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Biotech Science

Tuberculosis May Become A Global Threat Again 480

Iphtashu Fitz writes "The journal Nature Medicine is due to release a report today on how highly drug-resistant strains of tuberculosis are on the verge of becoming a global epidimic. Strains of TB that are highly resistant to antibiotics are becoming increasingly prevalent in places like Russia, eastern Europe, and China, and only small changes are required to make these strains start spreading quickly. Treatment for multiple-drug-resistant strains of TB requires a carefully monitored cocktail of drugs taken for months on end, a regimin that many, especially in poorer countries are unlikely to follow to completion. The strategy used by the World Health Organization to combat TB, the "directly observed treatment, short course" or DOTS, involves using trained health workers to watch patients take their long courses of drugs, since even a little carelessness could result in TB mutating into a more drug resistant form within the patient." Oh, Alexander Fleming ? where art thou now?
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Tuberculosis May Become A Global Threat Again

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  • by ackthpt ( 218170 ) * on Monday September 20, 2004 @10:42AM (#10297997) Homepage Journal
    All my life I've tested negative. A few years after moving to California, the great gateway to the developing nations of Asia, things changed. Where I worked they provided free TB tests, I thought "Cool, I'll save on going to my doctor and have my folder updated for the next few years", so I took the test. A pink spot appears on my left arm, while in the midst of a critical project I'm managing and -pfft- I'm sent home until I can prove I don't have the disease. After a week of cooling my heels at home, having a chest x-ray and hand-written letter from my doctor I return to work. His assessment is I don't have tuberculosis (formerly called Consumption in the olden days), but I've been exposed to it so my immune system is on red alert. I can no long have the little poke under the skin, but from now on must do the full doctor visit thing, whatever that will entail, including deductables and co-pays. Yay.

    So someone probably coughed in an elevator, in a kitchen or whatever and myself and anyone else in the vicinity were exposed.

    I was put on Isoniazid with vitamin B6 (because Isoniazid knocks the sh!t out of your liver) for 9 grueling months. The first month I felt like I was dying. It really played havoc with mountain biking and meant no beer for 9 months, it was glorius to be off it.

    Even two years ago it was recognized that there was an epidemic of TB in the asian sub continent and many of the H1B workers to came in may not have had it full blown, but had it and were bringing it into the USA. Could very well have been one of the fine people I worked with shortly after moving to California, but by no means would the state be unique. On weekends and holidays I'm a cyclist and put in long miles with considerable effort, which means I'm pretty well in tune with how my lungs are doing. Any little change, a day more phlegmy the others makes me take notice and track whatever seems be be going on. For that I thank all the brilliant people and lobbyists who made it so much easier during the tech boom to let people into the country on a rush to fill positions in businesses (which lobbied like hell for increases in H1B and more lax health screening.)

    A little background on TB, the bug is not killed by the immune system, but isolated. If it's under control that means a little cyst-like structure is built around it which hopefully contains it the rest of the hosts life. A severe respiratory infection can weakend the immune system to the point that the bug gets out and wreaks havoc, more likely at advanced age.

    • Wait a second, you didn't have TB but were put on a liver-destroying and probably resistance-breeding drug? Also, I would assume a bug in cyst-like structure eventually dies. Can it really survive forever without food in a warm human body?
      • by ackthpt ( 218170 ) * on Monday September 20, 2004 @10:57AM (#10298144) Homepage Journal
        Wait a second, you didn't have TB but were put on a liver-destroying and probably resistance-breeding drug?

        As the medical establisment goes in the USA, if there's a chance you have TB, they treat you as if you did have it. This was effectively: take the treatment and you can go back to work, don't take it and take your chances unemployed. See the light?

        Also, I would assume a bug in cyst-like structure eventually dies. Can it really survive forever without food in a warm human body?

        Various organisms are capable of surviving extended periods without activity, food, warmth, etc. Some bacteria, so I've heard, can survive hundreds of years waiting for conditions to be right to shed some little shell they get by in.

        • by danheskett ( 178529 ) <danheskett&gmail,com> on Monday September 20, 2004 @11:27AM (#10298450)
          As the medical establisment goes in the USA, if there's a chance you have TB, they treat you as if you did have it. This was effectively: take the treatment and you can go back to work, don't take it and take your chances unemployed. See the light?
          That's not right, and its probably untrue. If you were threatened with your job - even if you really did have TB - then your employer comitted an actionable offense. If they really, really, really did that you own them. Especially if it was in writing.

          An employer cannot legally terminate you because you have TB. Just as they cannot legally fire you if you are pregnant, have a broken leg, have HIV/AIDS, etc.
      • by BoldAC ( 735721 ) on Monday September 20, 2004 @11:14AM (#10298325)
        Alright, I'm a practicing lung doctor so I've got to say a little bit.

        Change in the skin TB status (or PPD) suggests a recent infection with TB. Placing someone of INH for 6 to 9 months greatly decreases the risk of someone developing active TB in the future.

        The amount of exposure and the potential risks for reactivation of the TB are all evaluated before INH is prescribed.

        INH can cause liver problems... and avoiding alcohol is a must.

        To answer the parent's other question--
        Using INH for a long enough duration will not cause resistence. Dead bugs can't develop resistence.

        Yes, it can survive forever.

        We see people that were exposed 20-30 years ago and have reactivation when placed on steroids or chemotherapy.

        In the grand scheme of things, TB may be getting worse worldwide, but here in the states it seems well controlled. We have a huge immigrant population, and I have seen on a couple cases of active TB over the last 5 years.

        I come to read slashdot in between patients to get away from medicine... please quit running these medical stories. They remind me that I'm not a real geek. :)

        AC
        • by Doc Ruby ( 173196 ) on Monday September 20, 2004 @11:36AM (#10298542) Homepage Journal
          "Alright, I'm a practicing lung doctor so I've got to say a little bit."
          [...]
          "Using INH for a long enough duration will not cause resistence. Dead bugs can't develop resistence."
          [...]
          "In the grand scheme of things, TB may be getting worse worldwide, but here in the states it seems well controlled. We have a huge immigrant population, and I have seen on a couple cases of active TB over the last 5 years."

          The article we're all discussing in this thread reports the incipient global TB epidemic caused by carpetbombing TB exposees with bacteriocides, which leaves the few mutants resistant to the drug to inherit their food supply: us. The principle of using a drug like INH "long enough" to kill all of the bacteria, even the more resistant mutants, depends on "long enough" being both less than the human lifetime, and humans nearly always following the long program. The biology of TB, or any other very large population fought with merely systematic techniques, allows at least a small population to survive, which can then reproduce. If large enough, that population can overcome the human immune response that resists the original infection (if the immune system hasn't been damaged too much, along with the liver damage, from the medication). Unless each bacterium is destroyed individually, systematic is all we've got, and we're dealing with statistics. The same reality applies to human behavior - highly variable across populations of millions, inevitably slopping across any thresholds. This attitude is solid biochemistry, but bad medicine. And it's the unchanging environmental factor within which TB has adapted. Without an alternative, the MDR epidemic seems inevitable, making inroads in the US more slowly, but just as inexorably as abroad.
        • About 10 years ago, 60 Minutes ran a story on the upswing of TB in the US, focusing on some studies done by -- NIH?? (don't recall specifically, but one of the major gov't health outfits). One of their case studies involved the shipyards at Long Beach (which for the geographically-challenged, is just south of Los Angeles proper). Turns out EVERYONE who worked there had been exposed, and many had active infections!! (These were American workers, not immigrants.) The thought was that because it's a relatively
          • Another study involved airliners -- and the conclusion was, if you're flying, you're going to be breathing recirculated air that has a strong risk of someone's wandering TB germs floating in it -- and that if you saw anyone coughing, you should consider yourself exposed.

