Drug-Resistant TB Hits N. Korea

I’ve previously explained my conflicted feelings about the Eugene Bell Foundation, but I would rate their reporting about the spread of disease inside North Korea as fairly reliable. A friend (thank you) passed along an e-mail message/ press release meant to recruit support for an EBF trip to North Korea. It contained this alarming news:

[C]ountermeasures are urgently needed for the recent increase of multi-drug resistant tuberculosis (MDR-TB) patients in North Korea.

After years of visiting and providing TB medicines for TB Care Centers in North Korea, EugeneBell estimates that over 30% of all TB patients in the country may be infected with MDR-TB. Evidence suggests the number of patients is increasing year-by-year.

In response to this growing crisis, the delegation visited six different North Korean TB Care Centers in early 2007 and collected sputum samples from 20 patients thought to be infected with MDR-TB and brought them to South Korea for study. The test results identified at least two or more strains of MDR-TB virus in over 60% of the samples.

If you haven’t heard about nasty new drug-resistant strains of TB (or if you’ve forgotten), you can read more here. MDR-TB is so contagious and difficult to treat that not even the most developed nations know quite how to respond to it. Although it’s debatable whether you can apply that description to Russia, MDR-TB has caused a health crisis there. One can only assume that it will spread more rapidly among a population wracked by hunger.

The Bell Foundation is setting up special wards in four cities, and the locations are telling: North and South Pyongan, Nampo, and even Pyongyang. I’ve written about previous reported outbreaks of other diseases in North Korea, including scarlet fever, typhoid, paratyphoid, typhus, and a large outbreak of measles (more). Those outbreaks differed from this one in that they mainly affected less-favored areas: North and South Hamgyeong and Ryanggang provinces. This time is different.

The presence of MDR-TB in the capital and other “core” areas is telling. It suggests that health conditions may be deteriorating in the parts of North Korea where the regime invests most of its resources. If MDR-TB spread there from the interior or the far north — something that’s hard to judge, since you’d expect North Korea to limit EBF’s access to those areas, and for EBF not to raise a stink about it — it may also suggest that the authorities’ ability to control the movement of its people continues to erode.

[Photo, distributed by the Eugene Bell Foundation, shows North Korean patients who have tested positive for multi-drug-resistant tuberculosis.]