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Quarantine Sought For Harsh TB Strain

People infected with a deadly, virtually untreatable new form of tuberculosis should be isolated and confined -- against their will, if necessary -- to prevent// a "potentially explosive international health crisis," according to a group of Canadian and African scientists.

These harsh measures are justified given the "extreme risk" posed by an ongoing outbreak of extensively drug-resistant TB (XDR-TB) in South Africa, they argue in today's edition of the medical journal Public Library of Science Medicine.

"We're not saying put people in leper colonies," Ross Upshur, director of the University of Toronto Joint Centre for Bioethics and co-author of the paper, said in an interview. "But if voluntary measures fail, we need systems in place to contain the spread."

Dr. Upshur said the call for draconian restrictions on the movements of people infected with XDR-TB is not made lightly -- it reflects the severity of the outbreak.

He also stressed that people who are isolated or detained should be compensated, to ensure they do not remain in the community and spread the illness to others.

"Right now, all the incentives are the wrong way," Dr. Upshur said, noting that when patients are in hospital in South Africa, they lose their social-welfare benefits.

TB is one of the oldest scourges known to humanity, and one-third of the world's population is believed to be infected. It is caused by a bacterium called Mycobacterium tuberculosis, which is spread through coughing or sneezing.

The disease can be easily cured with cheap antibiotics, but misuse has resulted in mutations that have rendered the drugs ineffective and made resistant TB a growing public health challenge.

Last September, the United Nations World Health Organization said there were 53 cases of XDR-TB in South Africa, of which 52 proved fatal, an unprecedented rate.

In total, more than 300 cases of XDR-TB have been identif
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