. The presence of XDR TB in an 11-month-old child underscores the observation that much of the disease is due to acquisition of the resistant bug, not selection of resistance in a patient non-adherent to therapy for an initially more sensitive mycobacterium. Young children with TB usually mean active disease in close family members or other caretakers. A map of South Africa showing the Eastern and Western Cape Provinces can be found at: <http://www.un.org/Depts/Cartographic/map/profile/southafr.pdf> - Mod.LL] [see also: Tuberculosis, XDR - South Africa (03) 20070209.0504 Tuberculosis, XDR - worldwide 20070205.0456 Tuberculosis, XDR - South Africa (02) 20070128.0375 Tuberculosis, XDR - South Africa: interventions 20070126.0349 Tuberculosis, extensively drug-resistant - Canada (ON) (02) 20070125.0340 Tuberculosis, extensively drug-resistant - Canada (ON) 20070124.0318 2006 ---- Tuberculosis, multiresistant - Hungary 20061110.3233 Tuberculosis, multiresistant - South Africa (KN)(04):nationwide 20061019.3003 Tuberculosis, multi-drug resistant - South Africa (KN) 20060904.2514] ......................ll/mj/dk http://www.promedmail.org/pls/promed/f?p=2400:1001:4326725834056541844::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,36408 |
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tony m
Valued Member Joined: December 28 2006 Status: Offline Points: 50 |
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Here's what happens when you are BIG PHARMA and you know only too well that your test can be positive not only for "HIV" but for TB and MDR-TB.Kindly note the statement
“AIDS, AIDS-related complex and pre-AIDS ARE THOUGHT to be caused by HIV.” Now, what if they are not caused by "HIV". Here's what. First pharmaceutical houses will lose billions each year by breaking their stranglehold on poor AIDS victims wallets. Second, by being forced to address the real etiology behind AIDS, that condition itself might be cured as a by-product of the successful developement of an MDR-TB biological that can be used in treatment and cure. Third, WHO will have to revise its annual mortality rating for TB and MDR-TB from "almost 2 million" to in excess of 5. Companies back down on HIV∫AIDS claim Astonishing revelation on Barnes blog by Culshaw Elite critics reach critical mass on expanded blog In an extraordinary development, companies making HIV tests are backing down on their claim that HIV is the undisputed cause of AIDS. Mathematician Rebecca Culshaw has just posted a very important note on the blog Barnesworld, now renamed "You Bet Your Life", at Dear Dr. Culshaw: "Well, What About Those Tests?". Culshaw has discovered that the inserts with AIDS tests show that the companies that make them have been backing down over the past year or two in the firmness of their statements that HIV is the cause of AIDS. She writes: I doubt even more that the majority of medical practitioners are aware of the subtle but significant shift in the language used in HIV test kits since the beginning of the AIDS era. For example, from 1984 until the very recent past, test kit inserts contained the unambiguous statement “AIDS is caused by HIV”. In 2002, the OraSure toned down that statement to say: “AIDS, AIDS-related complex and pre-AIDS are thought to be caused by HIV.” But just this year, in a remarkable – and potentially significant – shift in thinking, the trend seems to be toward making an even less committal statement. For example, Abbott Diagnostic’s ELISA test insert contains the following sentence: “Epidemiologic data suggest that the Acquired Immune Deficiency Syndrome (AIDS) is caused by at least two types of human immunodeficiency viruses, collectively known as HIV.” Vironostika appears to be even less willing to support a true causal role, as their 2006 test kit insert says: “Published data indicate a strong correlation between the acquired immune deficiency syndrome (AIDS) and a retrovirus referred to as Human Immunodeficiency Virus (HIV).” This remarkable shift in corporate conviction is as yet unexplained, but we suspect it has a lot to do with the appearance on the Web over the last two years of a copious amount of intelligent material undermining the sanctity of the paradigm, now increasingly crippled by mainstream papers removing the pillars of evidence supporting it. |
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Testing testing 123 testing....
TB patients misdiagnosed
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tony m
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"these patients are unable to mount an immune response and subsequently they present with pauci bacillary TB (ie. there are few TB organisms in their sputum) and the diagnosis in such patients may be missed, she said."
First of all TB in and of itself is often and traditionally "pauci bacillary", but there is a larger diagnostic problem here that is being completely ignored, as is why they are missing visualization of the germ left and right. This is touched upon by Lida Mattman in her description of TB and MDR-TB in "Cell Wall Deficient Forms - Stealth Pathogens": It is apparent that in any tissue the tubercle bacillus grows minimally as an acid-fast rod, the predominant growth consisting of pleomorphic structures, acid-fast only with modified stains. (Xalabarder, C., Formas L de microbacterias y nefritis cronicas, Publ. Instit. Antitubercul. Sup., 7:1-83, 1970) These are the viral-like forms of TB with no intact cell-wall membrane, which look like viruses and evade the radar (stealth pathogens) of traditional TB staining. They are also the preferred form that TB and the mycobacteria, for protective reasons, like to assume. In a long series of cases, employing the sensitive auramine-rhodamine fluorescent stain, only 50% of the specimens eventually yielded positive cultures which showed bacilli indirect smears. (Pollack HM and wieman EJ. Smear results in the diagnosis of mycobacterioses using blue light microscoy, J. Clin Microbiol., 5:329-331, 1977) Furthermore, Mattman goes on to point out: Blood (above sputum) is an exellent source for which to find these viral-like cell wall deficient forms of TB, SINCE APPROXIMATELY HALF OF PATIENTS WITH ACTIVE TUBERCULOSIS PRODUCE NO SPUTUM.(Chawla R Pant K. Fibeoptic bronoscopy in smear-negative pulmonary tuberculosis, Eur. respir. J., 1:804-806, 1988) Also there is no confusion (using blood) caused by the rich normal flora of organisms native to sputum and gastic washings. Blood usually yields a positive culture whether the tuberculous infection is in lung, meninges or other organs. The problem these people are facing is not in culturing these stealth forms of TB and MRD-TB because they can culture them in any of their standard culture media, it is in the staining that they are off. They should be using Kinyoun's stain, acridine-orange stain, Victoria Blue stain and the periodic acid method. And until they do so, they are getting,at most, half the story. |
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Now its the money $$$$$$$$$$
Drug-Resistant TB Needs $650 Million Effort, WHO Says (Update2)
By John Lauerman and Lisa Rapaport Feb. 26 (Bloomberg) -- Hospitals and clinics in developing countries need infection control equipment and personnel to stop the spread of drug-resistant tuberculosis that kills two-thirds of people infected, doctors said today. A strain of the disease, called XDR-TB, has reached at least 28 countries, including the U.S., and is not yet under control, said Paul Nunn, head of the World Health Organization's Stop TB department at a meeting in Los Angeles today. That compares with 17 less than a year ago, he said. The WHO yesterday said it is asking the U.S. and other donor countries and groups to provide $650 million to improve diagnosis and treatment for XDR-TB, an increase of almost a half-billion dollars over 2006. The strain can raise treatment costs from about $60 to as much as $15,000 per case in some poor countries because so few drugs can be used, doctors said. In South Africa, ``there are literally thousands of patients in long waiting lines and congested waiting rooms who are at risk of being exposed,'' said Karin Weyer, head of TB control for the South Africa Medical Research Council, in an interview. `I'm very concerned.'' Resistant strains themselves probably aren't spreading from country to country, Nunn said. The bloom in XDR-TB, or extensively drug-resistant tuberculosis, is most likely linked to inadequate treatment of tuberculosis in a variety of settings and countries. In the U.S., about four percent of TB patients have the resistant form. ``The drugs used are more or less the same everywhere,'' he said today in a speech at the 14th annual Conference on Retroviruses and Opportunistic Infections. ``Unfortunately, so are the defects in TB control.'' Lilly's Capastat Treating resistant strains such as XDR-TB requires drugs such as Eli Lilly & Co.'s Capastat, which can cost more than $4,000 per case, Nunn said. Weyer said in South Africa those costs can reach as high as $15,000. New drugs that might be effective against XDR-TB are at least five years away from testing, Nunn said. People with impaired immune systems, particularly those with HIV, are susceptible to tuberculosis. That presents problems because as many as one-third of South African health workers have the disease, Weyer said. African hospitals need ventilation systems and people specifically trained in infection control to prevent the spread of tuberculosis germs through the air, she said. ``This is something that the HIV community needs to be aware of,'' Nunn said. There were an estimated 650 XDR-TB cases in South Africa last year, 330 of them confirmed, and all nine provinces were affected. There were 106 cases of XDR TB confimed last year in an outbreak in Tugela Ferry alone, the focus of the KwaZulu- Natal outbreak in South Africa, Weyer said. Link to HIV The vast majority of XDR-TB infections occur in people whose immune systems are damaged by HIV, and about 84 percent of those patients died, she said. About one-third of South African health-care workers are thought to be HIV-infected. ``This raises difficult issues for HIV testing for health care workers in this environment,'' said Kevin de Cock, director of the WHO's HIV/AIDS program, in the news conference. The report was presented at the 14th Conference on Retroviruses and Opportunistic Infections. To contact the reporter on this story: John Lauerman in Boston at jlauerman@bloomberg.net . |
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ProMed post below for West Cape Area this post East Cape
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tony m
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For those that think that TB cannot kill in a matter of weeks: "At present, it has killed 98% of those infected within about two weeks."