            Yep, there was a case like that near here in the Midwest. Some idiot Maharishi cultist flew back from India through O'Hare, she landed in the US and keeled over from TB. The hospital asked the airline to track down every single person on ea

        • by aswang ( 92825 )
          Shoot, I just graduated from medical school and I've seen more than a couple of cases of active TB in the past year. I've even seen miliary TB and TB osteomyelitis. And this was in Chicago, not anywhere near the Mexican border.

          Of course it may have more to do with socioeconomics. Asking about TB was routine at Cook County, but when I asked about it at an affluent community hospital, everyone looked at me like I was crazy. "You mean people still get TB?"

      • by Deagol ( 323173 ) on Monday September 20, 2004 @11:51AM (#10298693) Homepage
        Check out the online entry for TB [merck.com] in the Merck Manual, Second Home Edition (I have this book at home). It's an interesting read.

        You may understand why doctors may default to such harsh treatment when in doubt. It's a damned tough bug. It can infect nearly any system in the body (even the brain, in rare cases), though it's most commonly found in the lungs. It'll sit dormant for an entire lifetime, popping up when the immune system is weak and/or when damage to the infected system released the cysts, activating the infection.

        There are 3 primary kinds of TB: Mycobacterium tuberculosis (the kind people mostly get), M. bovis (cattle variant), and M. avis (bird variant).

        I've read up on TB a bit (I also own the Merck Vet. Manual), because we own a cow. Cattle, a common vector for TB, are simply culled when bovine TB is detected. I assume that if effective treatment were possible, it would be similar to the long, expensive kind used on people and it's simply not profitable to cure a cow.

        What these sources really don't address (or address clearly to the layman) is whether or not the bovine and avian variants are a threat to people, and if they're treated the same way. Maybe an M.D. can clarify for me. :)

        • The primary problem with resistant strains of TB arise from the mismanagement of the treatments and or from its innate ability to remain latient for long periods of time. (I am an RN who has delt with many cases of TB probably more than most US Doctors individually ever see in a lifetime)

          The State of Alabama saw the resurgence of TB about 1990 as a result of the AIDS epidemic and the mismanagement of it by New York City. The NYC people had turned people loose with drugs and did not monitor their behavior

        • by aswang ( 92825 )
          M. bovis can cause cavitary lung disease and disseminated disease just like M. TB. Clinically and microscopically, they are indistinguishable. The only difference is in method of transmission. While M. TB gets inhaled, M. bovis is usually eaten, found in unpasteurized dairy products.

          M. avium usually doesn't pose a threat to people with intact immune systems, but it is a common AIDS-defining infection. There are also other Mycobacterium that are only usually found in AIDS like M. kansasii and M. scrofalace

    • Thank Bill Gates (Score:5, Informative)

      by Anonymous Coward on Monday September 20, 2004 @10:55AM (#10298118)
      Not sarcastic at all - The Gates Foundation is one of the major forces [eurekalert.org] fighting TB today.
      • by digidave ( 259925 ) on Monday September 20, 2004 @11:50AM (#10298688)
        What idiot modded this funny?

        I know we all hate Microsoft's business practices and Bill Gates' view of OSS, but it's impossible to deny the great things his foundation has done worldwide.

        Please, folks, separate the man from the business.
      • by Skinny Rav ( 181822 ) on Monday September 20, 2004 @12:43PM (#10299195)
        Somebody already replied that whoever moderated parent as Funny is a fucking moron.

        The problem with TB is it is poor man's disease (mostly), so there is not much money in it as patients with tuberculosis have no money for so called innovative drugs. Because of that there is not much research going on new treatments of TB. This makes Mr Gates' foundation even more valuable.

        OK, this guy is a blood thirsty businness shark but this doesn't mean everything he does is mean. It is better if he spends some of his enormous amounts of money on TB research than hoard it or build yet another billions of dollars worth house.

        Raf

        P.S. OK, as there are already more than 200 posts in this subject, probably all I've written is redundant, but what the heck...
    • by Karma Farmer ( 595141 ) on Monday September 20, 2004 @11:02AM (#10298197)
      Having the largest prison population in the world is a much bigger threat to America than H1B workers ever will be. Prisons are a breeding ground for communicable disease.
      • Having the largest prison population in the world is a much bigger threat to America than H1B workers ever will be. Prisons are a breeding ground for communicable disease.

        Not really.

        Having a large prison population creates, in effect, a large quarantine.

        It's also easier to make prisoners take their medications properly.

        • Having a large prison population creates, in effect, a large quarantine.

          Not really, since eventually most prisoners are released. Also prison warders come into contact with the prisoners, and then frequent other places outside the prison. If you want to lock up all prisoners forever, for even minor crimes, and also never let the warders mix with the general population again then you have quarantine.

        • by BoldAC ( 735721 ) on Monday September 20, 2004 @11:20AM (#10298373)
          Mostly false...

          Prisions are a huge breeding ground for TB. One of my partners just saw somebody that had baseball-sized masses growing from several sites on his body. He wasn't referred to a doctor for several months. Biopsy of these lesions showed tons of TB.

          Medical care in the prisions is very sub-standard.

          It is true that if you do not take your TB drugs as prescribed, you will be put into prision. Yes, America will force you to take your TB drugs... to keep you from infecting others.

          However, most prisioners are in and out of jail too often to really get adequate screening for infectious diseases.

          AC
      • Homeless infections (Score:5, Informative)

        by Hoi Polloi ( 522990 ) on Monday September 20, 2004 @11:58AM (#10298746) Journal
        The chronically homeless are also susceptible to TB from basically nonexistent health care and occasionally living in close quarters in shelters. Add to that their bodies are frequently weakened by alcohol abuse, poor shelter and poor hygiene and you have a vector for TB frequenting public transportation, emergency rooms, shelters, police, etc.

        Requiring them to take medicine isn't even a viable option since many suffer from mental illness and they also tend to move around a lot with no way to contact them.
      • by igny ( 716218 ) on Monday September 20, 2004 @12:10PM (#10298845) Homepage Journal
        Prisons are a breeding ground for communicable disease. While it is true that prisons allow diseases spread faster, the main reason why TB in prisons is so rampant is that TB mainly affects people with weaker immune system. People in prisons are under constant stress, probably lacking vitamins/minerals. Consequently their immune system weakens, and an exposure to TB is automatically followed by infection.

        I have a friend, who is a pulmonologist in Russia. He told me that in the past doctors rarely became infected even if exposed to TB constantly. Nowadays, doctors themselves lack vitamins and put under stress in Russia. This pulmonologist was infected once, and other doctors fall ill regularly.

