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Originally published June 12, 2007 at 12:00 AM | Page modified June 12, 2007 at 2:00 AM

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Guest columnists

We must step up our efforts against deadly TB strain

He's only 27 years old and he hasn't been charged with a crime, but Robert Daniels may be held in a jail in Phoenix until he dies.

Special to The Times

He's only 27 years old and he hasn't been charged with a crime, but Robert Daniels may be held in a jail in Phoenix until he dies.

Daniels is being quarantined in a hospital jail ward for carrying a highly contagious, virtually untreatable and very deadly disease.

Meanwhile, in South Africa, 100 patients fled a hospital after paramedics wearing head-to-toe protection brought in eight people with the same contagious infection.

This very real and very lethal disease is the same disease that has made headline news recently — it is a new form of tuberculosis called "extensively drug-resistant TB," or XDR-TB.

The deadly strain has been identified in 28 countries on five continents. It kills almost everyone it touches (up to 85 percent) with remarkable speed. In the first large outbreak in South Africa, 52 of 53 patients died, half within 16 days of diagnosis. More than 600 people have now been diagnosed with the disease in that country.

No one is safe from XDR-TB. As if to highlight the point, the widely publicized travels of Andrew Speaker remind us all that exposure to tuberculosis, and XDR-TB, can occur anywhere and at any time.

Tuberculosis is not an ancient scourge — it is a modern, growing epidemic. Just recently, King County reported that TB cases have doubled in the county compared with the same period last year. And while extremely drug-resistant TB hasn't arrived here yet, it is shaping up to be the public health crisis of 2007.

"It is here, it is really scary, and it is an emergency," warned Dr. Paul Nunn, the World Health Organization's coordinator of HIV and drug-resistant tuberculosis programs.

The U.S. Centers for Disease Control's Advisory Council for the Elimination of Tuberculosis has warned that "unless we take immediate measures, we as a nation will be forced to confront the inability to protect our population against this deadly strain."

Drug resistance makes the fight against TB critical. About one-third of the world's people are infected with latent tuberculosis — in King County, an estimated 100,000 people. It's spread by the simplest act — breathing. Most people with the latent form will never experience symptoms, but TB thrives in those with weakened immune systems. The combination of TB and HIV/AIDS in sub-Saharan Africa is particularly explosive.

In fact, TB is the biggest killer of people with AIDS. But while international attention has focused on preventing and treating HIV/AIDS, inadequate funding for TB control has allowed the disease to grow unchecked and mutate into frightening forms. Funding for elimination of the disease in the U.S. has plummeted so low that the Centers for Disease Control can no longer fulfill its mandated task to eliminate the disease. Meanwhile, King County is struggling to screen and treat the growing number of infected people.

Drug-resistant TB is the result of human failure — failure to fund programs that effectively treat standard TB, leading to improper treatment, which causes the development of drug resistance. Archbishop Desmond Tutu said it best: "Nowhere does XDR-TB occur in nature. Instead, the world is manufacturing it by failing to provide the essential elements of basic TB control everywhere."

It's time for the world — including the U.S. — to stop manufacturing dangerous forms of TB and to start funding solutions. The Stop TB Now Act of 2007 aims to do just that by supporting the Global Plan to Stop TB 2006 — 2015. If funded and implemented, the plan will cut TB deaths in half by 2015 and ultimately eliminate TB as a global health problem by 2050. Through the Stop TB Now Act, the U.S. would help to create the first new TB fighting drugs in nearly 50 years, the first new diagnostic test in over 100 years, and the very first effective vaccine.

Preventing the rise of drug-resistant TB requires quality, comprehensive TB control. Unless steps are taken now to strengthen control efforts at home, in Africa and throughout the world, these deadly strains will continue to spread and multiply. The resulting global XDR-TB epidemic will be an untreatable and unstoppable calamity.

Robert Daniels is in jail for failing to follow voluntary quarantine restrictions and exposing unsuspecting people in restaurants and stores to the disease. The plights of Daniels and Speaker are a powerful reminder that TB anywhere is TB everywhere. We cannot afford it at home and we cannot stand by while it ravages the world.

U.S. Rep. Adam Smith, D-Tacoma, is a co-sponsor of the Stop TB Now Act of 2007. Dr. David R. Park and Dr. James K. O'Brien are co-chairmen of the Washington State TB Advisory Council.

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