And for those who think that MDR-TB is not on a par with Bird Flu: "The World Health Organization has called for the world to prioritise XDR-TB on par with bird flu and recommended governments in impoverished sub-Saharan Africa develop one strategy to deal with the twin challenges of HIV and TB". Story below: Call for deadly TB isolation move South Africa should forcibly isolate patients infected with a deadly strain of TB to stop the disease spreading on the HIV-hit continent, experts say. South Africa's outbreak of the multi drug-resistant XDR-TB has killed at least 74 people in the past few months. Writing in the PLoS Medicine journal, the ethicists and HIV experts said the outbreak represented a "major threat" They said it may force authorities to override personal rights for the greater good. "Ultimately in such crises, the interests of public health must prevail over the rights of the individual" said Jerome Singh, of the Centre for Aids Programme of Research Jerome Singh, a lawyer at the Centre for the Aids Programme of Research in Durban, South Africa, said: "XDR-TB represents a major threat to public health. If the only way to manage it is to forcibly confine then it needs to be done. TB, an airborne bacillus spread through coughing or sneezing, can usually be cured through treatment. However, the XDR-TB strain may have mutated when patients skipped treatment or were dispensed inadequate antibiotic cocktails. The study, co-authored by the Aids programme and the University of Toronto's Joint Centre for Bioethics, said South Africa has logged almost 400 cases of XDR-TB, which is virtually impervious to treatment by most common TB drugs, and an unprecedented 30 new cases are diagnosed every month. At present, it has killed 98% of those infected within about two weeks. The outbreak has alarmed medical experts who say XDR-TB poses a particular danger to HIV-positive people whose immune systems are already severely compromised by the AIDS virus. South Africa has one of the highest HIV rates in the world with about 5.5m people infected in a population of 45m. Most of those who died of XDR-TB have tested positive for HIV. Mr Singh said South Africa's highly mobile workforce, rising overseas tourism, and the prevalence of XDR-TB in Johannesburg, the main transportation hub, increases the chance of XDR-TB spreading past national borders and into other African countries struggling with high HIV/AIDS infection rates. Duty And he added it was the public's duty to press the government into opening the debate. In South Africa, XDR-TB patients may visit hospitals as out-patients and then go home, which means they can easily pass the disease in their community. However, the experts said the challenge to control XDR-TB requires not just policy changes but also more state spending. Mr Singh said long-term hospital stays increase the national health-care tab and burden overstretched clinics particularly in rural areas with heavy patient loads, adding hospitalized XDR-TB patients should automatically qualify for a social grant. The World Health Organization has called for the world to prioritise XDR-TB on par with bird flu and recommended governments in impoverished sub-Saharan Africa develop one strategy to deal with the twin challenges of HIV and TB. South Africa's health department said it had discussed the possibility of enforced isolation with the World Health Organization, but had not yet reached a conclusion. Story from BBC NEWS: http://news.bbc.co.uk/go/pr/fr//2/hi/health/6289841.stm Published: 2007/01/23 10:06:46 GMT © BBC MMVII |
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Lets get to know Russia and TB MRD Mar 03, 2007 04:30 AM
MOSCOW–Once a hospital for Napoleon's troops, Moscow's Phthisio-Pulmonary Institute is now home to hundreds of Russian patients suffering from dangerous new strains of tuberculosis. Quarantined for months on end, they rest on shabby beds or shuffle through the corridors in cotton face masks. On the ground floor, a young man in pyjamas sits by a window looking out onto a snowy courtyard, chatting on his cellphone with a pretty girl shivering in the cold outside. The patients have been sent here from across Russia after they failed to respond to traditional drug treatment for TB, a highly contagious bacterial infection that can be deadly. TB remains one of the most common infections in the world's poorer countries. As in most Western countries, TB was all but eliminated in Russia under the Soviet system. But it has flourished here in recent years, feeding on the poverty and lack of proper health care that followed the Soviet collapse. According to the World Health Organization, Russia registered nearly 120,000 new TB cases in 2005, compared with only 1,616 in Canada. Worryingly, Russia has also become a breeding ground for drug-resistant strains of TB. According to the WHO, nearly 20 per cent of patients in Russia are suffering from multi-drug-resistant TB, or MDR-TB, which develops if patients are treated improperly and then becomes contagious as a new strain. Of those, some are developing a virulent and incurable strain known as extensive-drug-resistant tuberculosis, or XDR-TB, which experts warn could cause a global health crisis. "This is a very serious health problem, with very serious risks," says Sergei Borisov, the Phthisio-Pulmonary Institute's deputy director. "XDR-TB is the next step in the evolution of TB. We already have 30,000 people with drug-resistant strains who are a danger to the people around them and to the whole world." The majority of Russia's TB cases can be traced to the country's overcrowded and underfunded prison system. Alcoholics, the homeless and migrant workers are also especially susceptible to the disease. But health experts say TB is increasingly spreading into the general population. Dmitri Kozlov, a 24-year-old patient at the institute, was an active student when he was diagnosed with TB two years ago. He says he has no idea how he contracted the disease. He didn't respond to a first round of treatments and was diagnosed with MDR-TB eight months ago. After being sent to the institute, he had a second round of drug treatments and seems to be recovering. "It's been a very difficult time, but I've made a lot of progress and I hope I will be going home soon," he says, his voice muffled by a cotton mask he must wear over his mouth and nose. Borisov says he's happy for his young patient, but still worries. "If he has a relapse, there's a strong chance it will develop as XDR-TB," Borisov says. Few Russian doctors, even TB specialists, seem to be aware of the new strain. Murray Feshbach, an expert on Russian health policy at the Washington-based Woodrow Wilson International Centre for Scholars, says that on a recent fact-finding trip to Russia almost none of the doctors he interviewed in Moscow and St. Petersburg knew about XDR-TB. "At first, HIV/AIDS was ignored and the same thing appears to be happening here," says Feshbach, who is researching a report on XDR-TB in Russia. In the early 1990s, Russian health officials refused to accept the dangers of HIV/AIDS and today the country is suffering from a severe epidemic of the disease, with an estimated 1 million Russians infected with HIV. "We need to head this off before it gets worse. Russia is potentially a source for a very dangerous form of drug-resistant TB," Feshbach says. Attempts are being made to tackle Russia's TB epidemic and with state coffers swelling thanks to booming energy prices, the Russian government is spending more. Health Minister Mikhail Zurabov last month announced a five-year, $3 billion (U.S.) program to fight diseases such as TB, diabetes, HIV/AIDS and cancer, saying the government hopes to stem Russia's rapid population decline. More money is also coming from the international community. The Global Fund to Fight AIDS, Tuberculosis and Malaria, which has received about $430 million in funding from the Canadian government, is providing about $100 million for TB projects in Russia over the next five years, mostly focusing on increasing doctor training and buying new equipment to fight drug-resistant strains. Sitting in his cramped office at the Phthisio-Pulmonary Institute, Borisov says he believes more money for training and equipment will help. But he says Russia also needs to tackle social ills like rampant alcoholism, poverty and inadequate housing if it wants to come to grips with TB and stop it from spreading. "The fight against TB in Russia is not only a medical problem. It's a social problem." |
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tony m
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Lets get to know Russia and TB MRD Drug-resistant TB on rise in Russia......or, by getting to know Russia's problem, we get to know a bit more about our own. Not only are adults getting hit, but children as well.
