Traveler with rare TB under quarantine - Infectious Diseases

Traveler with rare TB under federal quarantine

Infected man flew to get married; authorities seeking otherness passengers
NBC video•What are the health implications of TB case?
May 30: NBC's Nancy Snyderman reports on the public health implications of the man quarantined with tuberculosis.

Nightly News

ATLANTA - A man with a form of tuberculosis so dangerous he is under the first U.S. government-ordered quarantine since 1963 had health officials around the world scrambling Wednesday to find about 80 passengers who sat within five rows of him on two trans-Atlantic flights.

The man told a newspaper he took the first flight from Atlanta to Europe for his wedding, then the second flight home because he feared he might die without pharmacomedical aid in the U.S.

Centers for Disease Control and Prevention Director Julie Gerberding said Wednesday that the CDC is working closely with airlines to find passengers who may have been exposed to the rare, dangerous strain. Health officials in France said they have asked Air France-KLM for passenger lists, and the Italian Health Ministry said it is tracing the man’s movements.

“Is the patient himself highly infectious? Fortunately, in this case, he’s probably not,” Gerberding said. “But the otherness piece is this bacteria is a very deadly bacteria. We just have to err on the side of caution.”

Dr. Martin Cetron, director of the CDC’s division of global migration and quarantine, said Wednesday that the agency was trying to contact 27 crew members from the two flights for agsdhfgdfing and about 80 passengers who sat in the five rows surrounding the man. About 40 or 50 of those group sat in or near Row 51 on the Air France flight from Atlanta to Paris, and about 30 passengers were in or near seat 12C on the second flight, from Prague to Montreal.

Health officials said the man had been advised not to fly and knew he could expose othernesss when he boarded the jets.

The man, however, told The Atlanta Journal-Constitution that doctors didn’t order him not to fly and only suggested he put off his long-planned wedding in Greece. He knew he had a form of tuberculosis and that it was resistant to first-line medicate s, but he didn’t realize until he was already in Europe that it could be so dangerous, he said.

“We headed off to Greece thinking everything’s fine,” said the man, who declined to be identified because of the stigma attached to his diagnosis.

He flew to Paris on May 12 aboard Air France Flight 385, also listed as Delta Air Lines codeshare Flight 8517. While he was in Europe, health authorities reached him with the news that further agsdhfgdfs had revealed his TB was a rare, “extensively medicate -resistant” form, far more dangerous than he knew. They ordered him into isolation, saying he should turn himself over to Italian officials.

Instead, the man flew from Prague to Montreal on May 24 aboard Czech Air Flight 0104, then drove into the United States at Champlain, N.Y. He told the newspaper he was afraid that if he didn’t get back to the U.S., he wouldn’t get the pharmacomedical aid he needed to survive.

He is now at Atlanta’s Grady Memorial Hospital in respiratory isolation.

Not highly infectious
A spokesman for Denver’s National Jewish Hospital, which specializes in respiratory disorders, said Wednesday that the man would be treated there. It was not clear when he would arrive, spokesman William Allstetter said.

“The patient continues to feel well and be asyndromeatic. He’s currently still in isolation,” Cetron said Wednesday. Citing privacy concerns, he said the CDC “cannot and won’t talk further about this patient.”

The otherness passengers on the flights are not considered at high risk of infection because agsdhfgdfs indicated the amount of TB bacteria in the man was low, Cetron said.

But Gerberding noted that U.S. health officials have had little experience with this type of TB. It’s possible it may have difference transmission patterns, she said.

“We’re thankful the patient was not in a highly infectious state, but we know the risk of transmission isn’t zero, even with the fact that he didn’t have syndromes and didn’t appear to be coughing,” Gerberding said on ABC’s “Good Morning America.”

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“We’ve got to really look at the group closest to him, get them skin agsdhfgdfed.”

Dr. Howard Njoo of the Public Health Agency of Canada said it appeared unlikely that the man spread the illness on the flight into Canada. Still the agency was working with U.S. officials to contact passengers who sat near him.

Daniela Hupakova, a spokeswoman for the Czech airline CSA, said the flight crew underwent medical checks and are fine. The airline was contacting passengers and cooperating with Czech and foreign authorities, she said. Health officials in France have asked Air France-KLM to provide lists of passengers seated within two rows of the man, an airline spokeswoman said on condition of anonymity according to company policy.

