Each year when our family renews our adoptive homestudy, we all have to repeat our TB skin test. I admit to thinking and verbalizing, ”TB test are old- fashioned and out-dated, wouldn’t it be more realistic to test prospective adoptive parents for HIV or a Hepatitis Virus?” It turns out that I was incredibly wrong about TB being out-dated; it seems that Tuberculosis is posing a major crisis in some public health circles.

Tuberculosis is a bacterial disease that is spread when infected patients cough; it usually affects the lungs. Programs are nearly always effective when well implemented, because TB is preventable and can be treated for about $16 per person, per year. Signs of TB have been found in ancient civilizations, such as Egyptian mummies, and it played a nasty role in the history of Utah. Known as the “consumption” in pioneer days, many young people suffered and died of it.

Mycobacterium tuberculosis is extremely drug-resistant tuberculosis XDR-TB; tuberculosis takes the lives of almost 2 million people every year. Apparently, it has been found in all nine provinces of South Africa, and at least one case of XDR-TB has been found in 28 other countries with more at risk, because of inadequate controls for airborne infection in the rest of sub-Saharan Africa.

International tuberculosis experts say the system is in deep trouble for many reasons: over use of antibiotics; failing to separate high-risk patients in hospitals and clinics; and cuts in spending for supplies of drugs and testing. When the bacteria are susceptible to antibiotics, tuberculosis is curable but can take months to treat with multiple medications; however, it becomes more deadly in its drug resistant form.

Healthy people aren’t as threatened by the outbreak of tuberculosis as the millions of people with weakened immune systems. Such as those infected by the H.I.V. AIDS virus, especially in poorer countries, or those being treated for cancer and other diseases. One study of patients infected with both XDR-TB and H.I.V. resulted in 85% of the patients dying from XDR-TB.

According to the NY Times 03/20/07

XDR-TB is defined as tuberculosis that is resistant to the two most important antituberculosis drugs (isoniazid and rifampin), along with two other drugs: a member of the fluoroquinolone class and at least one of three others (capreomycin, kanamycin and amikacin).

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