Health News

Drug-Resistant TB

April 2007 - The World Health Organization warned last year of the emergence of extensively drug-resistant TB. The new strain, which has been found throughout the world, including pockets of the former Soviet Union and Asia, is resistant not only to the first line of TB drugs but to some second-line antibiotics as well.

HIV patients with weakened immune systems are especially susceptible. In South Africa, WHO reported that 52 of 53 HIV patients died within an average of 25 days after it was discovered they also had XDR-TB.

How to deal with people infected with the new strain is a matter of debate.

Dr. Ross Upshur, director of the Joint Centre for Bioethics at the University of Toronto, said authorities should detain people with drug-resistant tuberculosis if they are uncooperative.

"We're on the verge of taking what was a curable disease, one of the best known diseases in human endeavors, and making it incurable," Upshur said.

But a paper Upshur co-wrote on the issue in a medical journal earlier this year has been strongly criticized.

"Involuntary detention should really be your last resort," Harrington said. "There's a danger that we'll end up blaming the victim."

In the United States, which had a total of 13,767 reported cases of tuberculosis in 2006, public health authorities only rarely have put TB patients under lock and key.

Texas has placed 17 tuberculosis patients into an involuntary quarantine facility this year in San Antonio. Public health authorities in California said they have no TB patients in custody this year, though four were detained there last year.

Upshur's paper noted that New York City forced TB patients into detention following an outbreak in the 1990s, and saw a significant dip in cases.