Thursday 11 April 2013

TUBERCULOSIS: Australia: First death from XDR-TB



[The New York TimesAustralia’s first death from XDR-TB — extensively drug-resistant tuberculosis, which is nearly incurable — has alarmed health officials and added new heat to a debate over how to treat immigrants with dangerous diseases. That debate echoes one on the United States’ southern border.
A long string of small Australian islands — bits of what was once a land bridge — mingle with islands belonging to Papua New Guinea, one of the world’s poorest nations. One of those islands, Daru, has a major TB outbreak in its shantytowns. Australia used to have two TB clinics on its islands, but closed them in 2011 and sent many patients back to Daru, instead offering foreign aid to help them be treated at home.
But the health system in Papua New Guinea is overwhelmed, and there are accusations that the foreign aid has been stolen. A World Health Organization report found serious drug shortages, and Australian television showed XDR patients mingling with others in Daru Hospital tuberculosis wards, raising the risk of spreading resistant strains.
Catherina Abraham, a 20-year-old Daru woman, went to Australia on a tourist visa in 2012 but ended up as a “medical refugee,” spending months in isolation in a Queensland hospital, posing for pictures and giving interviews before she died on March 8, according to an article in The Medical Journal of Australia. Australia, which otherwise has little tuberculosis within its borders, is still debating how to respond. Treatment for drug-resistant TB — when it works — can cost hundreds of thousands of dollars. Experts noted that the same problem exists on the borders between the United States and Mexico and between Finland and Russia.

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