Drug resistant tuberculosis hits the United States.

29 December 2009

One might wonder if medical science is starting to feel the fear, as Hunter S. Thompson once put it. Disease has long been an adversary of human life; everything from the common cold to exotic diseases that could have given H.P. Lovecraft a rough night's sleep have been worthy opponents. In recent years, however, the no-holds-barred battle royale has turned into a game of four-handed chess due to the appearance of strains of common diseases which have developed immunities to commonly used antibiotics. In a nutshell, if you are instructed by your physician to take all of your prescribed antibiotics even if you feel better, follow their orders. The reason for this is because antibiotics work by building up in your bloodstream and tissues; regular doses over time maintain these levels which renders your body an inhospitible environment for infectious organisms. The idea is for the active concentration to last longer than all the bacteria do. If you don't do this, not all of the bacteria will have been killed off and the ones which remain will probably evolve a resistance to whatever it was that you were on. Maybe your body's immune system will mop up the ones that remain, and maybe it won't.

It's the strains which escape that pose a threat today. The strains which killed an estimated 65,000 people in the United States in 2008. The news has been running stories about antibiotic resistant bacteria for a couple of years now. Staph, strep, salmonella... this has been going on since the 70's, depending upon who you listen to and how much you trust them. Now strains of tuberculosis and other microorganisms have been documented which are resistant to the best compounds pharmacology has to offer right now. Early in 2006 one Oswaldo Juarez from Peru was diagnosed with what is termed extremely drug resistant TB (XXDR, as distinct from multi-drug resistant (MDR) and extensively drug resistent (XDR) strains) after he was admitted to a hospital in Florida complaining of fever, chills, difficulty breathing, and coughing up blood. More's the problem, cases of XXDR TB are incredibly rare so medical science didn't have a whole lot of data to work from; his was the first case ever discovered in the US. They're not sure how many people he potentially exposed (which is transmitted through inhalation of droplets coughed or sneezed into the air) or where he contracted it. Late in 2007 he was transferred to the last remaining TB sanitarium in this country for aggressive treatment in quarantine.

Oswaldo was treated using a harrowing protocol of intravenous and ingested drugs administered several times a day. Some of the drugs had a beneficial effect, others did not. The side effects of such treatment, to be blunt, were hideous, but yet he endured. In July of this year he walked out of the sanitarium with his bags packed, his head held high, and his body rid of the bacterium (modulo a bit of scarring on his lungs).