Jintian Group 2005-8-4 9:23:56
The epidemic situation of legal infectious diseases in China shows that since March this year, tuberculosis has replaced rabies for the first time and become the "first killer" of infectious diseases in China. So far, the number of deaths caused by this disease is still increasing month by month.
According to the survey of the World Health Organization (WHO), the number of drug-resistant mycobacterium tuberculosis in the world is increasing due to the neglect of tuberculosis treatment. If we don't actively prevent and control it, the new strains that will be popular in the future will make human beings fall into a hopeless predicament.
China, an area with high incidence of tuberculosis in the world, surpassed rabies for the first time since March this year, becoming the disease with the highest mortality among Class A and B infectious diseases. Today, the death cases of tuberculosis are still increasing month by month.
Dr. Qian, an expert from China Representative Office, said in an interview recently that the number of tuberculosis patients in big cities such as Beijing and Shanghai is increasing recently. This problem is getting more and more serious.
Become the number one killer again
The distance from the ward to the bathroom is only 10 step, but Li Rong (pseudonym), who is 4 1 year old, regards it as a fear of the road.
Long-term low-level body is like a ball of cotton. Cough coming from the bottom of the chest tears the heart and lungs again and again. Her lips are purple, and she gasped like a fish thrown ashore. Just ten steps, she will brew for a long time, save enough strength and have a rest in the middle.
The twists and turns of illness and medical expenses of more than 700,000 yuan made Li Rong the most famous old patient in pulmonary hospital.
The attending doctor told the reporter that Li Rong had multiple cavities in his lungs. At present, his pleural effusion and pleurisy have almost no hope of cure.
Li Rong is a typical "primary multidrug-resistant pulmonary tuberculosis patient". This awkward name means that although it is not AIDS or cancer, she has no medicine to cure since she was infected six years ago.
The "multidrug-resistant tuberculosis" that afflicts Li Rong is a worldwide chronic disease. At present, there is no effective medicine to contain it, and its patients have become a terrible source of infection. China is becoming a high incidence area of this disease.
According to experts, the reason why ordinary tuberculosis in the past became refractory "multidrug-resistant tuberculosis" was mainly due to the variation of Mycobacterium tuberculosis.
Experiments show that in actual treatment, patients are easily resistant to a single antibiotic. If patients only take this drug, the natural law of survival of the fittest will lead to the dominance of bacteria resistant to this drug in the near future, thus ending in failure. Although this drug resistance can be solved by cocktail therapy, that is, the combination of multiple antibiotics, it is only a matter of time before the emergence of multi-antibiotic resistant tuberculosis.
In fact, in recent months, tuberculosis has surpassed all other infectious diseases for the first time and has quietly become the first killer of epidemic diseases. This fact has to make people pay more attention to tuberculosis.
April 2005 1 1 day, the national report on legal infectious diseases released by the Ministry of Health in March this year showed that tuberculosis surpassed rabies for the first time, becoming the highest mortality disease among Class A and B infectious diseases, and tuberculosis was also the highest incidence disease. Before that, rabies with a mortality rate close to 100% has been the "first killer" in infectious diseases.
In Shanghai, where medical technology is developed, although the incidence of tuberculosis is not as good as that of sexually transmitted diseases and AIDS, the mortality rate remains high and it has been sitting in the position of the boss.
On July 14, the epidemic situation of Class A and B legal infectious diseases in the second quarter of 2005 released by Shanghai Municipal Health Bureau showed that the top three diseases with death toll were tuberculosis, viral hepatitis and meningitis, accounting for 88.46% of the total deaths.
Li Yongxiang, the Shanghai Center for Disease Control and Prevention, told reporters that Shanghai was originally one of the areas with low tuberculosis epidemic in China. More than 8,000 cases of active pulmonary tuberculosis are newly discovered every year, including more than 2,500 cases of infectious pulmonary tuberculosis, and more than 200 cases die of pulmonary tuberculosis every year.
However, since 1999, the incidence of pulmonary tuberculosis has been on the rise, and the newly registered cases of active pulmonary tuberculosis and sputum positive pulmonary tuberculosis among floating population in this city have increased year by year, with annual growth rates of 10.7% and 15% respectively.
In the following months, tuberculosis not only quietly returned to the throne of "the first killer", but also the highest monthly morbidity and mortality increased.
On March 24th this year, the 10 World Tuberculosis Day, Vice Minister of Health Wang Longde held a special press conference on this situation, saying that the current tuberculosis epidemic situation in China should arouse social concern.
Wang Longde said that according to the survey of the Ministry of Health, nearly half of the population in China has been infected with tuberculosis. At present, there are about 4.5 million tuberculosis patients, including about 6.5438+0.5 million infectious tuberculosis patients, ranking second in the world. Every year, there are about 1.45 million new cases, and the number of deaths due to tuberculosis reaches1.30 million, which greatly exceeds the total number of deaths from other infectious diseases.
Experts predict that with the increasing tolerance of bacteria to antibacterial drugs and the possibility of AIDS patients complicated with infection, there is a possibility of further outbreak of tuberculosis.
Why is it revived?
192 1 year, French scientists Calmet and Jielang studied 15 years, and a vaccine containing rare active pulmonary tuberculosis bacterial strains-"BCG" finally came out. By the time 196 1 Jielang died, more than 200 million people around the world had been injected with this anti-tuberculosis vaccine, and BCG was still used to prevent tuberculosis.
