Experts: confine patients to stop new TB outbreak
Published Monday, January 22, 2007 11:35PM EST
A deadly new form of tuberculosis sweeping through South Africa has killed dozens of people, and experts say the outbreak must be stopped by forcibly isolating those infected.
"If you're coughing and you have tuberculosis in your sputum, you're capable of transmitting the disease to others," Dr. Ross Upshur, director of the Join Centre for Bioethics at the University of Toronto, told CTV News.
Upshur is one of three physicians who made the recommendation, published in the Public Library of Science Medicine, an international medical journal.
The other two, Jerome Amir Singh and Nesri Padayatchi, are members of South Africa's Centre for AIDS Programme of Research.
Extreme drug resistant tuberculosis (XDR-TB) has killed more than 70 people in the past several months, and continues to spread at an alarming rate.
Last September, the World Health Organization said there were 53 confirmed cases, and all but one were fatal.
A woman named Zuma began feeling feverish and suffering headaches in November, and was soon diagnosed with XDR-TB. Because it's resistant to almost all existing antibiotics, doctors have been forced to give her a drug that's so toxic it's also damaging her health.
"I'm scared," she said.
To stop more people like Zuma from suffering, Upshur has urged health officials to hold patients against their will if necessary, but pay for their welfare.
"This isn't carte blance to public health authorities to start locking people up," he told The Associated Press. "If we ask individuals to forgo their rights, they need to be supported."
Ronnie Green-Thompson, an adviser to the South African Department of Health, hinted in a press statement that officials are taking Upshur's proposal seriously.
"Holding the patient against their will is not ideal, but may have to be considered in the interest of the public," said Green-Thompson, adding that the legal opinion of human rights groups is also important.
Antibiotics-resistant tuberculosis exists in other areas of the world, including the United States. But experts believe poverty and the ravages of AIDS have created an ideal environment for XDR-TB to spread.
Many patients have weakened immune systems from AIDS, or are unable to take effective medication because they lack the money.
"I am afraid of XDR-TB," said Dr. Padayatchi, one of the country's leading TB experts. "I would be horrified if I got XDR-TB. Of course, we don't say that to patients."
With a report by CTV's Murray Oliver in Durban, South Africa, and files from The Associated Press