    • by terrymr ( 316118 ) <<moc.liamg> <ta> <rmyrret>> on Monday September 20, 2004 @11:13AM (#10298310)
      When I moved here from the UK, where everybody gets vaccinated against TB, I had to have a chest x-ray done to prove i didn't have TB because immunity from vaccination gives the same result on the skin test.
      • by BoldAC ( 735721 ) on Monday September 20, 2004 @11:24AM (#10298427)
        Yes, this is true...

        and it's a pain in the ass for us physicians. The vaccine only works for 10-20 years... so how do we test you guys over here in the states to see if you still have immunity?

        We can't test your arm everytime and watch you have a horrible reaction. Plus, we don't routinely immunize people here so we can use the PPD for screening. (Plus, we screwed up the immunizations over here a long time ago and actually GAVE a bunch of people TB.... so there is a natural reaction in this country not to do immunizations. Even though the immunizations are now really, really safe.)

        So you guys screw it up for the rest of us! :)

    • by zungu ( 588387 ) on Monday September 20, 2004 @11:13AM (#10298315) Journal
      Yes, developing countries do have TB. And I am sorry to know that you contacted. However, your direct attack on H1B workers for this is just bizzare and xenophobic. How about the 8 million Mexican illegal immigrants giving you a little TB infection? Why do only H1's figure in your post? BTW, TB is a "white-man's disease" we in India were introduced to TB due some assholes coming over from the "developed" world in the 16th century.
  • by Anonymous Coward on Monday September 20, 2004 @10:43AM (#10298008)

    Oh, Alexander Fleming where art thou now?

    Dead.

  • Here... (Score:5, Informative)

    by grub ( 11606 ) <slashdot@grub.net> on Monday September 20, 2004 @10:44AM (#10298014) Homepage Journal

    Oh, Alexander Fleming? where art thou now?

    He's right here, silly. [findagrave.com]
  • America (Score:4, Informative)

    by miracle69 ( 34841 ) on Monday September 20, 2004 @10:45AM (#10298026)
    America has the lowest rate of TB infection because we manage the disease differently than the rest of the world.

    The rest of the world gives the ineffective TB vaccine, while the US doesn't. The TB vaccine is known not to work, and it ruins the best test we have to screen for infection - the ppd (TB skin test).

    In America, we treat everyone that converts their skin test and we don't administer the TB vaccine. Our public health officials deserve a big pat on the back for this decision.
    • Re:America (Score:2, Interesting)

      by Anonymous Coward
      i dont know where you get such crap, less the mods who mod such ignorance up

      In June 1998, the U.S. Food and Drug Administration approved the first new drug for pulmonary tuberculosis in 25 years. The drug, rifapentine (Priftin), is approved for use with other drugs to fight TB. One potential advantage of rifapentine is that it can be taken less often in the final four months of treatment -- once a week compared with twice a week for the standard regimen.

      more here [lungusa.org]
    • Re:America (Score:4, Informative)

      by ackthpt ( 218170 ) * on Monday September 20, 2004 @11:01AM (#10298186) Homepage Journal
      America has the lowest rate of TB infection because we manage the disease differently than the rest of the world.

      By and large the living conditions, even the worst, are vastly superiour to the conditions many infected people come from. We've got water standards, human waste disposal, heated housing, good food, proper nutrition and for many good heathcare, though that's in decline and has been noted as potential threat which may increase frequency and spread of disease.

    • Re:America (Score:4, Informative)

      by AaronGTurner ( 731883 ) on Monday September 20, 2004 @11:23AM (#10298413)
      America has the lowest rate of TB infection

      The USA has a surpsingly high rate of infection for a Western nation, higher than most of North West Europe. This may be a result of higher rates of prescription of antibiotics in the USA, and slo the use of antibiotics in animal feed as a growth promoter. In any case in all Western nations there is a problem with TB becoming drug resistant which is likely to be a result of strains becoming resistant in those Western nations, not the importation of strains from Asia.

      Bacteria can become resistant by the exchange of plasmoids with other bacteria of a different species that has developed immunity. In addition the plasmoids that may convey resistance may give resistance to a wide spectrum of antibiotics. Thus being prescribed antibiotics for a cold (which will not help the cold) may convey immunity to a class of antibiotics on bacteria in your gut. It is possible for these to exchange plasmoids with TB bacteria. This can also occur in animal husbandry if antibiotics are used as growth promoters or as a prophylactic.

      In Europe use of antibiotics has been lower than in the USA, so bacteria are a little less resistant here, but we are catching up. TB is on the rise in Europe too.

      • Re:America (Score:4, Informative)

        by BoldAC ( 735721 ) on Monday September 20, 2004 @11:40AM (#10298571)
        Who modded this up?

        If we have a higher new infection rate... it would be because we don't vaccinate. Doesn't have anything to do with antibotics or growth feeds, or hormones.

        The drug resistant strains are mainly coming out of countries where the burden of disease is very high or the level of care is very low...

        America is not even quoted in the article:

        Strains of TB that are highly resistant to antibiotics are becoming increasingly prevalent in places like Russia, eastern Europe, and China, and only small changes are required to make these strains start spreading quickly.

        I am against antibotic overuse as well... but antibotic overuse is not the cause here. The cause of TB multi-drug resistance is people not taking their medications correctly! This is the reason we do direct observed therapy... to prevent this.

    • Re:America (Score:4, Insightful)

      by HidingMyName ( 669183 ) on Monday September 20, 2004 @02:02PM (#10300102)
      America has the lowest rate of TB infection because we manage the disease differently than the rest of the world.

      The rest of the world gives the ineffective TB vaccine, while the US doesn't. The TB vaccine is known not to work, and it ruins the best test we have to screen for infection - the ppd (TB skin test).

      In America, we treat everyone that converts their skin test and we don't administer the TB vaccine. Our public health officials deserve a big pat on the back for this decision.

      You make some interesting claims, but supply no references. I'm not an expert in T.B. but google is my friend :-). Let's examine these claims and some of the Google results.
      1. The CDC (U.S. center for disease control) inTrends in Tuberculosis --- United States, 1998--2003 [cdc.gov] states

        "During 2003, a total of 14,871 tuberculosis (TB) cases (5.1 cases per 100,000 population) were reported in the United States."

        While Eurosurveillance in 2002 reports on data (which may have been gathered in 2000) at Tuberculosis control in Europe needs expanded DOTS, linked HIV/TB control, and improved surveillance [eurosurveillance.org] reports:

        "In most countries of western Europe, reported TB incidence is below 15 per 100 000 and continues to decrease slowly. In central Europe, reported TB incidence ranges from 20 to 40 per 100 000 and is decreasing in most countries. TB incidence is much higher in Bosnia-Herzegovina (65/100 000) and Romania (124/100 000), where it has increased significantly in recent years. In eastern Europe, a further increase in reported incidence was observed in 2000 to an overall 89/100 000, a 56% increase since 1995. In countries providing representative data, the overall levels of drug resistance at the beginning of treatment remained low both in Western and Central Europe (less than 1% of patients never previously treated had primary multidrug resistance) and remained extremely high in the Baltic states (9-12%)."