1944 the discovery of streptomycin finally brought good news to tuberculosis patients. Because this antibiotic could effectively kill mycobacterium tuberculosis at that time, the United States even optimistically thought that tuberculosis could be eliminated at the end of the 20th century in the early 1980s.
An ancient disease, now there are effective treatments, why has it not been eliminated yet, but it still has such a high mortality and morbidity?
Tu Dehua, secretary general of China Tuberculosis Association, believes that the main reason for the serious recurrence of tuberculosis is that the whole society has not paid enough attention to this problem in recent years.
Dr. Qian's explanation is that once drug resistance occurs, all kinds of advanced drugs in the world are powerless at present. If it cannot be cured, it may be transmitted to others.
"40% of tuberculosis patients in China have drug resistance, and 10% of them are resistant to multiple drugs. China's MDR-TB patients account for a quarter of the world, belonging to many regions, and the degree has become more and more serious in recent years. " Qian believes that an important reason for multi-drug resistance of tuberculosis is the irregular use of drugs. "More seriously, some doctors don't understand tuberculosis, prescribe drugs casually, and there are problems with dose control."
In 200 1 year, China formulated a ten-year plan to prevent and treat tuberculosis. But money is not optimistic about the implementation of this plan. He believes that for millions of tuberculosis patients in China, 40 million yuan a year is far from enough, and local governments have not provided funds to prevent and control tuberculosis.
Qian told reporters that in big cities such as Beijing and Shanghai, where tuberculosis patients were rarely found before, the number of tuberculosis patients has also increased recently. "This is because the floating population has increased. They have no medical insurance, no money to see a doctor, and they don't understand tuberculosis. This problem is getting more and more serious. "
In addition to ignoring the mentality of tuberculosis epidemic and the problems caused by population mobility, experts agree that another important reason for the increasing incidence of tuberculosis year by year comes from the AIDS epidemic.
In fact, in recent years, the trend of interaction between tuberculosis and AIDS is very obvious. According to the WHO survey, at present, about 1 of every three HIV-infected people in the world suffer from tuberculosis at the same time.
Studies in Italy, Rwanda, Spain and the United States have found that TB carriers infected with HIV are 30 to 50 times more likely to develop TB than those who are not infected with HIV.
Maglio Raviglione, Acting Director of the Department of Tuberculosis Prevention and Control of the World Health Organization, said: "10 years ago, after the WHO declared the global tuberculosis emergency crisis, the epidemic situation of tuberculosis became more severe, mainly due to the spread of HIV. We need to redouble our efforts to deal with the interaction of these two deadly diseases, which have aggravated each other's influence. "
Lack of funds for folk research
"Through countless trials of different scales, the World Health Organization found that BCG, once regarded as a' life-saving straw', had no effect at all in preventing adult tuberculosis." Dr. Li Zhongming, who has worked in the Center for Vaccine Evaluation and Research of FDA for 13 years, told reporters that the main reason why newborns are still injected with BCG vaccine has changed from the initial prevention of tuberculosis to the prevention of miliary tuberculosis and tuberculous meningitis in newborns.
Jong Li said that according to WHO's follow-up survey of different people vaccinated with BCG, BCG has no absolute preventive effect on tuberculosis. The most typical example is that the highest incidence of tuberculosis is in India and China, and every newborn is compulsory to be vaccinated with BCG, but the incidence of tuberculosis in the United States is very low, and BCG is not vaccinated.
"It is also for this reason that China cancelled the BCG multiple cropping in August 1997." Jong Li said.
BCG, regarded as the "first shot for newborns", has been unable to effectively prevent tuberculosis, and the increasing number of drug-resistant strains has also left the former killer antibiotics helpless. How should we deal with the sudden arrival of tuberculosis like SARS?
Li Zhongming believes that there is an urgent need to develop a more effective vaccine. In fact, before that, as the general manager of Shanghai Haigui Biological Co., Ltd. and a special researcher at the Center for Genetic Immunity and Vaccine Research of Fudan University, he had been studying tuberculosis gene vaccine in Shanghai for two years. However, because the society has completely turned a blind eye to this field, the research funds have been stretched. So far, the biggest sum of money is a research fund of 2 million yuan from Shanghai Science and Technology Commission.
"Developing a vaccine requires at least 1 100 million yuan. We also hope that the country can come up with some special funds for tuberculosis prevention and control to support us, but unfortunately, at present, hundreds of millions of funds for prevention and control are earmarked, even if they are used for cadres to go abroad to inspect tuberculosis prevention and control, they cannot be used for the research of private tuberculosis vaccines. " Li Zhongming told reporters that the first tuberculosis gene vaccine formula he developed in China has applied for a national patent. On August 25th this year, he will conduct a one-year big animal experiment in p3 laboratory of Wuhan University together with Tokyo Tuberculosis Research Institute. They will test the effectiveness of the newly developed vaccine on monkeys. If all goes well, this new vaccine will fill the gap, replace the BCG vaccine and help adults prevent tuberculosis.
"But the closer we get to clinical trials, the more money we need. The millions of dollars we raised are far from enough. At present, we can only take one step at a time. " Jong Li said.
Good luck, peach.