A major part of this MDR-TB resurgence in Russia, as elsewhere, is fueled by cell-wall-deficient (CWD) forms of TB, also called "L-forms", which are stealth viral-like and resistant to conventional TB treatment. It is not that Russian scientists have been unfamiliar with this. On the contrary: By the 1990’s the Russians had hit their stride with regards to L-forms, light years ahead of American scientists, many of whom either completely ignored them as nonexistant, or made light of their importence. Gadzhiev’s study, in a target-oriented search for the altered L-Forms of tuberculosis in children,using special L-Form stains, provided a significant increase in the proportion of the cases that were documented as smear-positive for tuberculous meningitis. Again, these same L-forms persisted, even during taking TB medication, indicating the possibility of a chronic and relapsing disease. (Gadzhiev GS Characteristics of the mycobacteria in children with tuberculous meningitis Probl Tuberk. (11):8-10 1990) And just how high the percentage of L-forms can be in not only children, but adults with TB meningits was shown by Insanov in his comparative analysis. L-forms in tuberculosis meningitis accounted for 87.6% of the tuberculosis found in children with TB meningitis and 87.3% of those organisms like-wise isolated in adults. (Insanov AB Gadzhiev FS Comparative analysis of the results of spinal fluid microbiological study in children and adults who suffered from tuberculous meningitis. Probl tuberk. 1996; (5):25-8) Why? Because it is exactly these filterable units of CWD tuberculosis or L-forms that can easily penetrate the blood-brain barrier (Biron MG Soloveva Acute hematogenic generalization of tuberculosis caused by L forms of Mycobacteria Probl. Tuberk., 8:75-6, 1989), especially the blood brain barrier of the not fully immunocompetant neonate or infant or young child. Insanov added to this knowledge, saying that the viral-like L-forms of tuberculosis not only made tuberculosis chemotherapy less effective but were also accompanied by an insidious onset and the slow accumulation of pathologic change in children, not only making the disease more difficult to diagnose, but allowing months to years before its full spectrum of pathologic change was felt. Russian Cases of children who have died exclusively from L-forms are on record, such as the 3-year-old in Zemskova’s documentation (Zemskova ZS Generalized TB Caused by L Forms of TB Mycobacteria In a Child Prob. Tuberk. 2:64-6 1985.) |
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Published Friday, March 16, 2007
Hospital Worker With TB May Have Exposed 500 Patients RICHARD PÉREZ-PEÑA An employee at a Bronx hospital has tuberculosis and may have exposed hundreds of patients and co-workers, including more than 200 newborn babies, officials said yesterday. They appealed to people who could have been infected to arrange for testing and treatment. The employee, whom officials identified only as a woman, worked in the maternity ward, the nursery, the neonatal intensive care unit and the psychiatric ward at St. Barnabas Hospital, in the East Tremont section of the Bronx. Her TB was diagnosed on Jan. 29. Hospital and city officials did not disclose what kind of job the woman held, but expressed concern that those she had contact with, including infants, were especially vulnerable. The risk of developing the disease “is greatest in the first year after infection,” said Dr. Sonal S. Munsiff, director of the Bureau of Tuberculosis Control. “And in some groups, such as people with immunosuppression or very young babies whose immune systems haven’t developed yet, the risk is much, much higher.” The city’s Department of Health and Mental Hygiene and hospital officials have combed through hospital records and are trying to track down 532 patients, including 238 infants, and more than 100 other people, including people who have worked at St. Barnabas, who they believe might have been exposed. Officials said they decided to disclose the woman’s infection after they had trouble contacting many of the people they believed to be at risk. They asked any patients or employees who were in one of the wards where the woman worked between Nov. 1 and Jan. 24 — the last day she worked at the hospital — to call the hospital at (718) 960-3624, or the city’s information line, 311. Because the hospital worker showed no signs of illness until late January, officials say they are confident she would not have been contagious before Nov. 1. City health officials stressed that TB is neither uncommon nor highly infectious, and is usually passed from person to person only through prolonged close-quarters contact. In most cases, the disease strikes the lungs, causing a cough that can spread the bacteria that cause the disease. Untreated, most cases of active tuberculosis are eventually fatal. Dr. Munsiff said that as much as 10 percent of the city’s population is infected with the bacteria. The great majority of those people have a dormant infection and cannot infect others, and many people go decades with the germs in their system, with no resulting illness. But the germs can suddenly become active and multiply, and the patient then develops TB. There are about 1,000 new tuberculosis cases diagnosed annually in the city, Dr. Munsiff said, about two-thirds of them in foreign-born people, because the disease is more common in some other parts of the world. City and hospital officials would not say what country the infected hospital worker is from. “She is foreign born, but she is a longtime resident of the United States, and our understanding is that she had not recently been overseas,” said Fred Winters, a hospital spokesman. Dr. Munsiff said that 4 to 5 percent of the city’s cases of active tuberculosis — 40 to 50 people each year — are health care workers, who are at higher risk than most people because they spend so much time around sick people. Antibiotics work well against the strain of bacteria that infected the hospital worker, officials said, unlike their performance against some strains that have become drug-resistant. Even so, getting rid of the infection requires taking antibiotics for nine months. Sometime in late January, the sick hospital employee had a “persistent cough and shortness of breath, and she went to the emergency room at St. Barnabas on the 29th,” Mr. Winters said. Chest X-rays confirmed the presence of tuberculosis, and she was put into isolation and given antibiotics, he said. New York State requires that hospital workers have annual tuberculosis tests, called P.P.D. tests, which involve ****ing the skin to see if the immune system produces a reaction. But the test is of limited value. Anyone who has ever been infected can test positive on the P.P.D., even if the infection is dormant, and even if it has been eliminated with antibiotics. So a significant part of the population tests positive, as the St. Barnabas worker had for a number of years, Mr. Winters said. In addition, people who are infected, and even people who actually suffer from the disease, can test negative. http://www.tuscaloosanews.com/article/20070316/ZNYT04/703160385/1002/NEWS04 |
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HOSPITAL TB TESTING BEGINS By CARL CAMPANILE March 17, 2007 -- Twenty-five former patients who may have been exposed to killer tuberculosis by an infected nurse at St. Barnabas Hospital sought tests for TB yesterday . Ten were tested and 15 others called for appointments to be tested, said Barnabas spokesman Fred Winters. The city Health Department and hospital announced Thursday that 700 patients - including 238 newborns and tots - may have been exposed. Patients and staff who may be exposed can call the hospital at (718) 960-3624 or the city's 311 hotline for free testing. http://www.nypost.com/seven/03172007/news/regionalnews/hospital_tb_testing_begins_regionalnews_carl_campanile.htm |
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(MDR-TB) cases are found in the Western Pacific. A majority of them - around 140,000 cases - are concentrated in China.