        So the U.S. may have a lower rate of TB than western europe, and definitely has a lower rate than central or eastern Europe. However, I was not able to find a supporting reference for the U.S. having the lowest Rate of infection.

      2. Khaled Mohammed Abu Khadra's thesis abstract (Ph.D. thesis?) [environment.gov.jo] (the thesis itself was not directly linked), but the abstract gave hard numbers of preventive vaccination (vaccination prior to exposure) for the BCG vaccine in Jordan. The last paragraph of the abstract reads:

        "The overall vaccine effectiveness was 88% ; 85% for pulmonary TB and 95% for Extra-pulmonary TB. The vaccine was more effective (92%) when given shortly after birth, compared to 62% when given at school age."

      3. However, vaccines appear to become less effective after widespread usage (try googling on Ineffective TB vaccine), so they may be ineffective after all (a BBC Article [bbc.co.uk] gives 70% effectiveness ratings).
      4. Potential Public Health Impact of New Tuberculosis Vaccines [cdc.gov] by Ziv E, Daley CL and Blower, S. describes the outcome of a mathematical epidemiological model of Tuberculosis, which appears to indicate that vaccination AFTER exposure (post exposure) is likely to be more effective than pre-exposure vaccination at preventing disease (the authors make an interesting point that disease prevention is more important than preventing infection).
      I wasn't able to directly refute the claims, and I suspect some of them may be true given the information turned up.
  • by wiredog ( 43288 ) on Monday September 20, 2004 @10:46AM (#10298034) Journal
    MDR TB has been on the rise for years, as have worries about its transmissibility. Read "And the Band Played On" (mostly about AIDS in the 80's) or "The Coming Plague" (about emergent diseases) for good overviews.
  • by MalaclypseTheYounger ( 726934 ) on Monday September 20, 2004 @10:46AM (#10298035) Journal
    First it was going to be AIDS, then it was SARS, cancer is slowly being beaten...

    Maybe a nice new healthy TB strain will be the new plague to rid ourselves of some of the population.

    How long has it been, at least 400-600 years since a nice big population dwindling event has occurred...

    My daily commute isn't getting any shorter, oil seems to be running out... air is getting more and more polluted... time for the G-O-D to clean the house out a little...

    (and if it's my time to go, I'm fine with that)
    • by Karma Farmer ( 595141 ) on Monday September 20, 2004 @10:55AM (#10298121)
      How long has it been, at least 400-600 years since a nice big population dwindling event has occurred...

      The 1918 Flu Pandemic probably killed more people worldwide than The Black Death. The Black Death killed a larger percentage, though.
      • Well, over a period of centuries (6th, 14th, and 17th), The Black Death killed about 137 million people... The 1918 flu did kill about 25 million in one year, which is pretty significant.

      • by His name cannot be s ( 16831 ) on Monday September 20, 2004 @11:18AM (#10298360) Journal
        More Importantly, it is coming, just not how you beleive.

        While the Black Death did indeed kill less numbers, it did kill 25 million people(over 5 years), where the 1918 flu killed upwards of 40 million in about a year.

        The thing is the Black Death killed 1/3 of europe's population, fueling the greatest economic boom this planet has ever known (at least the one that didn't fall like the internet bubble).

        Upcomming in the next quarter century is the death of the Baby Boomers. When they start to pass on, they will leave behind more money and jobs than you can possibly imagine. This will fuel a new era of real money the likes of which the modern world has never experienced. Unfortunatly, the government that is in power when this begins to happen is going to get credited with the economic boom that will happen, without actually doing anything.

        Now, while the boomers don't represent 1/3 of the population, they nearly represent 1/3 of the weath, possibly causing the same sort of wealth redistribution that occured at the end of the Black Plauge. Trouble is, that the goods that North Americans will buy, will often be manufactured offshore, thereby moving the money off to other countries. Trouble with that? The governments of the last 40 years have been sucking the North American people dry, and the money that should rightly end up in the pockets of local producers, will move to their offshore competitors.

        So, When you get your inheritance, Buy North American! ... wow, neat rant ...
    • I don't find that particularly amusing. Several million people are dying in Africa each year from complications from AIDS/HIV-1, on the order of a holocaust about every 18 months with expectations of increased death rates for at least the next few years. Life expectancy rose from about 40 to 60 years of age from the 60s to early 90s and is now as low as 35. People are dying, not to mention that the susceptibility of AIDS patients to TB makes them a good vector to be infected and to mutate and be passed on t
    • How long has it been, at least 400-600 years since a nice big population dwindling event has occurred...

      My daily commute isn't getting any shorter, oil seems to be running out... air is getting more and more polluted... time for the G-O-D to clean the house out a little...


      Just wait until it's your family that gets sick, or better yet, yourself . I'm sure you'll be changing your tune in a hurry!
      • As dark as his humor tries to be, he does have a point. What happens if something like this reaches India or Pakistan, or perhaps one or more of several nations in South America, in which shantytowns with no sanitation and crushing population density? It's entirely possible that we could see millions die before it could be brought under control. But what of the political upheaval? TB can kill in weeks to months once it takes hold, and spreads via airborne particles. Most of those nations aren't that st
  • by Spy der Mann ( 805235 ) <.spydermann.slashdot. .at. .gmail.com.> on Monday September 20, 2004 @10:48AM (#10298061) Homepage Journal
    when we let big pharmaceutical companies take control of R&D.

    Most antibiotics today are BASED on peniciline. Truth is, these resistant TB strains are resistant against PENICILINE-based antibiotics.

    As I saw on Discovery once... There are thousands of natural antibiotics which are extremely complex. Some can be taken from cactae in South America, some can be taken from certain species of ants.

    But natural antibiotics just can't be patented (think of it as the OSS medicine), and companies don't give a sh*t about them.

    Hmph.
    • by PCM2 ( 4486 ) on Monday September 20, 2004 @10:54AM (#10298109) Homepage
      But natural antibiotics just can't be patented (think of it as the OSS medicine), and companies don't give a sh*t about them.
      "System and method of extracting natural antibiotics from an ant." What's the problem?
      • by twiddlingbits ( 707452 ) on Monday September 20, 2004 @11:03AM (#10298203)
        Ever heard of Tamoxifen for treatment of breast cancer? That drug was isolated from the Pacific Yew tree. Drug companies have a HUGE interest in "natural" drugs, but that does not mean they will find the cure for all diseases. It takes years to isolate and test the chemicals then more years to figure out how to make the drugs they did find in the tests. Then they have to scale the process to make tons of the drugs. Even with "fast-tracking", Parallel computing, folding algrithms,etc. you can expect 5-7 yrs from R&D to drugs you can buy.
    • TB has never been and never will be resistant to Penicillin. Your grasp of antibiotics is slightly less than your grasp of spelling.
    • by perdu ( 549634 ) on Monday September 20, 2004 @11:06AM (#10298227)
      But natural antibiotics just can't be patented (think of it as the OSS medicine), and companies don't give a sh*t about them.
      Not so, not so. Drug and biotech companies and public research institutes still grow exotic fungi and plants to look for new classes of active compounds. In the past 10 years, about 25% of all new drugs came from natural compounds or derivatives.