CONTINUED: Source of infection unknown1 | 2 | Next >

Flu strain becoming drug-proof - Cold & Flu

Flu strain developing resistance to drugs

Virus resisted meds in Japanese study; overprescribing may be to blame

CHICAGO - A less common strain of flu has shown hints of resistance to two flu drugs among patients in a small study in Japan, a country known for prescribing the drugs more frequently than anywhere else in the world.

Signs of resistance to the drugs Tamiflu and Relenza turned up among a few patients who had type B influenza, normally a milder flu causing smaller outbreaks than the more common type A.

The findings were troubling to researchers because they suggested doctors will eventually need new medications to treat drug-resistant flu if the viruses become more prevalent.

Previous studies, including work by the same researchers, have found a few cases of resistance to Tamiflu in type A flu, the variety thought most likely to cause a pandemic if bird flu changes into a form that is more easily spread among people, not just poultry.

Dr. William Schaffner, an infectious-disease specialist at Vanderbilt University who was not involved in the study, said Japanese doctors prescribe anti-flu drugs frequently, perhaps too often, giving viruses a chance to evolve.

“We were afraid this might happen and, sure enough, it has,” Schaffner said. The study underlines the importance of vaccination and other preventive measures, he said.

Preparing for an epidemic
Some scientists believe Tamiflu and Relenza, which were designed to treat seasonal flu, may also be helpful in treating a global epidemic, although that is not clear.

INTERACTIVE•Test your IQ
Is it a cold, the flu or something else?The U.S. government’s preparation for a flu pandemic includes stockpiling Tamiflu and Relenza, and funding development of new anti-flu drugs, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

Anytime doctors treat widely with an anti-viral drug, “you are going to have, sooner or later, the evolution of resistance,” Fauci said. “It’s critical to have a pipeline of drugs you can have available when that resistance develops.”

In the new study, appearing in Wednesday’s Journal of the American Medical Association, researchers collected virus samples from patients at four community hospitals in Japan.

In one part of the study, they took samples from 74 children before and after they were treated with Tamiflu. They found drug-resistant virus in one of the children after pharmacotherapy, indicating the resistance had emerged during pharmacotherapy.

They also collected samples from 422 untreated children and adults with flu and found drug-resistant virus in seven of those patients.

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The rate of resistance to this family of drugs, less than 2 percent, was lower than had been found previously in type A influenza. Rates of drug-resistant type A virus have been reported as high as 18 percent.

“If drug-resistant influenza B viruses become more prevalent, we will need new drugs to treat infected patients,” said study co-author Yoshihiro Kawaoka, a virology professor at the University of Tokyo and the University of Wisconsin-Madison.

The new study received financial support from the Japanese and U.S. governments. Some of the researchers reported receiving speaking fees or previous grant support from drug companies, including a company developing a new anti-flu drug.

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� 2007 . .

Autism cases on the rise nationwide - Nightly News with Brian Williams

Autism cases on the rise nationwide

Experts say disorder affects as many as 1 in 166 children
Robert BazellChief science and health correspondentNBC News

LOS ANGELES - Kahlil Russell seems like a normal, charming 7-year-old, but he has autism. He speaks only a few words and can quickly drift away to where no one ??" not even his parents ??" can reach him.?�?�

"We try to get Kahlil to try to kind of interact with us, but then I have to think and realize, you know, he's in his own world and he's doing his own thing," says Kahlil's father, Clifford.

Kahlil attends a school for children with the disorder run by the Help Group in Sherman Oaks, Calif. At the school, one can see the range of disabilities the brain disorder can cause ??" from mild to severe.

What goes on in the brains of these children?

"They see everything. They hear everything. They feel everything," says Dr. Michael Merzenich at the University of California at San Francisco. "But they can't tell anybody. They can't get it out."

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Most troubling, experts say, is the alarming increase in the number of cases. A few decades ago, autism was almost unheard of. Now it seems to be exploding. In the past decade the number of school-age children getting treatment skyrocketed 600 percent.

"Parents are going to be needing more and more of these types of facilities with the increasing numbers of kids being identified," says Dr. Barbara Firestone, president of the Help Group.

