Thousands at risk as TB 'evolves with a vengeance'
Published 16/09/2011 | 05:00
Multidrug-resistant and extensively drug-resistant forms of tuberculosis (TB) are spreading at an alarming rate in Europe and will kill thousands unless health authorities halt the pandemic, the World Health Organisation (WHO) has warned.
Launching a new regional plan to find, diagnose and treat cases of the airborne infectious disease more effectively, the WHO's European director warned that complacency had allowed a resurgence of TB -- and failure to tackle it now would mean huge human and economic costs in the future.
"TB is an old disease that never went away, and now it is evolving with a vengeance," said Zsuzsanna Jakab, the WHO's Regional Director for Europe.
"The numbers are scary," Lucica Ditiu, executive secretary of the Stop TB Partnership told a news conference in London. "This is a very dramatic situation."
TB is currently a worldwide pandemic that kills around 1.7 million people a year. The infection is caused by the bacterium mycobacterium tuberculosis and destroys patients' lung tissue, causing them to cough up the bacteria, which then spreads through the air and can be inhaled by others.
Cases of multidrug-resistant (MDR-TB) and extensively drug-resistant TB (XDR-TB) -- where the infections are resistant to first-line and then second-line antibiotic treatments -- are spreading fast, with about 440,000 new patients every year around the world.
According to the WHO and Stop TB, 15 of the 27 countries with the highest burden of MDR-TB are in the WHO's European region, which includes 53 countries in Europe and Central Asia.
More than 80,000 MDR-TB cases occur in the region each year -- almost a fifth of the world's total. The WHO said precise figures for XDR-TB are not available because most countries lack the facilities to diagnose it, but officially reported cases of XDR-TB increased six-fold between 2008 and 2009.
Rates are highest in eastern Europe and Central Asia, but many countries in western Europe have increasing rates of TB and drug-resistant TB, Ditiu said. Britain's capital, London, has the highest TB rate of any capital city in western Europe with around 3,500 cases a year, 2pc of which are MDR-TB.
Treating even normal TB is a long and unpleasant process, with patients needing to take a combination of powerful antibiotics for six months. Many patients fail to correctly complete the course of medicines, a factor which has fuelled a rise in drug-resistant forms of the disease.
Treatment regimes for MDR-TB and XDR-TB can stretch into two or more years, costing up to $16,000 (€11,500) in drugs alone, and up to $200,000 to $300,000 per patient if isolation hospital costs, medical care and other resources are taken into account.
Experts say around 7pc of patients with straightforward TB die, and that death rate rises to around 50pc of patients with drug-resistant forms.
The WHO's plan for tackling tuberculosis emphasises the need for doctors and patients to be more aware of the disease, to diagnose and treat cases promptly with the right drugs, and follow patients up over many months or years to ensure they take their medications.