Published Date: 2006-10-19 00:00:00
Subject: PRO/EDR> Tuberculosis, multiresistant - South Africa (KN)(04):nationwide
Archive Number: 20061019.3003
TUBERCULOSIS, MULTIRESISTANT - SOUTH AFRICA (KWA-ZULU NATAL) (04): NATIONWIDE
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Wed, 18 Oct 2006 13:30:27 +0100 (BST)
From: Mary Marshall <firstname.lastname@example.org>
Source: AllAfrica.com and Business Day (Johannesburg) [edited]
Scientists' suspicions that the deadly new strain of extremely drug
resistant tuberculosis (XDR-TB) first identified in KwaZulu-Natal earlier
in 2006 is circulating in all 9 provinces have been confirmed by the
National Health Laboratory Services (NHLS), it emerged yesterday, 17 Oct
2006. The disease has public health experts around the world deeply
worried, as it poses a severe risk to people infected with HIV.
XDR-TB first hit the headlines 2 months ago, when scientists told the 16th
International AIDS Conference in Toronto that a devastating outbreak
of the disease in rural KwaZulu-Natal had killed all but 1 of the 53
patients they had identified. All were HIV-positive.
Since then a total of 78 patients have been confirmed with XDR-TB in the
province, 74 of whom have died. Another 9 cases have been identified in
Gauteng, 10 in North West, 6 in Eastern Cape and 3 in Limpopo, according
to health department director-general Thami Mseleku.
However, scientists were still in the dark as to what proportion of
suspected TB patients were infected with XDR-TB, the Medical Research
Council's (MRC's) Karin Weyer told Business Day.
Speaking by telephone from the sidelines of a 2-day meeting on XDR-TB
convened by the health department, Weyer said the NHLS had analysed samples
from suspected TB patients. Provinces were about to begin detailed studies
to determine the extent of the disease, she said.
Weyer said hospitals urgently needed to improve their
infection-control measures to protect staff and patients from contracting
the disease within facilities. "Infection control in many public
hospitals is either inadequate or nonexistent," she said. A high
proportion of the XDR-TB cases studied in KwaZulu-Natal are believed to
have arisen from in-hospital transmission.
Yesterday's meeting included experts from the World Health Organisation
(WHO), the MRC, and the Southern African Development Community. It builds
on an emergency meeting in Johannesburg in September 2006, and the new WHO
task group on XDR-TB's first meeting in Geneva last week.
A statement issued by the WHO task group yesterday described the emergence
of XDR-TB as a "serious threat to public health, particularly when
associated with HIV".
[Byline: Tamar Kahn]
[The combination of HIV/AIDS and tuberculosis is a lethal one and similar
circumstances occurred in the USA with multiply-drug resistant TB in the
1980s in the USA, especially New York City. The profoundly
immunocompromised AIDS patient is much more likely to develop active TB
after exposure, and a nosocomial setting is a perfect venue to spread
multiply resistant strains.
The high mortality rate of XDR-TB in HIV affected people reflects what
occurs with untreated TB in immunosuppressed individuals.
A map of South Africa with its provinces can be found at:
ProMED thanks Mary Marshall for this submission. - Mod.LL]