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Drug resistant TB in India and spreading!

by MarkFlax Forum moderator / January 17, 2012 3:13 AM PST
Indian TB cases 'can't be cured'

Tuberculosis which appears to be totally resistant to antibiotic treatment has been reported for the first time by Indian doctors.

Concern over drug-resistant strains of TB is growing, with similar 'incurable' TB emerging in Italy and Iran
.

It was inevitable, and more than likely from a 3rd world or developing nation, but Italy is a surprise. I'm wondering if Italy's problems with refugees from North Africa is the source there.

Developing new anti-biotics has always been difficult an din fact I was surprised to read that there had been a 40 year hiatus in discovering new classes of anti-bacterial compounds. It's a Wiki page, but still interesting;
http://en.wikipedia.org/wiki/Antibacterial

There seems to be help on the way with a report in April 2011 of a new class of substances called benzothiazinones (BTZ), that could be used in the treatment of tuberculosis and drug resistant tuberculosis.

I wonder how long before testing allows this new class to be made available to health services.

Mark
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It's resurgence began with
by James Denison / January 17, 2012 11:13 AM PST

"the gay men's disease" now called AIDS from HIV infection. Since that situation was not dealt with properly and even gained "rights" in the following years, which has allowed HIV and TB to spread even wider, we now see it beginning to affect more and more people. If it had been nipped in the bud, the proper steps followed to control the activity that breeds it, we wouldn't be facing the monster it may grow to become, affecting far more than it ever should have.

http://www.doctorswithoutborders.org/news/article.cfm?id=4334&cat=field-news
Behind the clinic, some 30 patients wait in line, men, women, and children, all of whom have come to renew their prescriptions for anti-retroviral medicines or to be tested for tuberculosis (TB). Like most villages in Swaziland, New Haven is being ravaged by the double-edged sword of HIV/AIDS and TB. One in four adults is HIV-positive and, more importantly, 80 percent of the thousands of people in the country who develop active TB each year also have HIV/AIDS AIDS and tuberculosis have caused great sorrow in the community, remarks 62-year-old Sam Simelane, one of the few elders in the village. Many people have died; many have lost their entire family. In Swaziland, as in most countries in southern Africa, TB has become the leading cause of death for people with HIV/AIDS.

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5412a1.htm
Data collected by CDC's National Tuberculosis Genotyping and Surveillance Network at seven sentinel surveillance sites indicate that 44% of M. tuberculosis isolates from persons with newly diagnosed cases of TB were clustered with at least one other intrasite isolate, often representing TB disease associated with recent spread of M. tuberculosis (55). TB outbreaks are also being reported with greater frequency in correctional facilities (37), homeless shelters (33), bars (27), and newly recognized social settings (e.g., among persons in an East Coast network of gay, transvestite, and transsexual HIV-infected men [34]; persons frequenting an abandoned junkyard building used for illicit drug use and prostitution [26]; and dancers in adult entertainment clubs and their contacts, including children

http://bmb.oxfordjournals.org/content/54/3/579.abstract
the HIV epidemic is having a huge impact. HIV infection the risk of tuberculosis approximately 7-fold, though this may vary with the stage of the HIV epidemic, the prevalence of tuberculosis, and the age groups considered. Dually-infected individuals develop tuberculous disease at a rate of 5-10% per year. HIV also increases the risk of disease following recent infection, which makes a major contribution to the tuberculosis burden in some settings.

http://en.wikipedia.org/wiki/Bareback_%28sex%29As AIDS emerged and the sexual transmission of HIV became known in the 1980s, the use of condoms to prevent infection became much more widespread, especially among homosexual men. At the beginning of the AIDS crisis, in the context of the invention and development of safe sex, the uptake of condoms among Western gay men was so widespread and effective that condom use became established as a norm for gay sex. From 1995 several high profile HIV positive men declared their refusal to wear condoms with other HIV positive men in gay publications, dubbing the practice "barebacking". While these early articulations of barebacking expressed a concern for HIV prevention, in that they generally referred to dispensing with condoms in the context of sex between people of the same HIV status, the moral panic which ensued was so pronounced that barebacking came to be framed as a rebellious and transgressive erotic practice for HIV positive and HIV negative people alike, irrespective of the risks of HIV transmission

http://en.wikipedia.org/wiki/TuberculosisOnly about 5-10% of those without HIV, infection with tuberculosis develop active disease.[9] In contrast 30% of those co-infected with HIV develop active disease.[9] Extra-pulmonary TB may co-exist with pulmonary TB.Where the slide into drug resistance began.

http://en.wikipedia.org/wiki/Gay-related_immune_deficiency

Most TB cases are among HIV positive people. Here's a timeline of it's beginning.

http://en.wikipedia.org/wiki/Timeline_of_early_AIDS_cases

1980 Gaetan Dugas, so-called "Patient Zero", was a flight attendant who had over 2,500 sexual partners across North America. At least 40 of the 248 people diagnosed with AIDS by April 1982 were thought to have had sex either with him or with someone who had. Dugas refused to stop having unprotected sex after being diagnosed, and allegedly informed some of his sex partners that he had the "gay cancer" and perhaps they would get it too.

