National Jewish to treat TB patient

Bill Scanlon, Rocky Mountain News

Published May 30, 2007 at midnight

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A Georgia man with a rare and hard-to-treat form of TB will be treated at Denver's National Jewish Medical Center, where doctors who pioneered modern tuberculosis treatment will care for him.

The man, who is under federal quarantine at an Atlanta hospital, has a strain of tuberculosis called Extensively Drug Resistant TB, XDR for short. He is expected to arrive in the next couple of days.

The man, who had flown from Atlanta to Europe for his wedding this month and then back to North America, doesn't show any symptoms, and seems to have a relatively mild form of the XDR infection. Still, said Dr. Charles Daley, head of infectious diseases at National Jewish, one-quarter of people with symptomless TB still are able to pass it along to others.

Doctors will try several drugs on the patient, who has not been publicly identified, including those used to treat pneumonia and leprosy. Those drugs have shown promise against TB in labs, but are seldom used on humans.

If the man doesn't respond, surgery is another option. Dr. John Mitchell of the CU Health Sciences Center likely would do the operation, which could remove most of the TB from the lungs, making it easier for antibiotics to treat what remains.

Daley said the patient wanted to be treated at the Denver hospital, as did federal health officials.

National Jewish, which was established by Denver's Jewish community as a tuberculosis sanitarium in 1899, has been named the top respiratory hospital in America for several consecutive years by U.S. News and World Report, as well as by hospital ranking agencies.

In the past few decades, it has developed a specialty in the most difficult TB cases, including XDR. It is resistant to almost all drugs used to treat TB.

In the United States, there are usually one or two XDR TB cases a year, Daley said during a news conference Wednesday. Most people with the disease were born in another country or traveled to countries such as South Africa or Russia where it is more prevalent.

Around the world, only about 30 percent of XDR TB cases are cured, Daley said.

In this case, there's reason for optimism.

National Jewish treated three XDR TB patients in recent years, he said. Two were cured, and the third was healthy when he left the hospital, although his current condition isn't known, he said.

The man shouldn't be a health threat to the doctors and nurses who treat him, said Daley. Typically, even among household members of an infectious TB patient, only about a third contract the disease, he said.

Nonetheless, hospital personnel will wear masks in the man's presence, Daley said. The man will spend almost all his time in a small room equipped to ensure that his exhaled breaths don't escape, Daley said. A vent will draw the air through a duct system that includes an ultra-violet light, which should kill any TB bacteria.

He may be allowed outside, with a mask, but probably not until he has proven to be non-infectious, Daley said.

Although the man is surrounded by armed guards in Atlanta, there won't be a security guard at his hospital room at National Jewish — at least that's the plan for now, Daley said. If the man tries to leave the hospital, Denver police will be called, said Daley, who thinks such a scenario is remote.

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