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Drug-resistant TB worries officials [Mexico, S. Texas]
The Brownsville Herald/Monitor ^ | Jan. 30, 2006 | JENNIFER C. SMITH

Posted on 01/30/2006 9:50:39 AM PST by SwinneySwitch

REYNOSA — Pharmacy saleswoman Manuela Escobar Muñez quickly found at least three small cartons of antibiotics used to treat tuberculosis at the Farmacia Benavides on Avenida Miguel Alemán.

“This is the strongest,” she said, tapping the box labeled Ketek. “It’s very popular.”

In Mexico, anyone can pick up the antibiotic telithromycin — sold under the Ketek brand — or other potent antibacterial drugs such as rifampin to treat TB. Yet, Ketek is not specifically designated to treat the illness.

Easy dispensation of it and other drugs frustrates health officials, who say short-term and inconsistent medication use creates a drug-resistant variety of the life-threatening illness.

Tuberculosis is a bacterial disease usually affecting the lungs. If not treated properly, it can be fatal. Officials say the disease poses such a great public health risk because it is contagious and spread through coughing or sneezing.

The drug-resistant TB variation is costlier and takes longer to treat, hurting already strained federal and state budgets. And if re-sources are limited in treating normal TB cases, drug-resistant and the even more serious multi-drug resistant cases will only mul-tiply.

“In my opinion, the growth of this (drug resistance) could be considered an epidemic situation,” said Eduardo Olivarez, chief ad-ministrative officer for the Hidalgo County Health Department.

Drug resistance stemming from immigration from countries with lax TB treatment enforcement by the government and private physicians, intravenous drug use and alcohol abuse in a transient population, and diabetes have all contributed to making TB a potential health crisis.

MDR-TB incidents still comprise a small portion of TB cases but increased diagnosis in the Valley means more drug-resistant cases are inevitable. In 2004, the county health department handled 101 new cases of TB, a 25-percent increase from 2004.

“A slight increase in MDR cases causes us to use more money and more manpower to treat those cases,” Olivarez said.

Drug-resistant TB results when a patient takes fewer than the prescribed drug dosages, uses them occasionally or stops taking it too soon. The medication no longer kills the bacteria.

In MDR-TB, a patient’s immune system no longer responds to treatment from the basic antibiotics rifampin and isoniazid.

And subduing the drug-resistant TB threat is tough when ongoing state budget reallocations mean larger cities such as Dallas and Houston will probably receive the lion’s share of state TB funds. Local and regional health departments that receive funding through the state must then contend with reduced TB testing operations and staffing.

It costs the state about $2,800 and takes six to nine months to treat a standard TB patient. An MDR-TB client, on the other hand, has treatment costs running about $250,000 for the two-year duration of the treatment, said Charles Wallace, manager of the state’s infectious disease, intervention and control branch.

Hidalgo County’s TB budget hovers around $800,000, but “the increase (in TB cases) is not proportional to the increase in popula-tion,” Olivarez said.

“If the projected 20 percent cuts in funding for the 2006-2007 fiscal year occur, it will cripple the TB treatment operations in Hi-dalgo County,” Olivarez said.

The state’s $17 million TB budget, which is partially funded through the federal Centers for Disease Control and Prevention, is already limited in treating even standard TB cases, said Dr. Brian Smith, regional director of the Texas Department of State Health Services’ Region 11, which includes 19 South Texas counties including Hidalgo and Cameron.

“If we’re not able to … test the contacts and assure that treatment is complete in every case, then TB rates will go up,” he said.

The rate of incidence in the Rio Grande Valley runs at about 16 per 100,000 people, which is double the state TB incidence rate.

The state covers the cost of MDR-TB drugs for patients who report to the local health departments. But this means big bucks: For example, a multiple drug-resistant Valley family consisting of nine people recently cost the state $4 million in a three-year period. The figure includes the cost of drugs and multiple hospitalizations.

The disease is harder to treat when patients face a slew of health problems, especially diabetes.

“You can go up to 20 to 25 pills a day (per person), add to that insulin and diabetic meds,” said Cynthia Tafolla, director of Grupos Sin Fronteras (Groups without Borders), a binational effort between Mexico and the United States to minimize TB cases and treat them in Mexico.