========================
The real question is;
What's next? What new disease or more virulent strain of existing disease will come along? We see incurable HIV, now drug resistant TB.

http://bible.cc/romans/1-27.htm
International Standard Version (2008)In the same way, their males also abandoned their natural sexual function toward females and burned with lust toward one another. Males committed indecent acts with males, and received within themselves the appropriate penalty for their perversion.

Leviticus 18:22 "'Do not lie with a man as one lies with a woman; that is detestable.

Leviticus 20:13 "'If a man lies with a man as one lies with a woman, both of them have done what is detestable. They must be put to death; their blood will be on their own heads.

1 Corinthians 6:9 Do you not know that the wicked will not inherit the kingdom of God? Do not be deceived: Neither the sexually immoral nor idolaters nor adulterers nor male prostitutes nor homosexual offenders

Jude 1:7 In a similar way, Sodom and Gomorrah and the surrounding towns gave themselves up to sexual immorality and perversion. They serve as an example of those who suffer the punishment of eternal fire.

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Aids
by MarkFlax Forum moderator / January 17, 2012 9:10 PM PST

Well Aids may be making a bad situation worse, but the immunity of the TB virus has nothing to do with Aids.

The problem with immunity to antibiotics pre-dates Aids and had been well known for decades before that. I was hospitalised with suspected TB in 1967 and already then there were concerns about "Resistant strains" that could not be treated effectively by the use of single types of antibiotics.

I was found not guilty by the way! False alarm. Devil

Mark

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did you get the vaccine?
by James Denison / January 17, 2012 10:16 PM PST
In reply to: Aids

Some in UK got a TB vaccine years ago which causes them to always give false positives.

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Streptomycin in hospital
by MarkFlax Forum moderator / January 18, 2012 9:44 PM PST

But I think you're talking about the PPD skin test we all had at school. That showed nothing unusual, no inflammation or anything. I don't remember having the BCG vaccine. My problem was a general lung X-Ray scan showed up a shadow on my lungs, and I was whisked away to an isolation hospital immediately afterwards.

One injection, every day for two months, in the rear-end!

I was 16 at the time and had to bare my rear-end every morning to gorgeous nurses. Happy times! Happy

Then after I escaped I had to take Streptomycin tablets every day for a year. Huge dry paper capsules that were too large to swallow but I had to anyway. I tried dampening them once to make it easier to swallow. I didn't do that again though. The container collapsed inside my mouth and the medicine inside tasted awful.

I still have the shadow on my lungs. Every time I have a chest X-Ray now I have to go through the whole rigmarole of explaining my history. Now I simply take all the paper work with me and hand it to them.

Mark

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That is what causes the resistant strain of anything
by Diana Forum moderator / January 19, 2012 2:44 AM PST

Not taking the antibiotics until you're sure it's dead.

Diana

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Or, Diana...
by J. Vega / January 19, 2012 4:20 AM PST

Or Diana, an antibiotic that can not be always counted on to kill 100% . If it leaves just a small fraction of a percent, eventually that small fraction can reproduce and grow. But could you deny treatment to someone because the treatment is only 99.9 percent effective?

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Not sure what your point is
by MarkFlax Forum moderator / January 19, 2012 4:23 AM PST
In reply to: Or, Diana...

but medical doctors, at least here in the UK, always tell patients to finish the course of antibiotics.

It is well known here that not doing so may allow some bacteria to survive and so build up resistance to the drugs.

Mark

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(NT) That's what I'm talking about.
by Diana Forum moderator / January 19, 2012 8:59 AM PST
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My point was...
by J. Vega / January 20, 2012 12:02 AM PST

I was raising the point that even if everybody took their antibiotics perfectly, they don't kill 100% of the disease organism and the survivors will eventually reproduce. Resistant strains can develop because this is artificial selection. The antibiotic "selects" for resistant organisms, so you can end up with a resistant strain. Over prescription of antibiotics increases the risk of this happening.

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You mean that what I've always heard
by Diana Forum moderator / January 20, 2012 4:39 AM PST
In reply to: My point was...

that resistant strains are caused by people feeling better so they quit taking the antibiotics and a few of the bacteria escape and are not overwhelmed by the drugs is wrong?

Diana

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I don't think, Diana...
by J. Vega / January 20, 2012 6:58 AM PST

Diana, I don't think that is the major reason. When you take an antibiotic, you can cause artificial selection rather than natural selection in the genetics sense. You are culling out the organisms with genetic makeup that leaves them vulnerable to the antibiotic and leaving those with resistance to it. You are selecting for resistance to the antibiotic. Over prescription of antibiotics increases the odds that you may come up with a strongly resistant strain. If you keep killing off non-resistant strains, the resistant strains can eventually become dominate, and the same process continues to select for even more resistant strains from that pool of resistant genes. The antibiotic becomes less and less effective with time and eventually can become almost useless.

