S and Mexico is still small and the rates of multidrug resistant TBor MDRare

S and mexico is still small and the rates of

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the actual number of cases in the U.S. and Mexico is still small and the rates of multidrug-resistant TB—or MDR—are nowhere near as severe as India , China, or Eastern Europe, where drug-resistant TB is at epidemic proportions. In 2011, the most recent year available, Mexico had 467 MDR-TB cases, the World Health Organization estimates, while the U.S. had 124, according to the Centers for Disease Control and Prevention. Almost half of the U.S. cases came from California and Texas. Health officials say it is crucial to jump on prevention now, because the disease is transmitted airborne and can spread quickly. " We're all connected by the air we breathe, " said Thomas Frieden, director of the CDC, and a TB expert who successfully battled a major outbreak of multidrug-resistant TB in New York City in the 1990s, then spearheaded India's TB-fighting program for the World Health Organization. Gonzalo Garcia has struggled with drug-resistant tuberculosis while living in Tijuana. He doesn't know when he contracted the disease. In its drug-resistant forms, TB can still be fatal, and the treatment may be painful, requiring up to two years or more of medication and potentially months of isolation. Costs are steep too; according to a recent CDC study, treatment on average in the U.S. was about $140,000 and ran as high as $700,000 . For health officials, the challenge of trying to control an airborne disease along an area as large as the U.S.-Mexico border is enormous. More than 150 million people cross the border each year. Many, like Mr. Garcia, go back and forth to work, or to play, with visas that allow short trips in the border region. Two CDC quarantine stations sit along the border to deal with health concerns. "T B is the most common disease we get called about ," said Steve Waterman, chief of the CDC's U. S-Mexico unit in the agency's Division of Global Migration and Quarantine. The U.S.-Mexico border is "not like the Berlin Wall, " said David Shirk, director of the Trans-Border Institute at the University of San Diego. " It's one region. " That means people live on one side of the border and run a business on the other, and shoppers from both countries frequent the same malls, he said. In the Mexican state of Baja California, officials are treating three cases of XDR-TB, a rare but severe form of the disease in which a patient's TB is resistant both to the two most potent drugs for treatment as well as some drugs used to treat drug- resistant TB , said Dr. Laniado-Laborin. Six new cases of this type were reported in the entire U.S. in 2011. North of the border, in San Diego, the overall TB rate is around twice the U.S. national average. Los Angeles is grappling with its worst TB outbreak in a decade, and police have been reminded to use face masks when encountering those who are sick . "You can learn from San Diego how things could play out in the heartland of America," says Richard Kiy, chief executive of International Community Foundation, a public foundation that supports treatment of drug- resistant TB patients at Dr. Laniado-Laborin's clinic and elsewhere in Baja California.
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