The project, which began in 1995, collects samples from TB suspects in seven clinics Tamaulipas.

“With migration back and forth from Mexico to the United States, we definitely have to screen anyone who may come in contact with a case or someone who is a suspect,” she said.

They have reason to worry: 65 percent to 75 percent of the roughly 40 clients the program has treated each year in the last few years are multi-drug resistant.

But the binational program, which tested more than 1,000 people in 2005, has maintained a $160,000 budget for seven years de-spite a growing population seeking treatment and higher drug costs. Thus, strained program resources could limit the number of people who can be helped.

So patients who could have been treated at Mexican clinics will get treated in the United States at greater costs to the government — or not seek treatment at all, Tafolla said.

New drug-resistant and MDR-TB cases in Africa, Southeast Asia and Latin America have spurred drug companies to pour hun-dreds of millions of dollars in developing drugs to combat the infection, said Dr. Dave Griffith, the chief of TB services and medical director at the Center for Infectious Diseases in San Antonio.

“But how close they are to general use is still problematic,” he said.


TOPICS: Culture/Society; Foreign Affairs; Mexico; News/Current Events; US: Texas
KEYWORDS: aliens; borderslanguage; culture; illegalaliens; illegals; immigrantlist; tb
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To: SwinneySwitch

These are the pest-ridden workers that your local contractor brings to your home to do work at half the price...for which he charges you full-price, of course. Warms your heart, doesn't it.


21 posted on 01/30/2006 4:12:42 PM PST by kittymyrib
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To: spectre
Also, how many Illegal Immigrant children who attend our public schools have had the REQUIRED child hood immunizations?

Seriously, that was my next thought. Our school has a great many who I get to pay school taxes on and provide with free lunches and English As A Second Language classes.

22 posted on 01/30/2006 4:15:21 PM PST by mtbopfuyn (Legality does not dictate morality... Lavin)
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To: kittymyrib; SwinneySwitch

Did you watch last night's Extreme Home Makeover or whatever the name of the show is where they build a down on their luck family a new home? I was and am still royally ticked off. One of the designers was out with a group of 20-30 Mexican construction workers and he was praising their work and telling the viewing audience they didn't speak English. Hello, ICE! Talk about easy pickin's for deportation.


23 posted on 01/30/2006 4:23:23 PM PST by mtbopfuyn (Legality does not dictate morality... Lavin)
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To: SwinneySwitch

Investment opportunity--looks like a med with a growing market. Imagine TB making a comeback in the US.


24 posted on 01/30/2006 6:25:25 PM PST by Mamzelle
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To: mtbopfuyn
Here's a story to tick you off--suppose there's a fine art teacher at your school, and you want your kids to be in his class. Only your kids don't make it in. Walking past the classroom, you notice that almost every child in the class in Latino--a predisposition for art? Nah.

An art or music class is a great place to warehouse students who don't speak English.

This so rich RINOs can get their grass cut, cheap.

25 posted on 01/30/2006 6:28:33 PM PST by Mamzelle
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To: SwinneySwitch

Can TB be transmitted by food?


26 posted on 01/30/2006 7:26:41 PM PST by DeaconNoGood
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To: DeaconNoGood

Can TB be transmitted by food?

You'd better hope not!

http://www.freerepublic.com/focus/f-news/1424173/posts

http://www.freerepublic.com/focus/f-news/1396771/posts


27 posted on 01/31/2006 1:10:13 AM PST by garandgal
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To: DeaconNoGood

Can TB be transmitted by food?

Nah, for the most part that is for Hepatitis. Also rampant in the illegal immigrant society. Think of that when ya have your burger at a joint where nobody seems to speak english.


28 posted on 01/31/2006 6:51:17 AM PST by Sterco
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To: DeaconNoGood

"Can TB be transmitted by food?"

Maybe, if an infected person coughs or sneezes on it.


29 posted on 01/31/2006 7:52:33 AM PST by SwinneySwitch (Liberals-beyond your expectations!)
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