As usual my delving into family history has prompted a post … I’ve been researching my Great-great-Uncle who was killed in action at Somme, France whilst serving as a WW1 ANZAC and discovered that his father, my great-great-grandfather died from (and I shall quote from the Marlborough newspaper that it was printed in) … “that dread disease consumption“.
Now you may consider TB to be a third world, old-fashioned type of disease and to a degree you would be right however TB remains the second greatest killer globally (HIV/AIDS is number one) due to a single infectious agent. In 2013, 9 million people fell ill with tuberculosis and 1.5 million died as a result – 480,000 of these cases were MDR-TB (multi drug resistant). There is an upside to all this in that 37 million lives were saved due to effective diagnosis and treatment between 2000-2013 and the number falling ill to the disease each year is declining albeit slowly. New Zealand statistics show 305 cases nationwide during 2014 and this number has been relatively stable over the past five years.
MDR-TB is defined as those strains that are resistant to at least Isoniazid and Rifampicin (the two most powerful and standard first line drugs for treatment of TB). XDR-TB are strains that are extensively drug resistant and are defined as MDR-TB with additional resistance to any fluoroquinolone and at least one of the second line agents (Amikacin, Capreomycin or Kanamycin). Of the 480,000 MDR-TB cases in 2013 about 9.0% of these were determined to be XDR-TB. Within New Zealand the rate of resistance is much lower, on average only 1-2% of isolates each year showing this level of resistance. In the past 10 years there have been 33 cases of MDR-TB in good ol’ NZ and all but two of these cases were born overseas where it has been assumed they contracted it – 29 of these 31 cases were born in an Asian country. Only one case of XDR-TB has ever been identified in New Zealand, this was in 2010. I think this is one time were our geographical isolation from a large part of the world is to our benefit.
Tuberculosis was a disease that the WHO considered dropping from their watchlist in the 1960’s/1970’s due to it’s decline however it made a huge resurgence in the 1990’s with the number of HIV/AIDS cases increasing and is certainly a disease which we cannot afford to ignore.
You can view a copy of the 2014 WHO global TB report here.