All-Consuming Consumption

January 16, 2012

Torah Kachur

Tuberculosis has been around since antiquity - Nefertiti likely died of it, Aristotle believed that phthisis was contagious and it's what kills Doc Holliday in Tombstone.  It's not news or spread by sex or sexy to talk about and so it has become the world's silent killer.  In 2009, the World Health Organization estimates 1.7 million people died of tuberculosis.  Most of these infections are in the eastern hemisphere - India and Africa - where WorldVision could probably get pictures of sick, doe-eyed children to make money off of.  Yet, no one seems to care about TB....but we're going to have to.


 mycobacterium tuberculosis

Doctors from the P.D. Hinduja National Hospital and Medical Research Center in Mumbai, India have isolated and identified 12 patients suffering from a new strain of TB that is resistant to all known drug regimens.  This Total Drug Resistant (TDR-TB) form of tuberculosis has previously been identify 2 other times in Italy (2007) and Iran (2009).  This particular instance of the disease is troubling because all patients were identified in the same hospital - almost guaranteeing that the infection has a much farther reach than can be identified.


Tuberculosis is caused by a bacterium, Mycobacterium tuberculosis, that infects the immune cells in charge of getting rid of them from the lungs.  In these cells, called macrophages, the bacterium slowly replicates and if it gains entry into the bloodstream it can infect other tissues and form lesions known as tubercules.  Eventually patients die of suffocation as their lung tissue is slowly consumed with scar tissue and necrotizing tissue. 


Now, there is no treatment for these patients who contracted and likely have spread TDR-TB.  The appearance of TDR-TB is probably from complete medical mismanagement and incorrect treatment from previously identified infections.  Access to appropriate drugs and quality healthcare in India can vary widely and many patients don't successfully complete their prescribed course of antibiotics.  (Don't judge - I guarantee you have been guilty of not completing a course of antibiotics too). 


So here we sit - a silent killer that no one pays attention to.  It infects innocent parties that just happen to be downwind of a cough or sneeze of an infected person.  The treatment strategy is pretty simple - isolate the patients and wait for them to die, hoping to not see this level of drug resistance spread.


Udwadia, Z., Amale, R., Ajbani, K., & Rodrigues, C. (2011). Totally Drug-Resistant Tuberculosis in India Clinical Infectious Diseases DOI: 10.1093/cid/cir889



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