      • Where does that statistic come from? I work in natural products biosynthesis I always thought it was much, much greater. What's the other 75%? And don't say combinatorial chemistry.
    • by Martin Blank ( 154261 ) on Monday September 20, 2004 @11:07AM (#10298242) Homepage Journal
      No, this is what happens when people get viral infections and demand antibiotics from their doctors, which are 100% useless against viruses. Those carrying TB and overdoing antibiotics can give the virus an opportunity to evolve defenses against penicillin.

      Tip to help the world avoid this: Ask your doctor what his professional opinion is about the source of your illness. If he/she believes that it's viral, ask what kind of OTC medications (NyQuil, Benadryl, whatever) will work best to deal with the symptoms. It may not slow things much, but at least you'll know that you weren't the cause for the strain that kills us all.
    • I know that the pharmaceutical companies are "THE MAN", and therefore evil, but let's think about what that means for a little bit. You are saying that there exists a better, non-patentable method of producing a drug. And it is not being used because the pharmaceutical companies cannot patent it and thereby ensure profitability. No one else is making drugs from those sources either - even though it is known to be non-patented. So this is virtual proof that if we weaken the patent system, we will have LE
      • Why only replace market forces, that seems to be only half the problem? Why not work on replacing the institution of pharmaceutical companies (which are driven by profits) with other kinds of institutions, which might be driven by different goals?

        I also think that the greater the risk, the greater the reward. On the other hand, if you subsidize the risk (as we already do with government funded research), then you should be able to reduce the reward.

        One idea that I've gotten into for how to organize an e
    • by Aardpig ( 622459 ) on Monday September 20, 2004 @11:11AM (#10298300)

      But natural antibiotics just can't be patented (think of it as the OSS medicine), and companies don't give a sh*t about them.

      What utter bollocks. Aspirin (acetylsalicylic acid) was derived from a compound present in the bark of the willow tree (Salyx). It was patented on March 6, 1889.

    • Oh, puhlease. Does Occams razor mean anything to you? It's not ALWAYS big brother/black helicopters/aliens/Big corporations/...

      What you're calling antibiotics, most people call poisins. Organisms evolved these poisons in order to achieve an ecological advantage, but the problem is that they almost always come with side effects. Extermely rare indeed are the toxins that kill off only bacteria without killing you.

      The reason most pharmacutical companies concentrate on derivatives is because with relatively

    • What a day to be without mod points.

      Please do a quick Google for antibiotic families and modes of action. You will find pages like this [ukonline.co.uk] and this. [elmhurst.edu]

      Penicillin and derivitaves are still prescribed, but virtually every bug in the world (+ dog) is resistent to them.

      One evening of watching the Discovery channel does not a B.S. in Microbiology confer.

      The "natural" antibiotics to which you refer are still being found by the dozens. The problems are not (primarily) with patents. You have to:

      You have to fi

  • by solive1 ( 799249 ) on Monday September 20, 2004 @10:50AM (#10298071)
    Bacteria (not computer, although I suppose it could apply too) evolve regularly. Some strains of staph are now resistant to most antibiotics. I had a case of MRSA (Mesocillin Resistant Staph Aureus) two summers ago after having surgery. It was most unpleasant and only an IV-induced superdrug called Vancomycin could destroy it. So, to me it's not all that surprising that TB is making a comeback. It finally figured out how to immunize itself.
  • by MattW ( 97290 ) <matt@ender.com> on Monday September 20, 2004 @10:53AM (#10298099) Homepage
    This is why:

    (1) If you're proscribed antibiotics, you should take them exactly as instructed; take them for the whole course, do not stop in the last couple days or when the symptoms go away;

    (2) Do not attempt to "chase off" what you think might be an oncoming infection by taking a "leftover" pill or two from a previous subscription

    (3) Realize that many infections are viral; do not expect or demand to be proscribed antibiotics contrary to your doctor's wishes

    Doctors are now becoming very aware of bad behaviors which cause bacteria to become antibiotic-resistant, but convincing people to follow good practice is apparently harder.
    • by khallow ( 566160 ) on Monday September 20, 2004 @11:09AM (#10298275)
      The solution is to come up with drugs and distribution methods that don't rely on patients' ability to follow difficult regimes. Eg, why not implant all the doses at once with some sort of metering device that insures that the course is followed? Otherwise, you eventually will have to enforce treatment by withholding treatment from those who can't follow the schedule.
    • by kbahey ( 102895 ) on Monday September 20, 2004 @11:23AM (#10298407) Homepage

      Excellent advice.

      However, it does not work this way in every part of the world. In third world countries, antibiotics are not as regulated as they are in G8 countries.

      Pharmacists there dispense antibiotics freely without prescription, since many poor people go to the pharmacist for a cure, without having to pay the doctor's fee. This may not be purely legal, but everyone does it.

      This causes more and more strains to be resistant to antibiotics, and many of the new ones become ineffective quickly.

      This is why we see some almost eradicated diseases (e.g. TB in this case) revitalize and become more virulent.

  • What's interesting (Score:3, Interesting)

    by prisoner ( 133137 ) on Monday September 20, 2004 @10:53AM (#10298100)
    I don't know much about TB but I was having a discussion with a doctor the other day and he passed along this tidbit: Humans have never devised a way to kill viruses once inside the body. The common cold? Virus. What can you do? Wait it out. Sure we can treat symptoms and, in some cases, endrun the virus to head off some of its bad affects but meet it head to head and win? Hasn't happened yet. This discussion was in the context of the "every patient who has a cold wants an antibiotic" discussion. He has a tough time explaining to people that anitbiotics don't treat colds. Sure, they can contain a secondary infection but it won't help the cold at all...I don't know how much he was talking out of his ass but it was interesting.
    • Tuberculosis is caused by mycobacterium tuberculosis, and like its name, it is indeed a bacteria. However, we have not found any antibiotics succesfully in treating or killing completely the mtb. Infections of tb lie latent forever within your body. As per regard to perscribing antibiotics to viral infections (like the cold), they are nothing more than a placebo. Secondary symptoms can be placed under control by medicines (cold medicine, aspirin) that suppress immune responses, something that antibiotics
    • by lightknight ( 213164 ) on Monday September 20, 2004 @11:09AM (#10298280) Homepage
      Hmm. There is a way to kill (or otherwise slow down) viral threats: Interferon.

      The protein interferon, produced by animal cells when they are invaded by viruses, is released into the bloodstream or intercellular fluid to induce healthy cells to manufacture an enzyme that counters the infection. Interferon is therefore considered a potential medical resource as a BIOPHARMACEUTICAL.
      For many years the supply of human interferon for research was limited by costly extraction techniques. In 1980, however, the protein became available in greater quantities through GENETIC ENGINEERING.
      Scientists also determined that the body makes three distinct types of interferon, each perhaps with several members. These classes were first called leukocyte, fibroplast, and immune interferon after their supposed production sites, but it is now known that each particular class is not, after all, made by a single cell type.
      The classes are therefore now called, respectively, alpha, beta, and gamma interferon. Interferons were also first thought to be extremely species-specific, but it is now known that individual interferons may have different ranges of activity in other species.Alpha interferon has been approved for therapeutic use against hairy-cell LEUKEMIA and Hepatitis C. It has also been found effective against chronic hepatitis B, a major cause of liver cancer and cirrhosis, as well as for treatment of genital warts and some rarer cancers of blood and bone marrow. Nasal sprays containing alpha interferon provide some protection against colds caused by rhinoviruses.