WHO Calls For Urgent Action Against Multi-Drug Resistant TB in Asia-Pacific By Heda Bayron Hong Kong 19 March 2007 About two million people in the Western Pacific region develop tuberculosis each year. Poverty, an aging population and rising HIV infections are helping spread the respiratory disease. On World Tuberculosis Day, health experts in Asia stress the urgency of controlling a much bigger medical threat: drug resistant tuberculosis. VOA's Heda Bayron has more on the story from our Asia News Center in Hong Kong. Hong Kong primary school students listen intently to a TB prevention presentation The World Health Organization says more than a quarter of the world's multi-drug resistant tuberculosis (MDR-TB) cases are found in the Western Pacific. A majority of them - around 140,000 cases - are concentrated in China. This World Tuberculosis Day, the WHO is urging governments in Asia to invest in immediate action - saying stopping more virulent strains of the disease is costlier and more complex. A tuberculosis clinic in Hong Kong Unlike ordinary TB - which can be cured by antibiotics within six to eight months - MDR-TB requires more powerful and expensive drugs taken for more than two years, often with severe side effects. Dr. Pieter van Maaren - head of the Stop TB department of the WHO in the Western Pacific - says the emergence of MDR-TB can be blamed on a failure to implement the standard treatment strategy known as DOTS. "It's a man-made problem," said Pieter van Maaren. "What you see in China for example is, in the past, the TB control program was not very strong and they have not managed TB patients according to the DOTS strategy. But it was only in 2002, 2003 that the entire country had access to DOTS strategy - the best way of managing TB. That is why we see at this point in time the problem of drug resistant TB in China emerging." A DOTS clinic in Hong Kong Incorrect or incomplete medication leads to drug resistance. DOTS - direct observed treatment short-course - combats the problem by requiring patients to come to clinics daily or several times a week to take their medicines. There, health workers closely monitor correct dosage and duration of treatment. In Hong Kong - where the fight against TB and drug resistance has been successful - anti-TB drugs are given free in public clinics. Because of the city's small size, patients have easy access to them. In the past 50 years - Hong Kong has reduced the incidence of TB by almost 98 percent. Dr. S.L. Chan of Hong Kong's Tuberculosis, Chest and Heart Disease Association But Dr. S.L. Chan, a tuberculosis expert at the Hong Kong Tuberculosis, Chest and Heart Disease Association, says getting patients to stay on course with DOTS is a multi-faceted c******enge. "In the past you can say, 'You must have treatment' under supervision and they have no choice," said Dr. Chan. "But now because of human rights if you tell them, 'You must have DOTS' they will say 'I can't'. You can't force them… Another thing, [in Hong Kong] there is still a large proportion of the population suffering from tuberculosis in the age between 20-49. They are the working group. How can you imagine they come to the clinic for supervised treatment? Other c******enges include funding and reaching people in remote areas or places with overtaxed health facilities. The WHO is targeting its fight against TB in the world's most populous nation, China. Mario Raviglione is the global head of the WHO's Stop TB department. "We are now pretty confident that the Chinese are going to do the right thing, what needs to be done to save the situation," said Mario Raviglione. "Clearly there is a lot of work ahead." The Western Pacific sees two million TB cases develop each year and more than 800 people die from the respiratory illness every day. The WHO has set an ambitious goal for the whole region and that is to cut by half TB prevalence and mortality within three years. Doctors say the region's rising HIV/AIDS epidemic, persistent poverty and dismal public health funding are the main obstacles to these goals. The WHO says the region has only earmarked less than 10 percent of the nearly $1 billion it needs to combat the disease in the next five years. More than $200 million of it would be needed to contain multi-drug resistant TB. TB is spread through coughing and sneezing. In Asia, it is most prevalent in Cambodia, China, Laos, Mongolia, Papua New Guinea, the Philippines and Vietnam. http://www.voanews.com/english/2007-03-19-voa64.cfm |
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tony m
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In the rarified world according to WHO, take your DOT and leave your TB and possibility of spreading MDR-TB behind. But in the real world, typified by the droves of studies (such as the one below) that presently lace Medline, this is only part of the problem. And even when these medicines are taken faithfully, the anti-tuberculosis medicines themselves can spawn L-forms of TB, resistant to conventional therapy and therefore, in and of themselves,and by definition: MDR-tuberculosis.
L-forms, or cell-wall-deficient forms are a major part of how tuberculosis has had a grip on mankind for so long and so successfully. The germ adapts into a form where it cannot be attacked, often dorment, only to return another day: Probl Tuberk Bolezn Legk. 2006;(11):22-4. Links [Study of rifampicin resistance in L-forms of Mycobacterium tuberculosis, by analyzing rpoB gene mutations][Article in Russian] Mel'nikoava NN, Mokrousova IV. Twenty-nine Mycobacterium tuberculosis (MBT) L-form strains isolated from biopsy and surgery samples taken in 27 patients with extrapulmonary tuberculosis were studied. Since a direct examination of the resistance of L-forms is impossible due to their in vitro culturing features, it is expedient to use molecular genetic methods, by studying rpoB gene mutations. The study showed a high mutation rate (89.7%) in MBT L-forms associated with rifampicin resistance. The findings correlate with the recent years' monitoring of drug resistance in MBT in extrapulmonary tuberculosis, which has indicated that the total resistance of MBT from the foci of this form of tuberculosis to antituberculous drugs is as high as 90% and multidrug resistance is 30%. Moreover, the mycobacterial population was found to be heterogeneous. The ratio of rifampicin-resistant L-forms to sensitive ones in the established heterogeneity of the mycobacterial population calls for further studies. PMID: 17195586 [PubMed - indexed for MEDLINE] |
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TB World Day
From TonyM .....from post bellow .... Thanks Tony ..... In the rarified world according to WHO, take your DOT and leave your TB and possibility of spreading MDR-TB behind. But in the real world, typified by the droves of studies (such as the one below) that presently lace Medline, this is only part of the problem. And even when these medicines are taken faithfully, the anti-tuberculosis medicines themselves can spawn L-forms of TB, resistant to conventional therapy and therefore, in and of themselves,and by definition: MDR-tuberculosis. L-forms, or cell-wall-deficient forms are a major part of how tuberculosis has had a grip on mankind for so long and so successfully. The germ adapts into a form where it cannot be attacked, often dorment, only to return another day:.......................................... March 20 2006 another day ...... Officials investigating possible tuberculosis case at SCC EMILY DAGOSTINO, Staff Writer Published March 20, 2007 Officials from the S.C. Department of Health and Environmental Control are doing standard skin tests on people who came in close contact with the student who may have tuberculosis. Confirmation on whether the illness is actually active could take weeks, said DHEC spokesman Thom Berry. Meanwhile, the student is being treated with antibiotics as if he or she has an active, contagious case. “People often think that tuberculosis is a dead disease, and then you don’t hear about it anymore,” Berry said. DHEC, though, sees several hundred cases each year. “It’s not unusual for us to go into this type of environment and do this type of close contact investigation,” he said. “We’ve gone in and tested entire schools before.” http://www.goupstate.com/article/20070320/NEWS/70320010/1051/NEWS01 |
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tony m
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Suggested Title:
MDR-TB: Studies That WHO and Traditional American Medicine Would Like To Just Go Away And Die............or......Ignorance Is Bliss. Zhonghua Jie He He Hu Xi Za Zhi. 2001 Jan;24(1):52-5. Related Articles, Links [Observations of properties of the L-form of M. tuberculosis induced by the antituberculosis drugs] [Article in Chinese] Wang H, Chen Z. Department of Microbiology, Guiyang Medical College, Guiyang 550004, China. OBJECTIVES: To investigate the mechanism of generation of L-form of M. tuberculosis and its significance on the development, diagnosis and treatment of tuberculosis. METHODS: M. tuberculosis was inoculated into the non-high osmotic medium with rifampin, isoniazid or ethambutol and then the L-form was observed by microscopy daily. The cultures were filtrated to get the pure cultures of stable L-form by subculture with the non-high osmotic medium and characteristics of morphology, growth, susceptibilities to the antibacterial drugs and the special gene of M. tuberculosis were observed when the pure subcultures of the L-form were isolated. RESULTS: L-form of M. tuberculosis was induced by the concentrations of routine inhibition test of rifampin, isoniazid or ethambutol. The L-form would not be susceptible to the above mentioned antituberculosis drugs but susceptible to streptomycin, erythromycin, ofloxacin, norfloxacin and others. The morphologies of L-form were irregular or spherical with single, paired or chain form, and growth under the bottom of the medium but not movement or adhere to the glass. The L-form was negative by acid-fast stain and negative or positive by Gram stain. The gene of L-form reacted with the PCR kit for the M. tuberculosis and showed the same band. CONCLUSIONS: M. tuberculosis could be killed by rifampin, isoniazid or ethambutol but also could be induced to become the L-form by these antituberculosis drugs, and it is one of the important factor that affecting the effect of treatment of the tuberculosis. The cell wall deficient variants of M. tuberculosis could be determined by the PCR of M. tuberculosis. It is recommended that the L-forms should be noticed during the treatment with the antituberculosis drugs and combination treatment with antituberculous drugs to which the L-forms were susceptible, is also very important. Publication Types: English Abstract PMID: 11802941 [PubMed - indexed for MEDLINE] Zh Mikrobiol Epidemiol Immunobiol. 1984 Jun;(6):23-7. Links [Characteristics of the filterable L-forms of Mycobacterium tuberculosis and their significance in pathology] [Article in Russian] Golyshevskaia VI, Zemskova ZS, Korolev MB. The results of the present investigation indicate that antituberculosis therapy for a period of 6 months leads to qualitative changes in M. tuberculosis population. This is manifested by the appearance of the filterable L-forms of M. tuberculosis in pathological material. At the same time these forms retain the initial pathogenicity of M. tuberculosis and induce not only tuberculous, but also nonspecific inflammation. Among the population of these filterable forms organisms carrying the genetic information of the species and capable of replication processes have been detected. PMID: 6431716 [PubMed - indexed for MEDLINE] Frequency and dynamics of isolation of l-forms of m. Tuberculosis in the patients with relapses of lung tuberculosis E.F. Chernushenco, M.T. Klimenko, O.A. Zhurilo, A.I. Barbova, L.M. Tzygankova, S.G. Yasir, Zh.E. Vyalikh, P.S. Trophimova, N.A. Dolinskaya 64 patients with relapses of lung tuberculosis were examined. L-forms of M. tuberculosis were detected in 26 (40,6%) patients. In 73,1% of all cases L-forms turned out to be instable and reversed after 1 to 3 passages in vitro into typical bacterial form of the pathogene. Revertant cultures had the same characteristics as the typical bacteria, isolated in the same patients. L-forms excreters should be regarded as a group that needs follow-ap and antibacterial therapy. Key words: M. tuberculosis, L-forms, relapses of tuberculosis. Frequency and dynamics of isolation of l-forms of m. Tuberculosis in the patients with relapses of lung tuberculosis / E.F. Chernushenco, M.T. Klimenko, O.A. Zhurilo and al. // Ukr. J. Chemotherapy.- 2000.- N 3.- P. 17 - 20 |
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The resumption of consumption-- a review on tuberculosis.Programa de Pos-graduacao em Biologia Celular e Molecular, UFRGS, Porto Alegre, RS, Brasil. Among all infectious diseases that afflict humans, tuberculosis (TB) remains the deadliest. At present, epidemiologists estimate that one-third of the world population is infected with tubercle bacilli, which is responsible for 8 to 10 million new cases of TB and 3 million deaths annually throughout the world. Approximately 95% of new cases and 98% of deaths occur in developing nations, generally due to the few resources available to ensure proper treatment and where human immunodeficiency virus (HIV) infections are common.
In 1882, Dr Robert Koch identified an acid-fast bacterium, Mycobacterium tuberculosis, as the causative agent of TB. Thirty-nine years later, BCG vaccine was introduced for human use, and became the most widely used prophylactic strategy to fight TB in the world.
The discovery of the properties of first-line antimycobacterial drugs in the past century yielded effective chemotherapies, which considerably decreased TB mortality rates worldwide. The later introduction of some additional drugs to the arsenal used to treat TB seemed to provide an adequate number of effective antimicrobial agents.
The modern, standard short-course therapy for TB recommended by the World Health Organization is based on a four-drug regimen that must be strictly followed to prevent drug resistance acquisition, and relies on direct observation of patient compliance to ensure effective treatment.
Mycobacteria show a high degree of intrinsic resistance to most antibiotics and chemotherapeutic agents due to the low permeability of its cell wall. Nevertheless, the cell wall barrier alone cannot produce significant levels of drug resistance. M. tuberculosis mutants resistant to any single drug are naturally present in any large bacterial population, irrespective of exposure to drugs.
The frequency of mutants resistant to rifampicin and isoniazid, the two principal antimycobacterial drugs currently in use, is relatively high and, therefore, the large extra-cellular population of actively metabolizing and rapidly growing tubercle bacilli in cavitary lesions will contain organisms which are resistant to a single drug. Consequently, monotherapy or improperly administered two-drug therapies will select for drug-resistant mutants that may lead to drug resistance in the entire bacterial population.
Thereby, despite the availability of effective chemotherapy and the moderately protective vaccine, new anti-TB agents are urgently needed to decrease the global incidence of TB.
The resumption of TB, mainly caused by the emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains and HIV epidemics, led to an increased need to understand the molecular mechanisms of drug action and drug resistance, which should provide significant insight into the development of newer compounds. The latter should be effective to combat both drug-susceptible and MDR/XDR-TB.
PMID: 17160276 [PubMed - in process] |
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India's Multidrug-Resistant Tuberculosis Crisis
Abstract
Abstract:India has the highest number of tuberculosis cases of any country in the world, and many of these cases are MDR TB.
A combination of contributing factors has led to the current public health crisis: a failing National Tuberculosis Programme, denial and lack of compliance on the part of patients, lack of regulation of doctors in private practice, governmental policy failure and corruption, social and economic problems, and a growing HIV epidemic.
This situation must be combatted on several fronts, including promoting social change; increasing government funding; seeking global aid; implementing DOTS, non-DOTS, and NGO programs; integrating TB and HIV programs; funding research; enacting regulatory legislation; and establishing continuing medical education programs among private practitioners.
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Johns Hopkins Gazette | July 19, 2004
.............................................................3 to 1Males also Need Early ....Healthy Sexual Behavior Education
...................................................................................................
Because....
ONE female (25% of total sample)
was HIV infected for every
THREE males.
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HIV Testing Among Pregnant Women --- United States and Canada, 1998--2001
Since 1994, the availability of increasingly effective antiretroviral drugs for both the prevention of perinatal human immunodeficiency virus (HIV) transmission and maternal treatment has resulted in a greater emphasis on prenatal HIV testing and substantial increases in prenatal testing rates. In 2000, preliminary data indicated that 766 (93%) of 824 HIV-infected women in 25 states knew their HIV status before delivery (CDC, unpublished data, 2002). However, an estimated 280--370 perinatal HIV transmissions continue to occur in the United States each year (1).
