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Cape Town, Durban Major
Epicentres Of XDR-TB SA-1
By Adriana Stuijt
Exclusive to Rense.com
CAPE TOWN, South Africa -- In an article already published a full year ago by two top TB-researchers at South Africa's University of Stellenbosch' medical faculty, it was reported that the entire Western Cape province around Cape Town already was "particularly badly affected by the 'Tuberculosis Superbug" -- i.e. Extremely- Drug-Resistant Tuberculosis (XDR-TB) at that time.
Yet this vitally-important information about an XDR-TB epidemic in one of the world's most favourite tourist destinations was never passed along to the Centres for Disease Control in Atlanta by the country's anti-science national health minister. Her department had only informed the CDC about the outbreak at a former mission hospital at Tugela Ferry in KwaZulu-Natal, where 600 patients have already died of XDR-TB since October 2006. The current death rate of XDR-TB in South Africa also is not being published by the national health minister - but journalists in South Africa don't seem to dare ask her directly why this important information is being withheld from the public.
And even today, the Cape Town XDR-TB outbreak is still not mentioned by the Centres for Disease Control in Atlanta nor by the World Health Organisation, which both still state in their latest press releases that the Kwazulu-Natal XDR-TB outbreak remains the 'epicentre' of South Africa's epidemic.
This 'reporting oversight' by the South African health department to also warn about Cape Town's XDR-TB epidemic could have serious repercussions for the many foreign travellers to this beautiful city -- as South Africa's so-called 'Mother City' remains the most popular tourist destination on the African continent, with some 350,000 annual visitors in 2005. Yet no warnings about the XDR-TB epidemic in Cape Town are being published by the CDC or WHO -- only about the one in KwaZulu-Natal...
Yet a year ago, the team headed by Professor Tommie Victor (picture) of the University's Faculty of Health Sciences was already reporting widely that their own field-research proved that 'drug resistance may be an even bigger problem than previously thought" among the Western Cape's TB-patients; that these patients moreover, often harboured two different strains of TB simultaneously; and that their drug-resistant strain was actually made even worse by their being prescribed the cheaper line of TB- drugs.
'XDR-strain freely passed on into the community because it takes two months to diagnose...'
Professor Victor 's team had already discovered in 2003 that his TB patients harboured a uniquely-South African XDR-TB strain which was a mutation between the tuberculosis bacillus and the human-immune- deficiency virus which leads to Aids. The team named this the SA-1 strain. This XDR-TB strain has a recorded kill-rate of about 14 to 20 days from infection, the two outbreaks in KwaZulu-Natal and Cape Town have shown since that time.
Importantly, their "Biomedical Tuberculosis Research' at Stellenbosch University's Faculty of Health Sciences also showed that ­ because diagnosis was far too slow (taking up to two months) ­ 'the dangerous bacteria in drug-resistant strains of TB are freely passed on' (into the rest of the community.
Prof Victor warned that their "(examined Western Cape) patients were by then already showing resistance to as many as five of the six frontline anti-TB drugs and these "super-bugs" became increasingly resistant -- and that the patients remained so infectious that they continued to spread XDR-TB easily into the community, thus posing an increasing threat as it spreads.
Victor also pointed out the important fact that to treat multiple- drug-resistant TB with the correct drugs could cost as much as R20,000 ($200-US) per patient -- compared to about R200 a patient for drug-susceptible TB. This was important information as the South African government had actually slashed its TB-prevention budget by 50% only three years earlier as a massive cost-saving measure, yet here they were suddenly presented with a brand-new very deadly tuberculosis variety which would cost them huge dollops of extra cash to treat correctly.
His team's research showed that more than half of patients with drug-resistant TB who were tested in two of the Western Cape's four health districts were already resistant to Pyrazinamide (PZA) ­ which is only one of the four drugs being used in the so-called single-dose treatment of Tuberculosis in South Africa.
He warned in this report a full year ago that 'urgent efforts are needed to diagnose TB quicker and that if first-line treatment fails, the risk of multi-drug resistant TB grows even faster in patients who already are infected with multiple drug-resistant strains. "
"Two different TB-strains can be found in one patient simultaneously"
?Prof Rob Warren (pictured here) also of Medical Biochemistry at SU, has published additional research that has sunk the dogma that a person develops TB only through a single infection. He's released findings that that two different TB strains are being found in one patient simultaneously in the Western Cape's field-studies --
implying more than one infection.
Vaccination against the first TB infection would be useless
This finding means that (treatment against) the first infection clearly didn't protect the patient against a second infection ­ also posing serious implications for vaccine development. In fact, his research also showed that when treated with antibiotics, the resistant strain always emerged as the dominant one, he warned.
"Some South African patients have both drug-sensitive and drug- resistant strains TB at the same time. Treatment with antibiotics leads tot the resistant strain emerging as the dominant one. Poor diagnosis can lead to the multidrug-resistant strain being diagnosed only when the original diagnosis fails, while whole communities are put at risk. It can take up to eight weeks to identify whether a TB strain is resistant ­ while the infection is being passed on to others," Professor Warren warned.
XDR-TB Epidemic - Voice of America Information Video:
link http://www.youtube.com/watch? v=INdBNgOc5ls&mode=related&search=???



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