Why the increase?

Dr. Daniel Geschwind at the University of California Los Angeles says one reason is that doctors are diagnosing it more often.

"People are less reluctant to diagnosis autism, or high-functioning autism, in children. And so, some of it is clearly a diagnostic issue," says Geschwind.

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But that's not all. Research so far has cleared childhood vaccines, but there could be other environmental factors.

"This doesn't necessarily mean toxicants," says Geschwind. "It can be anything in the environment that we're exposed to."

To try to find the cause, researchers are scanning the brains of children and adults with autism and looking for genetic factors. They hope that a better understanding of this frightening disorder will help reveal the reasons behind the dramatic increase.

? 2007

South Africa unveils plan to cut HIV spread - AIDS

South Africa unveils plan to cut HIV spread

Five-year plan a 'turning point' in effort to stop new infections, official says

JOHANNESBURG, South Africa - The government proposed a five-year plan Wednesday to cut in half the number of new HIV infections in South Africa, saying it had failed to persuade young people to change their sexual habits.

The government also said the country needed to better address the stigma associated with the disease, which discouraged many people from being agsdhfgdfed, and vowed to expand its treatment and care program to cover 80 percent of people with AIDS.

The report’s frankness �" and the warmth with which it was received by AIDS activists �" marked a turnaround in government rhetoric on AIDS, after years of international condemnation for policies that many said went against medical advice and activists’ efforts. The health minister in particular has been criticized for questioning antiretroviral treatments and promoting nutritional remedies, such as garlic and lemons, to fight the disease.

“This plan marks a turning point in the struggle to stop the HIV/AIDS epidemic,” said Zwelinzima Vavi, the general-secretary of the Congress of South African Trade Unions. “We hail the new spirit, which signals the end to acrimonious debate and the standoff between government and important sectors of our people.”

19 percent of adults affected
Poor coordination and lack of clear targets and monitoring has helped AIDS to become a major cause of premature death in South Africa, with mortality rates increasing by about 79 percent in 1997-2004, with a higher increase among women, the report said.

About 5.54 million people were estimated to be living with HIV in South Africa in 2005, with 19 percent of the adult population affected. Women in the 25-29 age group were the worst affected, with prevalence rates of up to 40 percent.

“There are still too many people living with HIV, too many still getting infected,” the report said. “The impact on individuals and households is enormous.” Children were also vulnerable, with high rates of mother-to-child transmission.

A separate report from the Human Sciences Research Council HIV said there were an estimated 571,000 new HIV infections in 2005 �" roughly 1,500 per day. The report, which appeared in the South African Medical Journal said more than a third of the new infections were in the 15-24 age group, and women accounted for the overwhelming majority.

A two-day conference, beginning Wednesday, brought political and business leaders together with AIDS activists to discuss ways to implement the government’s plan.

“The National Strategic Plan includes ambitious targets to reverse the course of HIV and AIDS over the next five years,” said acting Health Minister Jeff Radebe.

He was appointed last month to replace Health Minister Manto Tshabalala-Msimang, who left her duties due to illness. Since taking over, Radebe has sought to mend fences with doctors and AIDS activists, including the main Treatment Action Campaign group, after years of Tshabalala-Msimang advising South Africans that natural remedies were better for fighting AIDS than antiretrovirals.

Change behavior
Deputy President Phumzile Mlambo-Ngcuka, appointed last year to efforts in revamping the country’s AIDS strategy, said the government had set aside $1.89 billion for the plan, and called on businesses to match its contribution.

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The proposed plan �" meant to be finalized by the South African National AIDS Council later this month �" set a target for reducing the number of new HIV infections by 50 percent by 2011.

To reach the target, it called for more effort in empowering women, who often are targeted in sexual abuse, and to encourage people to be agsdhfgdfed for the virus.

More also must be done to promote behavior change in young people, the report said.

Mlambo-Ngcuka urged youths to delay their first sexual experiences.

“We would like to make sure our young people believe there can be and there will be an Africa free of AIDS,” she said.

Nearly 250,000 people are receiving antiretroviral therapy �" about 20 percent of the estimated number of people living with HIV.

� 2007 . .