The primary strategy to prevent perinatal HIV transmission is to maximize prenatal HIV testing of pregnant women.
...................
My thought is.... get to it earlier.
Schools ...Colleges...Employers... should screen everyone, male and female.
..........................
Abstract...
Russia is experiencing one of the fastest growing HIV epidemics in the world. Russian sexually transmitted disease (STD) clinic patients are at elevated risk for infection with HIV and other STDs due to unsafe sexual behaviors.
Future risk reduction intervention efforts for this group must be grounded in a solid understanding of the factors associated with risky behaviors. We collected information about the sexual behaviors, substance use, protective strategies, and HIV-related attitudes of 400 high-risk men and women presenting at an STD clinic in a major Russian metropolis. Alcohol use in conjunction with sexual activity was common in this sample (85%).
One-third of study participants had more than 1 partner in the past 3 months, and about half (48%) of the sample had previously been diagnosed with an STD. However, despite this evidence of high-risk behavior, most participants (67%) reported using condoms less than half the time. High-risk behavior was associated with substance use and lower perceived severity of AIDS.
Self-protective strategies differed by gender: men reported higher condom use rates whereas women reported efforts to limit their number of sexual partners. This study has important implications for the development of culturally tailored interventions to help stem the spread of HIV in Russia.
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tony m
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Condoms have a variety of uses. Let's take this one, for example:
Although tuberculosis, or for that matter MDR tuberculosis is rarely thought of as a sexually transmitted disease, the potential for this had always existed. In the presence of prostatitis, it may be transmittedthrough the semen. (Lattimer J. K., Colmore H. P. Transmission of genital tuberculosis from husband to wife via the semen. Am Rev Tuberc 1954; 69(4): 618–624). And so remains ignored and unnoticed, the very real possibility of the genital transmission of M. tuberculosis,a disease affecting almost 2 billion people, intimately linked with and considered a reliable sign of AIDS, and frequently found in the genitourinary tract.(Wyngaarden J. B., 19th ed Cecil Textbook of Medicine; vol.2. Philadelphia: W.B. Saunders, 1992: 1740). Tuberculosis and Mycobacterium avium (also called Mycobacterium avium-intracellulare or MAI) are not only the recognized leading causes of infectious disease in AIDS today, they are by far the most important infections in AIDS. By 1954, a pattern emerged at Dr. John Lattimer’s Center for Genitourinary Tuberculosis. Men who developed tuberculosis epididymitis (inflammation of the testicles) were usually found to have an active focus of tubercular infection in their prostate and cultures of their semen were frequently positive for tubercle bacilli (IBID). By 1954 Dr. Edgar T. Peer of the Niagara ****ula Sanatorium, St. Catharines, Ontario, Canada, published, warning that if physicians did not wake up to the possibility of sexually transmitted genital tuberculosis, its diagnosis would continue to be unsuspected and underestimated. (Peer E. T. Genitourinary transmission of tuberculosis. Am Rev Tuberc 1957; 75: 153), which one day could lead to potentially catastrophic consequences. Nor were Peer and Lattimer alone. Netter mentioned that the spread of the tubercle bacilli through the female genital tract of the tubercle bacilli by coitus with a tuberculous male could not be denied (Netter FH. Reproductive system. The Ciba Collection of Medical Illustrations. New Jersey: West Caldwell, 1987; 2:188.26). In fact, wherever culture of the seminal fluid showed Mycobacterium tuberculosis, there was a possibility of transmission of genital tuberculosis from male to female via the semen through sexual intercourse (Chakravarty S. C., Sircar D. K. Genital tuberculosis in males.Seminal fluid culture and vaso-seminal vesiculography studies. J Indian Med Assoc 1968; 51(6): 283–286). While Lattimer and Peer showed that the development of tuberculous ulcers in the vagina or vulva resulting in swollen lymph nodes in the groin was due to semen positive males harboring M. tuberculosis, Hellerstrom clocked the actual incubation period from the date of coitus during which the wife was exposed – to the development of the vaginal or vulval ulcer and enlargement of inguinal lymph nodes at approximately 3–4 weeks (Hellerstrom S. Acta Dermato-Venereol 1937; 18(4): 465.) Heins offered a better idea of the potential potency of sexually transmitted mycobacteria such as tuberculosis, demonstrating that even the tame Mycobacteria smegmatis found in the smegma genital secretions of both men and women, when introduced into the vaginas of female mice, resulted in the immediate death of over half of an experimental group of 14 (Heins H. C., Jr, Dennis E. J. The possible role of smegma in carcinoma of the cervix. Am J Obstet Gynecol 1958; 76: 726–735). Lattimer’s cases Lattimer’s cases were compiled from European and American literature. The ulcer and enlarged nodes in the female, often misdiagnosed, closely resembled lymphogranuloma inguinale, syphilis or chancroids (Ibid) diseases that could coexist with tubercular sexually transmitted disease. By 1972, five years before gays started dying in the U.S., Rolland wrote Genital Tuberculosis, a Forgotten Disease? (Rolland R., Schellekens L. Genital tuberculosis, a forgotten disease. Ned Tijdschr Geneeskd 1972; 116(52): 2377–2378). And ironically, in 1979, on the eve of AIDS recognition, Gondzik and Jasiewicz showed that even in the laboratory, genitally infected tubercular male guinea pigs could infect healthy females through their semen by an HIV-compatible ratio of 1 in 6 or 17%, prompting him to warn his patients that not only was tuberculosis probably a sexually transmitted disease, but also the necessity of the application of suitable contraceptives such as condoms to avoid it (Gondzik M., Jasiewicz J. Experimental study on the possibility of tuberculosis transmission by coitus. Z Urol Nphrol 1979; 72(12): 911–914.) Gondzik’s solution and date of publication are chilling; his findings significant. Even in syphilis at its most infectious stage, successful transmission in humans was possible only in 30% of contacts (Smith L. H., Wyngaarden J. B. Cecil Textbook of Medicine. Philadelphia: W.B. Saunders, 1988). And just as males could infect females with sexually transmitted TB so could females infect males. Two years later, investigators in South Africa, itself perched on the precipice of a devastating sexually transmitted AIDS epidemic, issued a report of 91 cases of tuberculosis of the **** (Wilson-Jones E., Winkelmann R. K. Papulonecrotic tuberculosis; a neglected disease in Western countries. J Am Acad Dermatol 1986; 14: 815–826.) This was followed by documentation in which ‘HIV’ in young African females came only after first contracting genital TB (Giannacopoulos K. C., Hatzidaki E. G. Genital tuberculosis in a HIV infected woman. Eur J Obstet Gynecol Reprod Biol 1998; 80(2): 227–229.11). |
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Hows this ..... This is tragic ..... half the population ...
