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2014年9月23日 (火)

結核の予防 早期治療で感染拡大を防ごう

The Yomiuri Shimbun
Tuberculosis must be treated early to prevent widespread transmission
結核の予防 早期治療で感染拡大を防ごう

We should not shrug off tuberculosis as a “disease of the past.” Tuberculosis Prevention Week, which begins on Wednesday, should be used as an opportunity to recognize once again the importance of detecting and treating the disease at an early stage.

According to the World Health Organization, 8.6 million people contracted TB worldwide in 2012 and 1.3 million died from it that year. In Japan, about 20,000 people come down with TB every year and more than 2,000 die.

The TB bacteria cause inflammation in the lungs and can be transmitted between humans though coughing and sneezing. TB was once feared in Japan as a “disease that can ruin the nation.” In 1950, soon after the end of World War II, 120,000 people died of TB.

The threat of contracting the disease has since waned as medicines were developed and hygiene improved. Even so, the number of new Japanese TB patients per 100,000 people in 2013 was 16, five times larger than that of the United States.

In July, the Health, Labor and Welfare Ministry, the Japan Anti-Tuberculosis Association and other entities compiled an action plan aimed at lowering the contraction rate to less than 10 per year by the end of 2020.

To attain this goal, the first thing Japan must to do is improve measures to prevent TB among the elderly. In some cases, people contract the TB bacteria when they are young but symptoms do not appear for many years because they have latent tuberculosis. As people age, however, they develop symptoms when the bacteria become active due to weakened immune systems or diabetic conditions. There has been a conspicuous increase in such cases, and mass TB infections have been reported at facilities for the elderly.

Many elderly people do not develop typical symptoms, such as coughing or producing phlegm. Delays in detecting the disease can cause patients to develop serious symptoms and spread the disease widely. Weight loss and a slight fever are initial symptoms of the disease.

It is therefore important for patients to have their chests X-rayed and undergo other physical examinations at an early stage.

Poor affected most

TB is common among poverty-stricken people. Osaka city has given priority to providing homeless people with examinations free of charge and dispatching nurses to give medication to those with the disease, a program that succeeded in halving the contraction rate in 10 years.

In one case, young people contracted the disease from a person who stayed for an extended period at an Internet cafe. This shows the danger of contracting the disease in places frequented by people in their daily lives.

There has also been a rise in the number of foreign patients who visit Japan from countries with high TB rates. The United States and Britain conduct TB checks on foreigners before they enter either country. This is a measure worth considering for Japan.

Particularly worrisome is an increase in the number of people with strains of tuberculosis that are resistant to multiple kinds of drugs. Ordinary TB medicines are not effective in treating these strains of TB, which can lead to a high fatality rate. About 4.5 million people in the world are afflicted with multidrug-resistant strains of TB.

In Japan, less than 1 percent of all patients are infected with drug-resistant TB strains. But there is a risk these TB strains could spread, as more and more people travel between Japan and other countries.

A new Japanese drug effective in treating patients with multidrug-resistant TB strains has been approved in Japan and Europe this year. We hope it will help fight TB throughout the world.

BCG vaccines are widely administered to infants, but the effects wear off in 10 to 15 years. It is therefore essential to expedite the development of vaccines for adults as well.

(From The Yomiuri Shimbun, Sept. 22, 2014)Speech


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