EDITORIAL: Life Sentence: Untreatable TB Reaches U.S.

Apr 07, 09:26 AM

Current Headlines: By Tulsa World, Okla.

Apr. 7--Untreatable TB reaches U.S.

A 27-year-old man has been locked away in solitary confinement in a county hospital in Phoenix because he suffers from a new, virtually untreatable, strain of tuberculosis.

It is one of the first cases of extremely drug-resistant TB, or XDR-TB, if not the first, reported in the United States.

The airborne and highly contagious TB germ is usually spread by coughing and sneezing. Robert Daniels lived in Russia for 15 years and returned to the U.S. after being diagnosed with TB. He hoped to get better care here, and planned to eventually bring his wife and children from Russia.

Daniels was ordered confined by county health officials after he ignored doctors' instructions to wear a mask in public. He allegedly walked into a crowded convenience store without a mask. It's possible he will spend the rest of his life in what is in effect a prison cell.

TB is running rampant in sub-Saharan Africa and pockets of the former Soviet Union and Asia. The deadly disease, once almost wiped out, rebounded in tandem with the AIDS pandemic. TB germs flourish in the weakened immune systems of AIDS victims. Nearly 9 million people become sick

with TB each year worldwide and 1.6 million die. TB is the leading killer of people with AIDS.

There were 13,767 cases of TB reported in the U.S. last year. Almost all of them were the ordinary variety, which can be treated with an inexpensive course of drugs. A handful of people in the U.S. have been ordered locked up in recent years because they would not undergo treatment for TB or would not abide by quarantine rules.

XDR-TB is a sort of third-generation of the disease. Largely because of incomplete or improperly administered drug treatments in Third World countries, ordinary TB evolved first into multiple-drug resistant TB, which was resistant to four or more of the commonly prescribed drugs, and now into the virtually untreatable XDR-TB.

The incarceration of Daniels and others raises civil rights issues that undoubtedly will be debated in the courts.

Apart from that, Daniels' case is a grim reminder that the U.S. is not immune to the spread of the drug-resistant varieties of killer TB.

One way to prevent the spread of XDR-TB to these shores is to attack the disease at its source. The U.S. should significantly increase the $724 million a year it already contributes to global efforts to fight TB, to properly treat the ordinary cases and slow the rise of the drug-resistant varieties.

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Copyright (c) 2007, Tulsa World, Okla.

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