Australia hit by drug-resistant TB By Lucy Beaumont Health and Science March 21, 2004
Australia is at risk of the multi-drug-resistant strains of tuberculosis that the World Health Organisation warns are raging in Europe and Asia.
One-third of the world's population is infected with TB bacterium, which can be spread by coughing and sneezing and kills 2 million people a year.
WHO data, released ahead of World TB Day this Wednesday, showed that multi-drug-resistant TB levels were 10 times higher among patients in eastern Europe and central Asia. China, Ecuador, Israel and South Africa were also flagged as hot spots by the survey of 67,657 patients in 77 countries.
"Passport control will not halt drug resistance," said Mario Raviglione, head of WHO's Stop TB department. "Investment in global TB prevention will."
Each year there are 300,000 new cases of MDR-TB, which can emerge when patients do not complete a full six-month course of treatment and then be spread to others.
People can be infected with TB bacteria but not develop the disease, or develop it later when their immune system is compromised. Once active, TB can kill by eating holes in the sufferer's lungs.
MDR-TB is resistant to the two most common TB medicines, Isoniazid and Rifampicin. WHO reported that 79 per cent of MDR-TB cases are now "super-strains", resistant to at least three of the four main TB drugs.
Chris Pulpin, chief scientist at the World Health Organisation Collaborating Centre in Tuberculosis at Queensland's Mycobacterium Reference Laboratory, said that of the 852 notified TB cases in Australia last year, 16 were multi-drug- resistant. But migration and international travel could see cases rise significantly.
"In Australia, tuberculosis is normally reactivation of latent disease from migrants who've acquired it in high-prevalence countries," said Dr Pulpin.
"There is a huge potential impact because a lot of the drug resistance occurs in our neighbouring countries in South-East Asia, and even in East Timor and Papua New Guinea."
All the MDR-TB cases in Australia were in people born overseas and there have been no documented cases of transmission in this country. In the Western Pacific region, which stretches from Mongolia through Asia to Australia, TB kills 1000 people each day, said Community Health and Tuberculosis Australia's Mark Lambert.
"We're probably in one of the biggest hotspots in the world," Mr Lambert said. "About 30 per cent of the global TB burden is found in the region."
Australian researchers are getting closer to developing a more effective TB vaccine. Scientists from the University of Sydney's Centenary Institute of Cancer Medicine and Cell Biology reported positive results from animal trials of a new vaccine in the January Journal of Infectious Disease.
Modified strains of live tuberculosis bacteria had proved more effective in preventing the disease than the existing BCG vaccine, said team leader Dr James Triccas.
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