If ever there was a time to be getting more vigilant, not less, about combating tuberculosis, it is now, as strains of this ancient bug are becoming more virulent and better able to dodge our medical weaponry.
Take this disconcerting new study from researchers at the Johns Hopkins Bloomberg School of Public Health and colleagues in China, which found a strain of TB that actually “thrives” on rifampin, a front-line drug in the treatment of TB. The patient, a 35-year-old Chinese man, grew increasingly ill when doctors tried to treat him with a regimen that included rifampin. He was eventually cured when they switched to a different set of medicines, according to the study, which can be found here.
“Rifampin-dependent tuberculosis is an unrecognized and potentially serious treatment issue,” said Ying Zhang, MD, PhD, senior author of the study and Hopkins professor said, according to this news release. “Rifampin resistance is ominous. Our study highlights the potential dangers of continued treatment of MDR-TB with rifamycins that occur frequently due to delayed or absent drug susceptibility testing in the field.”
Against that backdrop, there was this story in Monday’s San Francisco Chronicle about potentially devastating cuts to that city’s TB control program.
“If we have five multi-drug resistant cases in San Francisco this coming year, we’re not going to have enough funding to manage them,” Dr. L. Masae Kawamura, director of San Francisco’s TB Control Section, told the paper. He said the TB section lost six employees this year to funding cuts. “We’ve already changed our operations to be lean, mean and efficient, but there’s a point where you’ve done everything you can, and that’s where we are now.”
Two days later, the SF Chronicle ran this piece about a man with drug-resistant TB who was allowed to board a flight from Philadelphia to San Francisco.
Taken together, these items do not paint a reassuring picture about the threat, or the response, to global TB.