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XDR-TB: the Latest Global Terror

Statistics that frighten were presented at the Conference on Retroviruses and Opportunistic Infections in Los Angeles//, the largest scientific gathering for AIDS researchers, Sunday.

Health professionals made the present scenario of XDR-TB or extensively drug resistant tuberculosis that is ravaging South Africa known here.

The meeting has drawn 3,800 of the world's leading AIDS researchers to report the latest scientific news on the spread of the epidemic, which has killed an estimated 25 million people worldwide since it first emerged 25 years ago.

The disease was first reported as an outbreak in a KwaZulu village but has since spread further to 9 provinces of the country, killing hundreds.

The disease is fatal to those infected with the virus HIV. Last year, 52 out of the 53 persons infected with XDR-TB died.

Says Dr. Karin Weyer, director of tuberculosis research for the South Africa Medical Research Council, in Pretoria: 'We believe that there are about 6,000 cases of multi-drug resistant TB in South Africa, and when we treat these patients about 10 percent fail to get better.

Extrapolating from that, we calculate that there are about 600 cases of patients with extensively drug-resistant TB in South Africa.

'Most of the patients who are co-infected with the extensively drug-resistant TB and HIV die within a month. 'Extensively drug-resistant tuberculosis represents the failure of tuberculosis control at the global level,' Weyer concluded.

According to Dr. Paul Nunn, director of the Stop TB program of the World Health Organization, nearly 9 million people in the world have tuberculosis, and the disease kills 1.6 million people a year.

He estimates that worldwide there are likely 16,000 deaths among those that are caused by infection with the extensively drug-resistant organism.

Nunn said that the WHO defines extensively drug-resistant tuberculosis as a form of the bacteria Mycobacterium tuberculosis that is resistant to standard oral drugs, to newer fluoroquinolones and to one of three injected drugs.

A study of guinea pigs whose cages were placed in the ventilation stream from rooms housing XDR-TB patients has created fears of the bacteria being airborne. Eighty percent of the animals tested positive.

'These outbreaks of this scary form of tuberculosis and its spread underscore that the healthcare infrastructure is largely unprepared for the aerosol transmission of such a pathogen,' says Dr. John Mellors, professor of medicine at the University of Pittsburgh and vice chairman of the scientific program at the retrovirus conference.

Such strains have now been reported in 28 countries with the bulk of them mainly in China, India and Russia.

Concludes Nunn, 'Extensively drug-resistant TB is a wake-up call for strengthening basic tuberculosis and HIV care, prevention and control and scaling up the management of drug resistant tuberculosis.’
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