      (http://hepatitis-c.de/whatinf.htm)

      Antibiotics do jack against viral threats. They are designed (for the most part) to disrupt the bacteria's cell walls (bleed them to death). Since human cells (animal type) do not have cell walls, your body is fine. Viruses do not have cell walls, hence they are ineffective.
  • My kids are gonna never believe that "when I was your age, my parents could take me to the doctor and get me a jab with a needle and it would cure any bacterial infection you got."

    And when they ask what went wrong do I get to tell them about free clinics giving unsupervised drugs to junkies in the US and Europe, and charity doctors giving unsupervised drugs to people in Africa and Asia who believe more in witch doctors and temple sacrifices than the germ theory of disease?

    Is it wrong to think we shoulda
  • by Fallen Andy ( 795676 ) on Monday September 20, 2004 @10:54AM (#10298108)
    My father lost his father when he was a mere 9
    years old to TB. I don't understand why people
    treat this as "someone elses problem" - it isn't a
    SEP. It *will* bite you. You'll never have to worry about new diseases because the old ones are doing nicely...

    The irony with TB is that
    people think they are getting well, and stop taking
    the drugs (which are making them feel ill). End result: great selection pressure to make resistant bugs).

    I for one pray that we can stamp out that big disease called ignorance (hey, look at what happened in Nigeria with that dumb fuck (who cares
    what religion?) and Polio). Damn. I had a friend
    with scars from hell and calipers when I was a kid
    and I'm a mere 45 year old. I never want to see
    such things, not even in my nightmares...

  • by jonathan z ( 773057 ) on Monday September 20, 2004 @10:54AM (#10298111)
    To anyone who's interested in the subject, I'd reccomend them to read Mountains Beyond Mountains [amazon.com] by Tracy Kidder, a halfway decent book on the very interesting subject of Dr Paul Farmer, who's been desling with TB epidemics in Haiti / Siberia / Etc for quite a while now. Very informative.
  • Golden Age (Score:5, Interesting)

    by dmh20002 ( 637819 ) on Monday September 20, 2004 @10:55AM (#10298120)
    History will show that the baby boom and X generations, who worry and fret about every little imagined risk, actually will have lived in the golden age of human health. This will be the period when antibiotics were effective and vaccines developed in the mid 20th century kept them safe from the viral diseases. Evolution will overcome all those safeguards.

    People under 30 have a bleak future.
  • World Travel (Score:4, Insightful)

    by wangotango ( 711037 ) on Monday September 20, 2004 @10:57AM (#10298141)
    Even things as simple as the commom cold are highly mobile conpared to a "few" years ago. Given air travel what it is today; a small outbreak of anything highly contagious can spell absolute disaster on a global scale. It's easy to forget people have only recently become the global travelers we now are. TB and all the others are no longer isolated to the point of initial/original concentration. Adds new meaning to "just off the jet".
  • I live in London and I have noticed over the years an increase in people spitting in the streets. Now dispite being fucking disgusting I believe this has contributed to the increase in the number of TB cases seen in the UK.

    I wish these people could get a bit of class and just stop spitting.
  • Old problem ignored (Score:4, Informative)

    by grape jelly ( 193168 ) on Monday September 20, 2004 @11:01AM (#10298181)
    Antibiotic resistance was noted in hospitals in the 50's and 60's, spurring the few physicians who observed it to advise restrictions on antibiotic prescriptions. Few, however, heeded this advice and decades later, antibiotics are still prescribed readily throughout the world -- even without a doctor's prescription or supervision in a number of countries. Of course there is significant noise now about the continued development of resistant bacteria, but it still has little effect in places where such drugs are easy to come by and cheap.

    As an interesting aside, bacteria aren't the only pathogens that can develop resistance to devices we use to kill them. Early protease inhibitor use in AIDS patients resulted in strains of AIDS that were resistant to that treatment.
  • Antibiotics abuse (Score:5, Insightful)

    by erroneus ( 253617 ) on Monday September 20, 2004 @11:08AM (#10298257) Homepage
    Personally, I hold doctors highly liable for the abuse, misuse and general over-use of antibiotics. Of course the patients are pretty damned stupid too, but I have seen cases where the doctor didn't see anything but a blood test before prescribing the antibiotics.

    There are so many natural ways to inspire your own immune system to build and strengthen itself and it seems to me that for capitalistic reasons alone medical professionals do not prescribe them.

    I'm not a doctor or medical expert either. But I'll say this much -- from the time I decided I was done taking pills and crap for every minor problem out there and let my body do its own healing, I have been a healthier, stronger person and I can't remember the last time I was sick... I remember what it was -- the flu -- but it was great than 5 years ago and basically, I just waited it out -- fever and headaches and agony and all. I recognize the fact that extreme situations call for the use of medicines and other modern medical techniques. But I think they are way over-used and in my opinion (guess) it's so they can way over-charge people.
    • by StefanJ ( 88986 ) on Monday September 20, 2004 @11:22AM (#10298399) Homepage Journal
      If the doctors are at fault, it is for bowing to the demands of ignorant, demanding patients who want antibiotics for every sniffle that little Tyffany or Brett get. I have had several co-workers who just wouldn't give up the belief that they could blast the common cold by having their pediatrician shoot up Junior with penicillin.

      The Mexican practice of selling antibiotics over the counter doesn't help either. They're treated as a cure-all down there, and immigrants continue the practice.

      Like the poster said, you're better off living a clean and healthy lifestyle, putting up with minor ailments, and saving antibiotics for actual bacterial infections.

      Stefan
    • Have to agree 100% with what you said. In fact, I could have written as I too had a mild case of the flu about 5 years ago. How mild? Yeah, my nose ran (no jokes please) and I was somewhat sore but I still attended my CS class that night after having gone through a full day of work. 3 days later I was pretty much back to normal.

      The only medication I take is the occasional Advil (3 times a year?)

      I regularly wash my hands when cooking and throughout the day (no, not compulsively) and use a bleach-based
  • Definitions (Score:4, Insightful)

    by SSonnentag ( 203358 ) on Monday September 20, 2004 @11:10AM (#10298281) Homepage
    If it's "worldwide" it should be called a pandemic threat, not simply an epidemic threat.
  • by Anonymous Coward on Monday September 20, 2004 @11:16AM (#10298344)
    Tubercolosis? LOL! This is not a problem! We live in a perfectly disinfected world... COUGH!! ... no bacteria can survive COUGHHH COUGH! we have the most advanced antibiotics and medicines... COoOoooOUGH! COUuUuuuGH!!
    COUGH... WTF!?... COUGH! COUGGGHHH! SCOUGHGCH... BLEURG...
    *STUNF*
  • by bodrell ( 665409 ) on Monday September 20, 2004 @11:19AM (#10298363) Journal
    Imagine a super-strain of leprosy . . .

