Resistant TB case a wake up call for SAfrica

JOHANNESBURG, Sep 15 (Reuters) South African officials said the spread of highly drug resistant tuberculosis to a Johannesburg hospital was a ''wake-up call'' to intensify work on defences against the possibility of a deadly outbreak.

The TB case, which emerged this week in South Africa's economic hub, has served as a reminder that the government must revamp policies at local hospitals, equip laboratories with the latest diagnostic tools and speed-up delivery of antibiotics.

''We have set up an expert consultative forum to look at protocols and guidelines to see what we need to change... and look at cost implications,'' Dr. Joe Khoali, TB adviser for the Gauteng Health Department, said on Wednesday.

There is concern the virtually untreatable disease, known as XDR-TB (extremely drug resistant tuberculosis) could move quickly through South Africa, where an estimated one in nine people are infected with HIV/AIDS.

TB is the leading killer of those infected with HIV as it thrives in weakened immune systems, and doctors have voiced fears that a major outbreak of the deadly TB strain could sharply hike the country's already considerable AIDS death toll.

TB, an airborne illness spread through coughing and sneezing, kills an estimated 1.7 million people annually.

Today, a Johannesburg hospital detected the first case of XDR-TB outside KwaZulu Natal province where 60 people have died and doctors report two to three new cases a month.

The infected woman had refused doctor's orders to stay put at the Sizwe Hospital but health authorities later persuaded her to go into isolation to prevent spread of the disease.

''The patient is happy and everything is under control,'' said Sizwe CEO Elizma van Staden.

Doctors specialising in infectious diseases are urging the public to remain calm.

''It doesn't spread like wildfire. I think we must be careful and not say this is going to result in a huge outbreak,'' said Prof.

Umesh Lalloo, professor at the Nelson Mandela School of Medicine in Durban.

Authorities say some family, friends, health care workers and those who came in contact with the infected woman are being asked to undergo testing but it takes up to six weeks to analyze the results in a laboratory.

Medical experts have criticised South Africa for weak surveillance and are asking the government to start a national campaign to pinpoint the number of people infected with the virulent strain and the communities where they live.

The Health Department reports four of the country's nine provinces including Gauteng, KwaZulu Natal and the Eastern and Western Capes -- comprise 80 per cent of the TB burden and have been at the centre of control efforts.

It is not clear if their efforts are paying off. For instance, in 2004 Johannesburg had a cure rate of just 61 per cent of all TB patients -- far below a WHO target of 85 per cent success.

REUTERS SY MIR RAI0935