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New TB variant resists multiple medications

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There are no positives after hundreds of infants were potentially exposed to tuberculosis at the Guam Memorial Hospital nursery earlier this year. However, the incident has raised concerned about the emergence of multi-drug resistant TB on island.

It's good news for the 217 infants and 112 adults who have been tested for TB as part of a response effort at the public hospital. So far, none has shown any signs of TB infection. The screening took place at GMH over the past two weeks.

"There were 14 physicians that volunteered without pay, they came in day and night and saw the babies, and the parents and the nurses. And security guard, everyone volunteered to help," explained GMH assistant director of medical services Dr. Kozue Shimabukuro, adding that the effort isn't over yet.

"90 babies are still out there without being able to be phone contacted, so that's why Public Health stepped into identify the physical addresses of these babies as much as possible," said the physician.

As of Wednesday the TB response effort for this particular incident has been transferred from GMH to Public Health, with Dr. Shimabukuro saying, "The screening and also the follow ups and dispensing of the medication will be done at the Northern Community Public Health."

Dr. Shimabukuro added that while some parents have raised concern about the side effects of the preventative TB treatment, it is imperative that they continue the treatment until the infants are 6 months old.

"X-ray may be negative, and your exposure risk is low, but if there is a 1 percent chance of my baby getting tuberculosis, I will prevent it, and that medication, INH, will do just that for you," said the doctor.

Meanwhile, CDC expert Phillip Talboy added that an emerging issue in Guam is the discovery of multi-drug resistant TB. He said, "Some of the statistic show it could be up to $250,000, between $125,000 and $250,000 to treat an MDR case."

Administrator of the Public Health Bureau of Communicable Disease Control Josie O'Mallen said there have been 8 cases of MDR tuberculosis in Guam over the past two years, something Dr. Shimabukuro feels is a serious threat the government should be addressing.

"Remember, this is still a life-threatening disease if an immune-compromised patient catches it or the young ones catch it, so this is the tip of the iceberg as you have stated, and we need to get control of this and I think that Guam needs more support, public understanding, and Public Health needs more support to control this disease," she said.

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