ICL: Tuberculosis


ICL: Tuberculosis

Being Alive; November 1992
Walt Senterfitt

The conference rightfully gave attention to the resurgent epidemic of pulmonary tuberculosis, partly associated with HIV and frightening in the spread of multiple-drug resistant (MDR) strains. It is good to see the new support for rapid research into detection, prevention and treatment, but scientists have a lot of catching up to do. Several instances of rapidly spreading outbreaks (even among generally healthy non-HIV+ people) underscore the crucial public health importance of strictly adhering to current CDC guidelines for prevention and adequate treatment, even as we are waiting for better diagnostics and new treatments. (As we've discussed before, key problems with TB are slow and fallible diagnostic techniques, the need for prolonged treatment, and the ready emergence of resistance if treated too briefly or with not enough drugs.)

A report came that offers some hope from a large inner-city hospital (Jackson Memorial in Miami) about their success in controlling an outbreak of MDR-TB. They treated 80 cases of MDR-TB between March 1988 and October 1991, and started observing transmission in the hospital from one patient to another after about two years. They implemented measures to control the outbreak (added more drugs to the treatment regimen, started stricter isolation procedures while people are possibly contagious, using better masks for isolation) and have not had any cases of in-hospital transmission since July 1991.

Finally, on another hopeful note, two others studies gave more evidence that so far, the same treatments and prophylaxes used against TB in HIV- people work as well and without significantly increased toxic side effects in HIV+ people.
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