TB... or not TB

The article I chose is about tuberculosis and the drugs used to treat it.  It was published on February 5^th 2013.  The full article can be found at: http://www.nytimes.com/2013/02/05/opinion/ 

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           According to the World Health Organization more than eight million people get sick with tuberculosis every year.  In 2011, 1.4 million people died from it; that is the second deadliest infectious disease after AIDS.  There have been many improvements in the treatment of TB over the years and the death rate and infection rate is slowly decreasing.  Even with these improvements there has been some scary new research showing that certain distributed drugs could actually aid the disease in becoming resistant to drugs.

            There are many different drugs used to treat TB.  Typically multiple drugs are administered and then through tests doctors can see which is effective for that specific case.  This particular study was of two common medicines, insoniazid and rifampicin.  They used samples from pharmacies and markets in 17 countries where TB is common.  They finished with shocking results.  Nearly one of every ten pills failed to meet basic quality standards; in Africa nearly one in six pills did not meet the standard.  These poorly made antibiotics were widely used to treat TB.  They are almost certain that the bad drugs are making the disease more resistant to drugs; this could mean a large threat to public health around the world.

            The failing pills had to little of the ingredient that kills the TB bacteria.  The drugs will kill off some of the bacteria but leave the strongest to multiply.  In these cases the patient could then spread drug resistant TB, which is far more deadly and harder to control.  Something that caught my eye was that the drugs were coming from qualified manufacturers but were poorly made or were ruined in transport.  Many people cant travel to clinics that have medicine from public health departments so they are forced to take their chances with the medicine they have available.

            As a society, we don’t question medicine often.  When we think of medicine we know there is a chance that it will not help cure us.  However, we associate that with our body rejecting it, not because the medicine we receive is sub par.  Lucky for us, bad TB drugs are not a problem in the US because we have stronger manufacturing practices.   But there are so many people in so many countries that don’t have access to great medicine, which is causing more and more cases of TB to show up.  I find this article very interesting, yet very startling that medicine (something we associate with a cure) could actually be harmful.


Pictures were used from:
http://www.mcclatchydc.com/2009/04/01/65262/drug-resistant-tb-may-spiral-out.html
http://www.boston.com/bigpicture/2008/12/2008_the_year_in_photographs_p.html

Is Health Care Only An Issue When It’s Political? By Marissa Perez

This article interested me as it was about an epidemic disease which we have not talked about in class yet. The title of the article is “Measles and Weasels” and it was written by Huma Yusuf from the New York Times on January 25th of this year. The full article can be found at http://latitude.blogs.nytimes.com/2013/01/25/a-measles-outbreak-in-pakistan-fuels-competition-among-politicians/ . 

In the article, Yusuf writes about how Pakistan has currently been threatened by a measles epidemic. Measles is an infection of the respiratory system caused by a virus and the disease has flu like symptoms as well as a quick-spreading rash. The World Health Organization has recorded 103 children who have died from “pneumonia and other measles-related complications between January 1st and 19th” in Pakistan.

The epidemic has hit the city of Punjab the most severely, Pakistan’s most populous and politically influential province. The author interestingly brings up how the fear of this health crisis has become a political matter in Pakistan. The increasing death rates are raising questions about the prospects of the Pakistan Muslim League-Nawaz (PML-N), which forms the government of Punjab. On a national level, the PML-N is the “leading opposition party to the Pakistan People’s Party, or P.P.P.” Thus, the leaders of the Punjab do not want to be accused with failing to provide healthcare for their citizens. 

Flag of the Pakistan Muslim League-Nawaz 

A consequence of this political matter is the argument that the Punjabi government has played down the risks of a measles epidemic. Contrary to this belief, Shahbaz Sharif, a PML-N leader, has taken action in aid to Punjab’s citizens. The government has launched a public-awareness campaign, as well as stocked up on vaccines and lowered the recommended age for inoculating children.

Those against the PML-N have chosen to use this measles epidemic to their advantage. Advisor to the prime minister on human rights called for Sharif’s resignation stating, “No one in the Punjab government has taken responsibility of the utter failure and lack of governance, especially in the health sector.”