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Blimey
by MarkFlax Forum moderator / January 22, 2012 6:07 AM PST

That means all the medical advice I've been hearing for the last 4 decades is wrong.

How can I tell them?

Mark

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Blimey yourself, Mark...
by J. Vega / January 22, 2012 1:12 PM PST

Sorry Mark, your sarcasm is lost on me. Yes, you should do the whole prescribed course of an antibiotic, but when this sub thread started I was talking the cause of resistant strains. People not completing the entire course of an antibiotic may be a factor in their development and increase, but I still think that over prescription of them is a much greater factor.
I don't think you need to tell doctors about that. In the past people would go to the doctor with something like the flu and insist that the doctor prescribe an antibiotic. Even though one would be useless against a virus, many doctors gave in to eliminate the nagging. The same happened with something caused by a bacteria, but was minor and didn't require the antibiotic level of treatment. But the patient wanted the full bore treatment.
As time rolled on resistant organisms developed and studies eventually showed the problem with over prescription. Such articles were picked up by the general media and the patients started to understand the problem. Now, people are starting to to think about antibiotics used commonly in other ways, like in the feed of livestock as "preventatives". Now you have them used as a matter of standard use in millions of livestock animals. Studies about them showing up in meat and milk are appearing.
Now there is also a lot of discussion about the increase in resistant organisms. At the risk of repeating myself, I still hold that over use in both people and livestock is a greater reason for this increase than humans failing to complete the entire course of treatment of a doctor prescribed antibiotic. My opinion, I will admit is influenced by past years when I thought my field of work would be in bacteriology. I will admit that that work tends to make me more worried about the subject than the norm to this day.
You have your opinion, I have mine, and we seem to disagree.

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Or you mean..
by MarkFlax Forum moderator / January 20, 2012 5:03 AM PST
In reply to: My point was...

let's just forget about antibiotics?

If that's the case then we can also forget about disinfectant kitchen and bathroom cleaners, because they only kill 99% of all household germs.

Mark

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(NT) You'd maroon them all on an island?
by Roger NC / January 18, 2012 11:32 AM PST
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That's an idea
by James Denison / January 18, 2012 11:51 AM PST
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what is quarantine?
by James Denison / January 18, 2012 12:23 PM PST

Simply a separation. The many are in the larger area, the fewer are in the smaller area. When one group is quarantined, in a sense so is the other, from them.

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That's right
by JP Bill / January 18, 2012 12:27 PM PST
In reply to: what is quarantine?

so you won't be lonely, all alone on your island.

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I lived on an island for 3 years
by James Denison / January 18, 2012 12:40 PM PST
In reply to: That's right

Enjoyed it immensely! Laugh

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Good for you
by JP Bill / January 18, 2012 1:15 PM PST
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We need the HIV colony
by James Denison / January 18, 2012 7:30 PM PST
In reply to: Good for you

For anyone who has shown they will continue to spread the disease knowingly. Told you have HIV, then have sexual encounter with someone after that, or use some other means to create risk for others, off you go to the HIV colony. Come to think of it, look at all the other crime it probably would remove from the streets, especially prostitutes of both sexes. This is a good idea you came up with.

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(NT) Sure you do.
by JP Bill / January 18, 2012 7:42 PM PST
In reply to: We need the HIV colony
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(NT) No surprise.
by Roger NC / January 21, 2012 12:42 PM PST
In reply to: That's an idea
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LOL, why should you be surprised?
by James Denison / January 21, 2012 1:24 PM PST
In reply to: No surprise.

You're the one who suggested it! Laugh LOL!

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RE: You're the one who suggested it
by JP Bill / January 21, 2012 8:00 PM PST

So NOW it's YOU, that doesn't recognize TIC.

Remember the post you made a couple weeks ago...others not recognizing TIC

Of course, your "That's an idea" post could also have been TIC, is that a possibility?

facetious......Treating serious issues with deliberately inappropriate humor; flippant.

Tongue in Cheek Definition: in an ironic or facetious manner,

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I'm glad you got it too.
by James Denison / January 21, 2012 9:25 PM PST

Embarrassing you felt a need to assure us of it though. Silly

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you should be embarrassed
by JP Bill / January 21, 2012 10:29 PM PST

Perhaps you could add TIC in any post that you make that is TIC,

OR

IF we don't see TIC in your post...you don't have your TIC.

I'll make that assumption unless I see TIC in any of your posts.

Perhaps it could be "your Signature"...something you put in all your posts at the end

TIC

James TIC Denison

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Quite frankly, I can believe you'd not object
by Roger NC / January 22, 2012 1:07 AM PST

to shipping them all off to an island to live or die on their own, with no outside help.

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Yes, you suggested "maroon"
by James Denison / January 22, 2012 2:17 AM PST

I spoke of "quarantine". I don't know why you'd insist on abandonment. I certainly never did. Or do you not understand the difference?

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