    Just a little background info, blatantly ripped off of this website: http://encyclopedia.thefreedictionary.com/mycobact erium [thefreedictionary.com]
    Sorry for the crappy formatting.

    Mycobacterium is the only genus in the family Mycobacteriaceae of bacteria. This genus includes many pathogens known to cause serious diseases in mammals, including tuberculosis

    Tuberculosis, also called TB, phthisis, consumption, and nicknamed the white plague, is the most common infectious disease in the world today. It is caused by a bacterium, usually the Mycobacterium tuberculosis but any member of the so called Tuberculosis complex will do. If left untreated, more than 50% will die in a few years time. It causes about 2-3 million deaths per year out of 9-10 million cases and is especially prevalent in undeveloped, tropical countries.

    and leprosy

    Hansen's disease, also known as leprosy, is an infectious disease caused by infection by Mycobacterium leprae. The modern name of the disease comes from the discoverer of Mycobacterium leprae, G. A. Hansen. Sufferers from Hansen's disease have generally been called lepers, although this term is falling into disuse both from the diminishing number of leprosy patients and from pressure to avoid the demeaning connotations of the term.

    Most mycobacteria are classified into two categories, the fast-growing kind and the slow-growing kind, and most mycobacteria share some common characteristics:
    * They are widespread organisms, typically living in water (including tap water treated with chlorine) and food sources.
    * They can colonize their hosts without the hosts showing any adverse signs. For example, millions of people around the world are infected with M. tuberculosis

    Mycobacterium tuberculosis is the bacteria that causes most cases of tuberculosis. Its genome has been sequenced.
    It is a Gram-positive aerobic mycobacterium that divides every 16-20 hours. This is extremely slow compared to other bacteria which tend to have division times measured in minutes (for example, E. coli can divide roughly every 20 minutes). It is a small rod-like bacillus which can withstand weak disinfectants and can survive in a dry state for weeks but can only grow within a host organism.

    but will never know it because they will not develop symptoms.
    * Mycobacterial infections are notoriously difficult to treat. The organisms are hardy and can survive long exposure to antibiotics, which naturally leads to antibiotic resistance Antibiotic resistance is the ability of a microorganism to withstand the effects of an antibiotic. Antibiotic resistance develops through mutation or plasmid exchange between bacteria of the same species. If a bacterium carries several resistance genes, it is called multiresistant or, informally, a superbug.

    Most mycobacteria are susceptible to the antibiotics clarithromycin and rifamycin, but antibiotic-resistant strains are known to exist.
    * Mycobacteria tend to be fastidious (difficult to culture), sometimes taking over two years to develop in culture.
    Species * M. tuberculosis, which causes tuberculosis Tuberculosis, also called TB, phthisis, consumption, and nicknamed the white plague, is the most common infectious disease in the world today. It is caused by a bacterium, usually the Mycobacterium tuberculosis but any member of the so called Tuberculosis complex will do. If left untreated, more than 50% will die in a few years time. It causes about 2-3 million deaths per year out of 9-10 million cases and is especially prevalent in undeveloped, tropical countries.
    * M. leprae
    Mycobacterium leprae, also known as Hansen's bacillus, is the bacterium that causes leprosy (now called Hansen's disease). It is an intracellular, pleomorphic, but usually rod shaped, acid fast, gram positive, aerobic only remotel

  • Three year old news (Score:5, Informative)

    by obby.net ( 772345 ) on Monday September 20, 2004 @11:24AM (#10298428)
    The story about the nicaraguan deaf children, and this tuberculosis story were both covered thouroughly in the PBS documentary series Evolution [pbs.org]. Portions of the relevant segments are available online on the PBS website:

    Deaf Children Video [pbs.org]
    Tuberculosis Video [pbs.org]
  • Artificial lungs? (Score:3, Interesting)

    by skwirl42 ( 262355 ) on Monday September 20, 2004 @11:27AM (#10298441) Homepage

    We've got artificial hearts, artificial limbs and we're working on artificial eyes. What's it going to take to make artificial lungs? I'm talking from a technical standpoint here, not socially or legislatively.

    • Re:Artificial lungs? (Score:3, Informative)

      by gwydion04 ( 756582 )
      Trouble is, you'd have to somehow come up with 100m^2 of membrane that possesses the right permeability to O2 and CO2, is not thrombogenic, and prevents bacterial/fungal growth... AND can fit in your chest.

      /3rd year medical student
    • We've got artificial hearts, artificial limbs and we're working on artificial eyes. What's it going to take to make artificial lungs? I'm talking from a technical standpoint here, not socially or legislatively.

      BBC had some news a while back. Don't know the status of it now. Artificial lung breakthrough [bbc.co.uk]

  • by jelevy01 ( 574941 ) on Monday September 20, 2004 @12:01PM (#10298766)
    I highly recomend reading Mountains Beyound Mountains: Health the World: The Quest of Dr. Paul Farmer [amazon.com]

    He essentailly discovered that DOTS doesn't work

    In this excellent work, Pulitzer Prize-winner Kidder (The Soul of a New Machine) immerses himself in and beautifully explores the rich drama that exists in the life of Dr. Paul Farmer. A Massachusetts native who has been working in Haiti since 1982, Farmer founded Zanmi Lasante (Creole for Partners in Health), a nongovernmental organization that is the only health-care provider for hundreds of thousands of peasant farmers in the Plateau Central. He did this while juggling work in Haiti and study at the Harvard Medical School. (Farmer received his M.D. and a Ph.D. in anthropology simultaneously in 1990.) During his work in Haiti, Farmer pioneered a community-based treatment method for patients with tuberculosis that, Kidder explains, has had better clinical outcomes than those in U.S. inner cities. For this work, Farmer was recognized in 1993 with a MacArthur Foundation "genius grant," all of which he donated to Zanmi Lasante. Using interviews with family members and various friends and associates, Kidder provides a sympathetic account of Farmer's early life, from his idiosyncratic family to his early days in Haiti. Kidder also recounts his time with Farmer as he travels to Moscow; Lima, Peru; Boston; and other cities where Farmer relentlessly seeks funding and educates people about the hard conditions in Haiti. Throughout, Kidder captures the almost saintly effect Farmer has on those whom he treats. Copyright 2003 Reed Business Information, Inc.
  • by jonabbey ( 2498 ) * <jonabbey@ganymeta.org> on Monday September 20, 2004 @12:09PM (#10298842) Homepage

    One of the very best things I've read on the topic of antibiotic-resistant bacteria:

    Bruce Sterling: Bitter Resistance [eff.org]

  • Bacteriophage saga (Score:5, Informative)

    by Anonymous Writer ( 746272 ) on Monday September 20, 2004 @12:10PM (#10298847)

    Bacteriophage [wikipedia.org] appears to be an alternative to antibiotics for fighting bacteria. An article [discover.com] (you have to pay to access it) in Discover Magazine [discover.com] by Peter Radetsky about bacteriophage was published in November, 1996. It was mentioned [archive.org] by a man named Caisey Harlingten in a Horizon [bbc.co.uk] documentary on the BBC [bbc.co.uk], and seems to have been an important publication that set things into motion. What isn't mentioned in the transcript is that right at the end of the documentary, text appears that says the deal between the American company called Georgia Research, Inc. set up by Harlingten and the Eliava Institute fell apart.

