According to reports in Reuters and the LA Times, Los Angeles County Department of Public Health aided by the Centers for Disease Control and Prevention (CDC) have identified 78 cases, including 11 deaths, from a unique strain of tuberculosis. The LA County Health Department is trying to track down, test, and treat those who have this strain of the disease. As the LA Times puts it, “But officials are concerned that the outbreak could spread beyond skid row if action isn’t taken.”
When such a “scare” of a disease comes around, there is a notion of “It can’t happen to me.” Many people will decide that this mainly affects people on skid row, mainly alcoholics, drug users, and prostitutes. They stay secure in their notion that it can’t happen to their middle-class or upscale gated communities, coffee shops, malls, and schools. Moreover, as taxpayers, they balk at funding the detection and control of such disease. While I’m sure that the LA Health Department is putting everything they can into it right now, that if this goes on very long they will be told by the taxpayers through the representative government that there are “other priorities”.
Unfortunately, the notion of the underclass having the disease and it remaining there is flat-out untrue. If just one person goes into that area and goes into their area – a police officer, firefighter, hotel maid, restaurant worker, soup kitchen or shelter volunteer, bargain hunter, drug dealer, or anyone, then comes into their upscale community or someone in the community goes to them, it’s easily spread, and then it spreads through the community – across all socioeconomic classes.
Moreover, this is not just a problem of Los Angeles. With the ease of travel in the early part of the 21st century – automobiles, buses, planes, and trains, it will not be long before someone acquires this strain of TB in the LA area, and travels to other parts of the United States – and the world – spreading the disease before they even know they are sick. That is true even if they are frequently tested.
If this strain is not easily treated with the existing TB drugs, making it a variant of a drug resistant strain, this could have dire consequences for the majority of the US population. It would be just as bad as if it were a TB-XDR or TB-MDR strain coming from North Korea, as I’ve previously blogged on this site. It will be worse, because this strain already exists here in a number of people.
TB is a slow-acting infection in many cases. It will be years or decades before this is taken seriously by the majority of the public. Alas, the majority of Americans are nearly complacent about TB – that it was stamped out years ago, as we don’t have TB sanitariums as we did even in the early part of the 20th century. The TB that exists is considered to be a problem with the third world, on illegal immigrants from third-world countries, from the “skid row” alcoholics and drug users (along with the notion that it’s their fault for not “living right”). And, moreover, a problem in AIDS.
In fact, TB is considered one of the “AIDS-defining diseases” according to the CDC and AIDS awareness, treatment, or activism organizations. That is, a condition which if you have, is considered evidence for a diagnosis of AIDS. Of note, a positive HIV test is no longer a requirement for a diagnosis of AIDS. So, someone who is a drug user, gay, or Haitian with this strain of TB gets it diagnosed as AIDS. Someone who is heterosexual, American, not suspected of drug use will be diagnosed with TB, possibly of a particular strain or type.
This could cause a problem for containing the disease, as well as controlling it.
Getting the TB test will probably cause some people to get an AIDS diagnosis. There is still a stigma associated with AIDS, because HIV which used to be part of the definition of AIDS is spread through certain behaviors – specifically it’s usually sexually transmitted or transmitted via needle sharing in drug use. A few people are recognized to have gotten it without engaging in risky behaviors, including infants, recipients of HIV-tainted blood, accidental needle sticks, and the like.
This will lead to less people allowing themselves to be tested for TB because of the stigma attached to getting a diagnosis of AIDS. Diagnosing them with AIDS makes it less likely that they will get appropriate treatment for their TB, instead of a large cocktail of expensive drugs with horrible side effects. The proper treatment for TB is expensive enough – especially drug-resistant strains of TB, but there’s no need to add other things, and possibly not include the TB drugs.
Now, it is possible to have Tuberculosis and a legitimate diagnosis of AIDS as well. I’m not refuting that. It’s also a given that a significant number of people with TB will be wrongly given a diagnosis of AIDS – along with its death sentence.
There are strains of TB which do not respond well or at all to the drugs we have for them. They are also just as easily spread as other strains of tuberculosis. In the past, all identified TB patients were quarantined or isolated via the TB sanitariums. The World Health Organization suggests quarantining or isolating people with TB-XDR (EXtensively Drug Resitant) if voluntary measures do not work. The CDC maintains the ability to quarantine people against their will, even though they have only done it once with TB-XDR in 2007, and it was many years previously that they had quarantined a case of tuberculosis. But, they still can.
AIDS quarantines have been talked about in the past. It was talked about in the 1980s, and there were such proposals for laws. They were shot down, because AIDS as caused by HIV can only be transmitted by contact with bodily fluids – not casual contact. However, now with TB being an AIDS-defining illness, along with certain other persistent infections including candida or recurrent pneumonia which are transmitted by casual contact, it might be time to revisit that.
AIDS activists will not permit such a thing! At the same time that they say that hard-to-transmit HIV is not an AIDS-defining condition, they say that AIDS is equally difficult to transmit. To increase the number of AIDS victims, and research funding, and funding for AIDS organizations, all of these other conditions, including TB, were put on the list of AIDS-Defining illnesses. Now, tuberculosis redefined as AIDS IS a transmittable disease, is airborne, and is something that must be controlled.
Who will win? The public who may become panic-stricken for fear of this disease, whether it is by then called tuberculosis, or AIDS, or something else, will demand protection. It may mean another bout with murderous homophobia – the -phobia being the operative word because it is fear of TB – reclassified as AIDS which has been thought of as a primarily gay disease, is killing their friends and family.
I’ve said for a long time that the next pandemic will be from a disease which has been well-known for a long time, and possibly or probably treatable with existing medicines which are off-patent. I’ve said that the old disease will get convoluted in the definition of a new disease which gets a lot more research funding than any old disease, and the whole thing will become a disaster, all in the quest for funding and the educated researchers who should know better about what they’re doing, being blinded by the notion of getting recognized for their research in the new disease. It won’t give as much prestige to discover an old, well-understood disease is causing death and suffering in modern times. The pharmaceutical companies which fund a lot of disease and drug research won’t make any money if a researcher discovers that a dread-disease can be treated with Isoniazid or Rifampin – an important discovery a couple of generations ago.