Monday, October 02, 2006

Mexico and drug-resistant tuberculosis

Lindsey Collom:

"It's just an airplane ride away," said Dr. Karen Lewis, tuberculosis-control officer for the Arizona Department of Health Services.

The majority of drug-resistant infections are brought to the U.S. by legal visitors, many of them unaware that they carry the deadliest strains. Lewis said those strains develop when patients interrupt their months-long treatments, giving the still lurking infection a chance to mutate.

In 2005, the most important risk factor associated with tuberculosis in Arizona and nationwide was birth outside the U.S., according to the state's Tuberculosis Surveillance Report, released last week.

Local and national health experts say a recent tuberculosis outbreak in other countries, such as South Africa, where 50 people recently died of an "extensively drug-resistant" strain, underscores the need for testing.

The "extensively drug-resistant" tuberculosis has been found in limited numbers in the U.S, with 74 reported cases since 1993.

The strain is nearly impossible to cure because it is immune to the best first- and second-line tuberculosis drugs.

It's also as easily transmitted as the simple strain.

Nationwide, there has been a spike in milder but lethal "multidrug-resistant" tuberculosis, which responds to more treatments but can cost up to $250,000 and take several years to cure.

About 130 people in the U.S. were diagnosed with multidrug-resistant tuberculosis in 2004, up 13 percent from 2003. More than 40 cases in Arizona were found to be resistant to one or more forms of anti-tuberculosis medication, according to the 2005 report.

That year, Arizona reported 281 active tuberculosis infections. A total of 172 infected people were foreign-born, 68 percent from Mexico, where the tuberculosis incidence rate is 10 times higher than in Arizona.

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