Half PNG people get TB infection ............... www.chinaview.cn 2007-03-22 13:25:51 WELLINGTON, March 22 (Xinhua) -- It is estimated tuberculosis (TB) has infected 50 percent of Papua New Guinea's population and it is spreading. The daily local newspaper Post Courier reported Thursday the World Health organization (WHO) in Papua New Guinea (PNG) said the spread of tuberculosis is under-reported and it's likely that more than the estimated 50 percent of its 500,000 population is infected with the disease. The Global Fund has agreed to give PNG 20 million U.S. dollars for the next five years to help in it its fight against TB. The technical assistant for the WHO's tuberculosis control program, Iraingo Moses, said the five-year strategy will help monitoring and improve evaluation as most Centers treat TB don't report it. She said the strategy should also ensure quality diagnosis and regular drug supplies, helping with direct observation treatments and the government's commitment to placing medical resources in regional areas. PNG is the world's most diverse country, with more than 700 native tongues. Some 80 percent of the people live in rural areas with few or no facilities. Many tribes in the isolated mountainous interior have little contact with each other, let alone with the outside world, and live within a non-monetarized economy, dependent on subsistence agriculture. Moses said the funding will expand WHO's TB program to parts of the country that aren't being treated. "This money should help us get our coverage up to around 80 percent of the population and help us to detect more than 70 percent of all new smear positive cases and also help us get our cure rate well above 85 percent," said Moses. Editor: Jiang Yuxia |
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tony m hi .. with World TB Day and lots of TB news about numbers , lots of 50% of populations in several countries , I couldn't get your post on wrapping in plastic { condoms }out of my brain as it could help save some of these infections .. and its not going to happen is it ... they can't stop HIV with condom education . How will they apply this ...... for TB .. its going to be years away isn't ...?
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World TB Day --- March 24, 2007World TB Day is observed on March 24 each year and commemorates the date in 1882 when Dr. Robert Koch announced the discovery of Mycobacterium tuberculosis, the bacterium that causes tuberculosis (TB). Worldwide, TB remains one of the leading causes of death from infectious disease. An estimated 2 billion persons (i.e., one third of the world's population) are infected with M. tuberculosis. Each year, approximately 9 million persons become ill from TB; of these, nearly 2 million die from the disease. World TB Day provides an opportunity for TB programs, nongovernmental organizations, and other partners to describe problems and solutions related to the TB pandemic and to support worldwide TB-control activities. The theme for this year's observance is "TB Elimination: Now is the Time!" After approximately 30 years of decline, the number of TB cases reported in the United States increased 20% during 1985--1992. This led to a renewed emphasis on TB control and prevention during the 1990s. However, although the 2006 TB rate is the lowest recorded in the United States since national reporting began in 1953, the average annual decline has slowed since 2000. In addition, multidrug-resistant TB remains a threat, extensively drug-resistant TB has become an emerging threat, and persons of racial/ethnic minority populations and foreign-born persons continue to account for a disproportionate number of TB cases.
CDC and its partners are committed to eliminating TB in the United States. In many states, education and awareness programs convened by local TB coalitions will take place in commemoration of World TB Day. Additional information about World TB Day and CDC TB-elimination activities is available at http://www.cdc.gov/nchstp/tb/worldtbday. |
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tony m
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"tony m hi .. with World TB Day and lots of TB news about numbers , lots of 50% of populations in several countries , I couldn't get your post on wrapping in plastic { condoms }out of my brain as it could help save some of these infections .. and its not going to happen is it ... they can't stop HIV with condom education . How will they apply this ...... for TB .. its going to be years away isn't ...?"
Many, many years away Candles, if at all. Probably at the same time that they realize that AIDS itself is from MDR-TB, which I predict will also come to pass. After, all, your AIDS tests for "HIV" all cross-react with TB and the mycobacteria and there is nothing being attributed to "HIV" (low CD4, apoptosis, etc) that you can't find in the TB literature. |
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At present, there are only seven doctors at King George V to oversee the 100 MDR TB patients, 30 XDR patients and 200 weekly outpatients who attend the bi-weekly clinics. These doctors are also assisting to treat patients at a new 120-bed facility opened in Durban's Clairwood area which only has one doctor at present.................................................
Margo estimates that in KwaZulu-Natal alone, there are around 40 000 people with active, infectious TB. "We know that we have under-estimated the cases of MDR TB, but even if we triple our figures, this would mean that there are 3 000 cases of MDR TB in KwaZulu-Natal. This poses far less of a risk than ordinary TB to ordinary people," says Margo. ....................... South Africa: Drug Resistant TB Poses Greatest Risk to Healthcare Workers Health-e (Cape Town) March 23, 2007 Posted to the web March 26, 2007 Kerry Cullinan Cape Town Until recently, Mandla was a nurse at a Durban hospital. But for the past few months, he has been a patient trying to shake off multi-drug resistant (MDR) TB. "I became sick with TB in August last year. By January, I had finished my normal TB treatment but I still wasn't cured and that is when they found I had MDR TB," says Mandla, a tall, thin man in his thirties. "I took my treatment properly without a break and this is the first time I have had TB," adds Mandla, who said he had lost both his appetite and energy. It is highly likely that Mandla picked up MDR TB from one of the patients he cared for. Healthcare workers are the most at risk of getting MDR TB - and its incurable cousin, XDR TB. "MDR and XDR TB are no more infectious than ordinary TB," says KwaZulu-Natal provincial TB manager Bruce Margo. 'These are not super-bugs that can infect people more easily. "South Africa has a very high TB rate, and there are a lot of people with active TB coughing and sneezing in their communities. So ordinary people are most at risk of getting TB. "But healthcare workers are most at risk of getting MDR and XDR TB as they are more likely to come into contact with them than ordinary South Africans." Margo estimates that in KwaZulu-Natal alone, there are around 40 000 people with active, infectious TB. "We know that we have under-estimated the cases of MDR TB, but even if we triple our figures, this would mean that there are 3 000 cases of MDR TB in KwaZulu-Natal. This poses far less of a risk than ordinary TB to ordinary people," says Margo. However, the serious, drug-resistant cases were most likely to end up in hospitals cared for by nurses like Mandla and doctors like Dr Igbal Master, a long-term TB doctor at King George V Hospital, the Durban hospital with the greatest cases of MDR TB in the country. "About 10% of people with normal immune systems who are exposed to the TB bacillus develop TB," says Master. "If you are healthy, you are unlikely to get TB. I have been exposed to TB and MDR TB over many years and have not developed active TB. But there is a chance that, as I get older and my immune system weakens, MDR or XDR is waiting for me," says Master with a rueful laugh. People with HIV are at great risk of getting TB, yet many healthworkers are reluctant to reveal their HIV status to their employers - and they thus endanger their own health by working on wards with TB patients. Since the public outcry over XDR TB, special masks are available for health workers but only one nurse in the male TB ward at King George was wearing a mask. Masters says that most of the doctors have stopped using the mask, which is really uncomfortable in the tropical climate and "interferes with doctor-patient relations". Dr Shamila Maharaj, the hospital's medical manager, says that it is hard to attract doctors to work at her hospital. Nurses' salaries have been hiked to the highest grades to attract staff. "I had a young doctor interested but then he came back and started asking many questions about his risks and compensation if he became infected," says Dr Maharaj. "I think there should be some kind of incentive, like the inhospitable or scarce skills allowance, to attract health professionals as we are really struggling to get doctors," she said. The many research institutes wanting to study drug-resistant TB could also help by providing sessional doctors, she adds. At present, there are only seven doctors at King George V to oversee the 100 MDR TB patients, 30 XDR patients and 200 weekly outpatients who attend the bi-weekly clinics. These doctors are also assisting to treat patients at a new 120-bed facility opened in Durban's Clairwood area which only has one doctor at present. http://allafrica.com/stories/200703260404.html |
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tony m
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"About 10% of people with normal immune systems who are exposed to the TB bacillus develop TB," says Master."