    Wired [wired.com] wrote a follow up article [wired.com] on the story. One of the disputes involved another man, Alexander Sulakvelidze, opposing the seemingly pointless aim to genetically engineering phages, which Harlingten wanted to do. This possibly has something to do with the fact that genetically engineered products are protected by patents [greenpeace.org] and can be regulated by intellectual property laws, whereas natural phages are not. This [regma.co.uk] is what Harlingten is up to now. He is trying to apply phage therapy to multi-drug resistant Tuberculosis [findarticles.com] . And this [intralytix.com] is what Sulakvelidze is up to now, applying phage therapy to livestock.

    Evergreen State College [evergreen.edu] and the Rowland Institute at Harvard [rowland.org] have pages about bacteriophage. Phage therapy may have some side effects, however. Some types of phage carry genes that can actually make bacteria pathogenic [evergreen.edu] (briefly mentioned at end of page). This has been observed in E. Coli [onetel.net.uk] as a response to antibiotics [216.239.57.104].

  • by haggar ( 72771 ) on Monday September 20, 2004 @12:10PM (#10298850) Homepage Journal
    This "mix" is (or should be!) mandatory for any form of TBC, not only multi-resistive.
    These antibiotics are extremely hard on your liver and also damage your eyesight. One of them colors your urine in pink/red. One additional drawback is that, at the end of the 6-month regimen, your system defenses will be at an all-time low, and it will take several years before you can be back to what you were before the therapy.

    IF you default on this therapy, however (if you stop the start taking the medicine again, or you don't take all the pills in the mix etc.) you are going to develop a resistive or multi-resistive strain of TBC. If you develop the multi-resistive strain, you're in GREAT trouble, and are a huge hazard for the people you spend time with (which is, presumibly, the ones that are most dear to you). There are very few antibiotics which are effective with such strains, and are both expensive and hugely damaging to the liver (that's why they are not used with normal strains). Even with them, your chances of survival are not great.

    So, if you do happen to get TBC, don't fuck around wth it, be pedantic and take all the medication every day, without ever skipping a dose.
  • by Fantastic Lad ( 198284 ) on Monday September 20, 2004 @01:15PM (#10299525)
    Jeez.

    Saw this coming from 20 years ago.

    I remember sitting in high school science class going over the details. Our Birkenstock-wearing teacher was probably breaking the rules by telling us what he'd learned. Darned socially aware hippies!

    Livestock farmers mixing non-lethal doses of antibiotics into the feed to keep bacteria at controllable levels. (Creating bacteria breeding boilers.)

    Junkies, who destroy their immune systems with their chemicals of choice, would normally die off fairly fast but for black-market/clinic-distributed, improperly used antibiotics. Concentrated junkie populations, like those I've walked among in Vancouver and Amsterdam are super-breeders for germs. Chilling and very real.

    And then of course, there's the regular citizenry and drugs like 'Contact-C' which allow people to ignore symptoms which would normally put them in bed (where one can properly recover without drugs), and thus keep them at work where they spread the virus and wear themselves down further until a simple viral infection can graduate into a full-fledged bacterial bloom. --Then it's off to the doctor for antibiotics which many don't bother finishing properly once they feel their symptoms fading. --Doesn't matter how often you explain the Hows and Whys to a drone about why they HAVE to finish their antibiotics prescription. People who have been programmed to glaze over when confronted with important knowledge are both common and dangerous.

    Humanity is getting exactly what it designed for itself.

    Fortunately, ignorance is self-punishing and awareness protects those who choose to learn and act upon what they learn. --Viruses can be avoided if one has groomed their awareness, health and energy. I've not been sick in several years now, and I certainly don't manage it by allowing some drug-salesman 'doctor' to jab me with thimerosal/mercury-laced flu shots! (Which dull the brain, and I strongly suspect, reduce the strength of one's natural immune system, thus increasing the perceived need for just such profitable pharmaceuticals).

    But you know, 'Science' is good and great and all that, precluding the need to question the intent behind the needle. Far too many people have traded their critical minds for easy, false trust and never question when they see the 'Science' label and hear an authoritative, soothing voice.

    Remember; it's okay to be wrong. You will constantly be faced with false data if you choose the road of continual learning. Just be sure to correct it accordingly as you discover it. You WILL be punished for your mistakes by those who want to stop you from learning, but that's part of the journey. --In the long run, the lemmings are the ones who get sick, and they want your (enforced) company.

    How much do you value your social acceptance?


    -FL

  • by Baldrson ( 78598 ) on Monday September 20, 2004 @02:26PM (#10300428) Homepage Journal
    Major media are carrying the story [go.com] that the UN is blaming much of the spread of drug resistant TB on the prevalence of AIDS/HIV-infection. This is due to the susceptibility of those populations to become infected and spread the disease to others.
  • by buckhead_buddy ( 186384 ) on Monday September 20, 2004 @02:34PM (#10300539)
    Sorry, I don't want to drag this off-topic into another screed about the evils of extended copyright, but it is mildly relevant.

    My grandfather was a well-respected medical researcher. The works that he developed his fortune and reputation have been superceded, but toward the "mature" part of his career in the 1930's he did a lot of work on tuberculosis especially with animal tests on cattle. The articles my grandfather wrote are still under copyright. He's been dead for decades, and tuberculosis has been a non-issue for most Americans for years. Now that a more vicious strain of TB is starting to emerge, I find it disturbing that this material is still illegal to share.

    If you can't see what I'm talking about, look at the two-digit year rollover problem framed in the media as Y2K. All of the research into the causes, identifications, and solutions to the "millenium bug" will remain under copyright for close to 90 years under current copyright law. Imagine though that copyright was extended yet again and these works weren't public domain until AFTER the next two digit rollover in 2100.

    Just as people have already started to build two-digit years into databases again, so have people given up on many practices that might minimize the spread of TB. Some people can't even identify these practices or understand why they're at issue.

    I realize that the research into Y2K and bovine tuberculosis isn't "gone" that it's still around under lease, but it seems that having only the choice of paying for out-of-date information on a tangential problem or recreating the works someone else did is a waste of resources (money or time) that could be better applied toward whatever problem is causing researchers to look back on these old issues.

    I'm thinking about digging into my grandfather's work papers (what's left anyway) and trying to digitize some of his data, notes, and private letters on the subject of bovine TB. Some of this data probably can't be collected today because of regulations on animal testing that didn't exist in the 1930's. I know full well that it would be irrelevant to the current threat of drug resistant tuberculosis strains, but it might let some researchers or problem-solvers keep their money and time focused where the real problem is rather than paying/recreating old research.

    While I'm not against people making money from their research and creative works, the length of time that this stuff remains under protection is absurd. The money made either for my family or the publishers trailed off to nothing decades ago. The potential monteary profit of his work is far outweighed by my own interests in not becoming a victim of a drug-resistant version of this affliction. The benefit of this work today is only as part of a contextual frame or foundation for research into other communicable diseases.

The opossum is a very sophisticated animal. It doesn't even get up until 5 or 6 PM.

Working...