The criticism continues with several past healthcare failures which have occurred in Pakistan. In 2012 more than 40 people across Punjab died after consuming a toxic cough syrup produced locally and several patients died after being prescribed contaminated heart medication at the Punjab Institute of Cardiology. In the midst of all this, the Health Department of Punjab has been in a labor dispute with the Young Doctors’ Association, resulting in major doctors’ strikes.

        Shahbaz Sharif (left) remains determined to defend the Pakistan Muslim League-Nawaz and the healthcare system in Punjab. He is trying to replicate his one big success from last year, when his department managed to curb a dengue fever epidemic. The number of reported cases fell from 21,000 in 2011 to approximately 250 in 2012. In regards to the measles epidemic which is happening now, Yusuf writes that “The patients are just lucky that what’s good for the politicians happens to be good for them, too.”

This article really shows how epidemic diseases affect all aspects of society, including the government and politics. In this case, a measles epidemic was a way to attack another political party. This reminds me of our Black Death unit where we studied several different situations where the disease was being used as a form of bioterrorism. Dating back to 1346, the Mongol Tartar army hurled infected plague victims’ bodies over Caffa’s walls due to financial disagreements. Similarly, a toxin, Agent Orange, was sprayed throughout Vietnam in the late 1960’s, causing major defoliation and disease-infected crops.

Although the measles epidemic in this article is not being used as a direct form of bioterrorism, it has stirred many political feuds. I agree with Yusuf that the measles patients are lucky that the government in Punjab is under high pressure to provide proper healthcare for its citizens. Although this can be seen in a negative light, I think healthcare is inevitably driven by political issues that affect the people. Punjab is suffering from a political dispute and I believe the Pakistan Muslim League-Nawaz is working its best to improve healthcare for the benefit of the people.

New SARS-Like Virus Threatening to Spread by David DiRocco

Saudi women protect themselves from the novel coronavirus

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SARS along with HIV AIDS seems to be the main focus of epidemic medical attention these days. Even as suburban high school students, we encounter talks of these viruses everywhere from the television to school classes.

This is why I have chosen to present an article published by ABC News on February 14, 2013 about a new SARS-like virus showing up in the United Kingdom.

I have combined this summary of the ABC article with that of another, more recent article published by the World Health Organization on February 21, 2013.

This is called 'novel coronavirus', or NCoV. In an informal setting, it is sometimes called Saudi SARS.
This respiratory disease was first found in a Qatari patient in the Middle East who had recently traveled to Saudi Arabia in September of 2012.
Much like Severe Acute Respiratory Syndrome (SARS), which had killed a tenth of the 8,000 people it had infected worldwide, symptoms common to both viruses include severe respiratory illness, fever, coughing and breathing difficulties.
There is a family cluster of three in England who all test positive for NCoV. One of which, who already had underlying health issues, has died.

“Confirmed novel coronavirus infection in a person without travel history to the Middle East suggests that person-to-person transmission had occurred in the UK,” said John Watson, the Health Protection Agency (HPA) head in Britain in relevance to the most recent case for England.

The WHO said that although this case in England seems to have been of person-to-person transmission, it still believed “the risk of sustained person-to-person transmission appears to be very low.”

On February 21, 2013, The Ministry of Health in Saudi Arabia had informed WHO of another confirmed case of novel coronavirus. The patient was hospitalized on January 29 3013 and had died on February 10. The worldwide number of confirmed infections is currently at 13. Six of which have died. Most of these patients have recently been to the Middle East.

WHO does not believe that any trade restrictions with the Middle East is necessary nor do they believe that any special screening at points of entry with regard to this event needs to be applied. WHO continues to closely monitor the situation.

This appearance of NCoV is very startling. It is frightening to consider what this relatively small outbreak has potential to become. The virus is very deadly and has the ability to pass from person to person. WHO encourages anyone with strange, unexplained pneumonia or severe respiratory illness not responding to treatment to be tested.

For the ABC article: http://www.abc.net.au/news/2013-02-14/new-sars-like-virus-shows-person-to-person-transmission/4519386

For the WHO publication: http://www.who.int/csr/don/2013_02_21/en/index.html

Picture credit: http://en.mercopress.com/2012/09/26/following-two-cases-world-health-organization-instructs-on-novel-coronavirus