Page 4815 - Week 13 - Wednesday, 11 November 2009
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Foundation. There is a lot of information available. There is also an excellent summation of the disease publicly available on the Wikipedia site, and I will quote briefly from that:
Tuberculosis (abbreviated TB … ) is a common and often deadly infectious disease caused by mycobacteria … Tuberculosis usually attacks the lungs … but can also affect the central nervous system, the lymphatic system, the circulatory system … the gastrointestinal system, bones, joints, and even the skin.
Tuberculosis is spread through the air, when people who have the disease cough, sneeze, or spit. Most infections in human beings will result in … latent infection, and about one in ten latent infections will eventually progress to active disease, which, if left untreated, kills more than half of its victims. The classic symptoms of tuberculosis are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss …
The diagnosis relies on radiology (commonly chest X-rays), a … skin test, blood tests, as well as microscopic examination and microbiological culture of bodily fluids. Tuberculosis treatment is difficult and requires long courses of multiple antibiotics. Contacts are also screened and treated if necessary. Antibiotic resistance is a growing problem in … multi-drug-resistant tuberculosis …
And we are yet to find out in this case if this involves a multi-drug-resistant strain, but if it does then it is cause for even more concern. It continues:
People with prolonged, frequent, or intense contact are at particularly … risk of becoming infected, with an estimated 22% infection rate. A person with active but untreated tuberculosis can infect 10–15 other people per year.
Dr Ellis makes the point that infants under one year of age are extremely vulnerable to infections and are particularly susceptible to invasive, disseminated tuberculosis disease. Infants under the age of one are at the highest risk of mortality and morbidity. Possibly the most frightening aspect of this situation is that no-one can test any of the babies to reassure the parents that their newborn is free from infection as the tests in babies and children are very unreliable. The side effects of the medications are also very nasty.
I think it was worth reading that to realise that this is a very serious situation. TB is a very nasty disease.
I would like now to express the concerns I have with what has occurred. The first point I make is that this is not about screening. I understand that it is impractical and that it may be impossible to screen people. This is about procedures around visiting and partners staying in postnatal wards and who has been exposed. And this is about information management after the incident and about clearing up confusion.
The first question is: who has actually been exposed? The figures being presented by the ACT government are loose and limited information is being provided. As I understand it now, no more information is being provided by the Canberra Hospital. The minister should clarify how many people have been exposed, how many are being tested and confirm that ACT Health has identified everyone who might have been exposed.
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