- The Washington Times - Wednesday, September 6, 2006

TUGELA FERRY, South Africa — A deadly new strain of extremely drug-resistant tuberculosis discovered in South Africa is likely to have spread beyond the rural area where 52 of the 53 persons diagnosed with it have died, the doctor who discovered the super bug said.

The extent of the outbreak in the KwaZulu-Natal region of eastern South Africa is unknown because tests are expensive and specialized, said Dr. Tony Moll.

Dr. Moll identified the strain in tests carried out at King George V Hospital in Durban, the provincial capital about 150 miles southeast of Tugela Ferry, where he works at a government hospital.

“Most hospitals don’t have such facilities and support,” Dr. Moll told the Associated Press this week.

Extremely drug-resistant TB has been identified among mobile miners and probably can be found all over the country, Dr. Moll said.

The World Health Organization issued a warning at a press conference in London on Friday. WHO classified the strain as extremely drug-resistant, saying drugs from two of the six medicines used as a last line of defense against TB proved ineffective against the new strain.

Drug resistance is a common problem in TB treatment, but the new strain appears particularly virulent. Worldwide, about 2 percent of drug-resistant TB cases are classified as extremely drug-resistant.

Dr. Moll found only a few cases in thousands of people tested, but said the strain was “very highly troubling and alarming because of the very high fatality rate.”

TB has been on the rise because AIDS has lowered so many South Africans’ ability to fight it and other infections. All 53 patients who had extremely drug-resistant TB tested positive for HIV or were suspected positive, Dr. Moll said.

The government estimates more than 5.5 million of the 44 million South Africans are HIV-positive, second only to India. On average, more than 900 people die of the disease each day in South Africa.

A high illiteracy rate and failure to complete the grueling six-month regimen of medication that can cure TB has fueled a crisis with drug-resistant TB in South Africa.

Dr. Moll said his Church of Scotland Hospital, founded by Scottish missionaries and now government-run, has 1,300 people on anti-retrovirals but that there probably are 10,000 or 12,000 in the community going untreated for many reasons, including the stigma attached to AIDS. The doctor, who has worked at the hospital for 20 years, said he became suspicious when AIDS patients responded well to anti-retrovirals but died rapidly.

Further tests showed the TB strain was drug-resistant. Sixty percent of the patients had never had TB before, so had no history of failing to complete the course of medication, which usually leads to resistance.

Officials from the WHO, the South African Development Community and the U.S. Centers for Disease Control and Prevention will meet in South Africa this week to discuss how to confront the threat posed by drug-resistant TB.

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