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Virus X Frank Ryan A Review - New Scientist 22 Mar 97

AS WE approach the end of the millennium, is the end of the world nigh? War and political strife confront us at every turn, ominous comets streak the sky and our food is tainted. To top it all, a new breed of diseases is about to overwhelm us. Consultant physician Frank Ryan describes the real threat of the coming plague. High in the mountains of New Mexico in May 1993, a mysterious virus began to attack the Navajo population. Almost every one of the 13 victims of the initial outbreak died within a few hours of contracting what turned out to be a new strain of hantavirus. More cases have been cropping up in the region. Most worrying is that the disease is carried by a widespread American rodent, the charmingly named deer mouse. Ryan takes us through the drama of discovery, the people, the high-security research establishments, the uncoiling of viral RNA and the eventual pinning down of a new species-though this is a kind of bi6diversify we can do without. Emerging infections are not new. But the newer intruders do seem to be getting a grip; more people are suffering from encephalitic and arthritic viruses, haemorrhagic fevers, diarrhoea-causing infections, human T cell leukaemia virus, Legionella, Lyme disease, toxic shock syndrome, HIV, flesh-eating bacteria and Ebola. Add to this the growing threat posed by the evolution of drug resistance in pathogens such as the tuberculosis bacterium, and one is soon persuaded that plague is fast becoming the most threatening of the Four Horsemen of the Apocalypse. Ryan challenges the notion that certain questions are too appalling to contemplate. They must be faced. The most alarming is whether the whole human species is under threat from a pandemic virus or bacterium. As we encroach on the last remaining acres of wilderness in the world, will a new virus, the equivalent of an airbome HIV, say, sweep us into oblivion? We may hope that most of these new infections will behave as recent outbreaks of Ebola, Legionella and Lyme disease-and even Escherichia coli-have done so far, restricting their life cycles to a closed shop of unlucky individuals. But Ryan is certain of one thing: the Universe is not benign and we must do everything in our power to mitigate the danger.

Incurable TB threatens millennium New Scientist 1 Nov 97

SHOCKING new figures have confirmed repeated warnings that drug-resistant tuberculosis is breaking out in "hot zones" all over the world, says the WHO. If efforts to treat TB are not stepped up, resistant strains will spread rapidly-placing impossible demands on the healthcare systems of poor countries. The first worldwide survey of drug-resistant TB reveals that 10 per cent of the 6 to 8 million new cases recorded two or more drugs. "We stand at the edge of the millennium, facing the spectre of incurable TB," says Arata Kochi, director of the WHO's Global TB Programme. Multidrug-resistant TB was reported in all 35 countries surveyed. But thi worst hot spots were in India, Russia, Latvia, Estonia, the Dominican Republic, Argentina and C8te dlivoire. There many TB patients don't take a complete course of drugs, increasing the likelihood that the bacterium, Mycobacterium tuberculosis, will become drug resistant. The danger, says Michael lseman, a TB expert at the National Jewish Medical and Research Center in Denver, is that resistant TB will spread from these zones into other areas where drug treatment is similarly patchy. To prevent this happening, the WHO wants TB patients to be given a combination of four drugs and be monitored for six months to ensure that they finish the course. This would cure most patients infected with standard strains of M. tuberculosis. And while it won't directly help most patients with drug-resistant TB, it will slow the rise of drug-resistant strains. The recommended treatment costs up to $200 per patient in developing countries. Launching programmes to extend the tmatment worldwide will cost $100 million, roughly ten times the WHO's currant annual budget for TB control. That sounds expensive, but treating drug-resistant cases costs 100 times as much-which many countries cannot afford. Kurt Kleiner, Washington DC each year are resistant to at 'Programmes to extend the least one of four major drugs. Two per cent are resistant to treatment will cost $1 00 million