The dilemma of a deadly disease: patients may be forcibly detained

The dilemma of a deadly disease: patients may be forcibly detained

Doctors fear TB strain could cause a global pandemic if it is not controlled

Chris McGreal in Johannesburg and Sarah Boseley, health editor
Tuesday January 23, 2007
The Guardian

South Africa is considering forcibly detaining people who carry a deadly strain of tuberculosis that has already claimed hundreds of lives. The strain threatens to cause a global pandemic, but the planned move pits public protection against human rights.

The country's health department says it has discussed with the World Health Organisation and South Africa's leading medical organisations the possibility of placing carriers of extreme drug resistant TB or XDR-TB under guard in isolation wards until they die, but has yet to reach a decision.

Pressure to take action has been growing since a woman diagnosed with the disease discharged herself from a hospital last September and probably spread the infection before she was finally coaxed back when she was threatened with a court order.
More than 300 cases of the highly infectious disease, which is spread by airborne droplets and kills 98% of those infected within about two weeks, have been identified in South Africa.

But doctors believe there have been hundreds, possibly thousands, more and the numbers are growing among the millions of people with HIV, who are particularly vulnerable to the disease. Their fear is that patients with XDR-TB, told that there is little that can be done for them, will leave the isolation wards and go home to die. But while they are still walking around they risk spreading the infection.

Now a group of doctors has warned in a medical journal that if enforced isolation is not introduced XDR-TB could swamp South Africa and spread far beyond its borders. Regular TB is already the single largest killer of people with Aids in South Africa.
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