In November of 2008, an aricle was released to the public on new and emerging infectious diseases of today. The main ailment discussed was MDR TB--rather, Multi-Drug-Resistant Tuberculosis--which, according to doctors, is a new strand of the traditional, fairly easy-to-treat TB. MDR TB is resistant to the two drugs most commonly used to treat this disease, and as a result it can take up to four times as long to cure and the treatments that must be used instead are more costly and more toxic to the human body. What's more, the rate at which cases of the new strand are occuring is somewhat alarming, but at the same time not all that surprising considering MDR TB is just as contagious as traditional TB. Therefore, we need to do everything in our power to prevent further spread--we're not careful, we may have a global epidemic on our hands!
Like all organisms on Earth, germs are constantly multiplying and mutating in an attempt to make their race stronger. Thus, it makes sense that if a mutation occurs in a pathogen allowing it to become stronger and more resistant to certain drugs, it will be more likely to survive and reproduce in the future. With this knowledge in mind doctors are theorizing that MDR TB is a manmade ailment, in that many people will simply stop taking their antiboitics before the prescribed dosage is complete because they don't feel sick anymore. This, in fact, is a huge mistake, for it allows more of the stronger TB cells to multiply while the immune system is busy fighting off the remaining pathogens that would have been killed by antibiotics, and, in the long run, leads to new diseases like MDR TB that are much harder to get rid of. To solve this problem, most doctors are now highly recommending directly-observed treatment (DOT) with TB cases so as to make sure the patient takes ALL of their medication and prevents any further mutations of the strain...but this action is very expensive and can only do so much.
In recent years TB hasn't been much of a threat to our society here in the US, thanks to our decent healthcare and education system. However, the world is small and things could change quickly if we don't act to prevent. Within the last five years there have already been several cases of MDR TB in the United States, brought from Thailand to California when refugees decided to relocate from overseas. The CDC is working hard to keep the "outbreak" under control, but we all must be cautious. MDR TB could appear anywhere in the world unexpectedly--therefore, we are ALL at risk! One good thing that's come of this new strain is that doctors and patients alike are working harder to make sure the FULL dosage of antibiotics is taken when prescribed. What's more, general knowledge of TB in the United States seems to be increasing over time. If we all work together and take care of ourselves and loved ones, we should be able to MDR TB in its tracks--seems like a good thing to strive for in 2009, yeah?
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Since the beginning of host-pathogen interactions, there has been an evolutionary "arms race" whereby a host continually evolves to become immune or adapt to a pathogen and in turn the pathogen co-evolves to become adapted against the hosts' immune system. I think you made a good commentary about how MDR-TB causes for even stronger drugs to fight it off and yet it comes at the cost of being toxic to us as well although to a lesser degree. It brings forth to deliberate about the possibility that during the course of the host and pathogen race, that perhaps both eventually evolve so well that the only thing that will kill the other, will also kill itself. I think your summary also inspires discussion on how medicine should be regulated. Granted that pathogens will naturally mutate but what about the mutations we could have prevented? Such as those infected individuals not finishing the dose of their treatment and/or being administered the incorrect dosage to begin with so that it's not strong enough to kill off the infection when needed. As you mentioned, MDR-TB may readily be due to individuals not owning up to their responsibility to follow through with their prescription as directed. The blunt truth of that is a shame for in the end we all have not only an obligation to ourselves but also to each other. With that, please finish your antiobiotics!
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