I am not sure where Dr. Master gets his information,but its dead wrong with an emphasis on the word "dead". It seems like they say anything they want to say. |
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tony m
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http://www.joimr.org/JOIMR-2007-5-1-Cantwell.pdf
As this discussion on MDR-TB shows, one cannot talk about MDR-TB without getting involved with "HIV". But is it really "HIV"? In the just released PDF given above, researcher Dr. Alan Cantwell MD seems to think not. Interesing read. Highly recommended. |
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Berry added that a few more tests still needed to be read. ........... TB tests come back negative EMILY DAGOSTINO, Staff Writer Published March 30, 2007 Tuberculosis skin tests of more than 40 people at Spartanburg Community College have come back negative, a state health official said on Thursday. The S.C. Department of Health and Environmental Control started its investigation at the school last week after a "suspect case" of tuberculosis showed up. The investigation included skin tests for people who had close contact with the infected individual. "All of the tests that we have read so far -- and we've read a majority of them -- are negative," DHEC spokesman Thom Berry said in a phone message. "We haven't had a single positive show up." Berry added that a few more tests still needed to be read. The brief scare over whether the bacteria may have spread, though, seems to have passed. DHEC is still waiting on lab results to determine whether the original "suspect case" was an active case of tuberculosis. Determining whether individuals infected with the bacteria are contagious usually takes several weeks. It's standard procedure, meanwhile, to treat them as if they have active tuberculosis and are contagious. Most people who have been infected -- about 5 to 10 percent of the population -- fend off the bacteria and don't experience the active disease, which is characterized by a heavy cough, chest pain, fatigue and fever. DHEC sees hundreds of new tuberculosis cases statewide each year. Last year there were 12 in Spartanburg County and 222 across the state. Emily Dagostino can be reached at 562-7221 or emily.dagostino@shj.com http://www.goupstate.com/article/20070330/NEWS/703300339/1051/NEWS01 |
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TB walking through the door ....
TB RISE IN CITY DOWN TO IMMIGRANTS 11:00 - 05 April 2007 An influx of immigrants is behind a "significant" rise in tuberculosis cases in Nottingham, say experts. The number of cases in Notts has more than doubled in two years. Hotspots for the infectious lung disease are Hyson Green, Forest Fields, Radford and The Meadows, according to the Health Protection Agency. Two-thirds of patients are thought to be in the city centre, with others in outlying suburbs and Mansfield. Latest figures show there were 118 cases of TB in Notts last year. In 2004 there were 53. Leicestershire had more, with 285 last year and 310 in 2005. In 2004, there were 198. Derbyshire had 80 cases last year, compared to 67 in 2005 and 81 in 2004. Dr Richard Slack, the Health Protection Agency's consultant in communicable diseases, said the increase was due to people coming from regions with high instances of TB, such as Africa and parts of Asia. But poor living conditions also play a part in spreading the disease, but Dr Slack warned people not to panic. "The figures for 2002 to 2006 show an increase in Notts slightly greater than the national average," he said. "And if you compare the 2004 figure with last year's, there is a significant increase. "The disease is largely seen in particular community groups, who come from countries with high instances of TB. "There is no doubt this is a disease of overcrowding and to some extent poverty, even in the UK." The agency is monitoring the situation closely. Dr Slack said TB, which was common in the early part of the 20th Century, was still rare in Britain. "The numbers are still pretty low," he said. "Not everybody getting on the 58 bus is going to catch it. It is also worth pointing out that not all cases are infectious - in some cases it is 'locked away' in parts of the body." Dr Slack also said that the screening process for picking up new cases when someone moved to the UK had improved. And GPs are encouraged to send new patients who are at risk to be checked out at the chest clinic at the City Hospital. About 8,000 new cases of TB are currently reported each year in the UK. It can be spread by an airborne germ after a person who has TB of the lungs coughs or sneezes. It usually takes several months for symptoms to appear and these include fever and night sweats; persistent cough; weight loss and blood in phlegm or spit. http://www.thisisnottingham.co.uk/displayNode.jsp? |
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Health Minister Ivo Paulo Garrido told Reuters almost half of Mozambique's 18 million people were infected with tuberculosis (TB)......................
HIV/AIDS infects 1.6 million Mozambicans, with 500 new infections every day.................................. Mozambique struggles to curb TB, seeks U.N. help Sat 7 Apr 2007, 11:16 GMT By Charles Mangwiro MAPUTO, April 7 (Reuters) - Mozambique will seek United Nations funding to fight a sharp rise in the lung disease tuberculosis, which has been overshadowed by HIV/AIDS, its health minister said on Saturday. Health Minister Ivo Paulo Garrido told Reuters almost half of Mozambique's 18 million people were infected with tuberculosis (TB) -- compounding the health crisis posed by HIV/AIDS. "It is extremely serious not only because of a very high prevalence of TB, but also because of the growing interaction between TB and HIV/AIDS," he said. "Despite commendable efforts by the government to control it (TB), impact on incidence has not been significant and the epidemic has now reached a serious stage and, for the first time, we will need $22 million from the (U.N.) Global Fund to spend in three years," he said. The minister said the money would be used for treatment and identification of TB patients, since many Mozambicans who suffer from it live far from health centres or were unaware that they had the disease. HIV/AIDS infects 1.6 million Mozambicans, with 500 new infections every day. Garrido said the HIV epidemic has fuelled the rise in TB incidence not only in Mozambique, but across Africa, so that the number of TB cases occurring each year has trebled since 1990. Garrido said the continent would require $2.9 billion in new funding during 2006/2007 and urged African countries to commit more human and financial resources on anti-TB and HIV efforts. http://africa.reuters.com/wire/news/usnL07261620.html |
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Cork Ireland
12/04/2007 - 11:27:02 AM TB vaccine to be offered to all newborn babies in Cork The HSE says all babies born in Cork from this October onwards will be routinely offered the BCG vaccine against TB. Their parents will also be offered advice on the matter prior to the baby's birth. The move follows a recent outbreak of TB among children and staff members at two creches in Cork. At the moment, the BCG jab is only administered to newborns who are at risk of developing TB, namely those whose parents or siblings have a history of the condition. It is also given to children on request. http://www.irishexaminer.com/breaking/story.asp?j=264144451&p=z64y453y4&n=264145394&x= |
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Cattle TB spreads among clubbers
Three of the cases are linked to the same bar and nightclub Six people have contracted bovine tuberculosis in an outbreak in Birmingham which has killed one man. Three are thought to have picked up the infection at a bar and nightclub, two had visited the same venue and one was acquainted with others infected. Most of those who were affected suffered from other diseases. The Health Protection Agency (HPA) said measures were taken to halt the spread of the infection and there was no continuing public health risk. New DNA investigation techniques showed all six cases were linked either by person-to-person spread or by being infected by a common source. The source of the outbreak is thought to have been a man who drank untreated, unpasteurised milk. Anyone who experiences persistent weight loss with night sweats, tiredness and a cough should seek medical attention as it is just possible they might have TB Prof Hawkey Professor Peter Hawkey, from the Regional Centre for Mycobacteriology at Birmingham Heartlands Hospital which made the discovery, said the six were connected by a "complex social web". All were young people, with an average age of 32, and were known to go to nightclubs or pubs, two were found to be a couple. Prof Hawkey said most cases of TB are usually found in people in their 60s and 70s but said people using pubs and clubs in the Birmingham area should not be concerned. HPA investigation "The risk is tiny," he said. "But the health message is that anyone who experiences persistent weight loss with night sweats, tiredness and a cough should seek medical attention as it is just possible they might have TB." The last case was reported in February this year and it is thought the outbreak is over, said BBC Midlands Today science and environment correspondent David Gregory. The outbreak was first thought to be a blip in the TB figures because the rate of infection was more than the amount expected for cases of bovine tuberculosis. The HPA investigation was launched after one case was reported in 2004, four in 2005 and one at the beginning of this year. It said on average three cases a year are reported in the West Midlands. Dr David Hunt, from HPA West Midlands, said: "Each of these cases was thoroughly investigated at the time and all appropriate measures were taken to ensure that there would be no further spread of infection. "We have no reason to believe that there is a continuing public health risk." ......... sure ........... http://news.bbc.co.uk/1/hi/england/west_midlands/6039216.stm |
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