TB disaster on our doorstep

People from Papua New Guinea’s Western Province being transported to Daru hospital to undergo testing for TB Photo: AusAID

Medical experts are warning the Australian mainland is at risk of being invaded by a deadly strain of tuberculosis (TB) from Papua New Guinea (PNG), report Matt Garrick and Mark Roy in the Torres Strait.

An outbreak in PNG’s Western Province of an incurable form of tuberculosis, known as XDR-TB (extensively drug-resistant TB), has been labelled by TB expert Steve Vincent as “a public health disaster likely to cost billions”.

“It is inevitable it will spread into the Australian population,” Dr Vincent said. “Patients get profound weight loss, night sweats, coughing, then they fade out and die.”

PNG residents are allowed to travel into the Torres Strait region of Australia, for traditional activities, under an international treaty. Doctors in the Torres Strait have said they have a duty of care to treat those who turn up on our doorstep.

“It is the job of customs and immigration to determine who comes into our country, not physicians,” one doctor said.

A report released late last month analysing the risks from TB in the Western Province of PNG said the possibility of the illness making its way into the Torres Strait could rise if residents on Boigu and Saibai increased interaction with residents from PNG.

The report, written by Victorian epidemiologist Emma McBryde, said residents of the outer islands of the Torres Strait should avoid sharing school rooms, homes or hospital wards with PNG residents without proper isolation and ventilation.

The report suggested the closure of Queensland Health’s TB clinics on Saibai and Boigu in June this year could help reduce chances of the disease being transmitted into Australia.

“Closing Saibai and Boigu TB services is likely to reduce the risk of XDR-TB transmission to Australian residents, by reducing the number of PNG Nationals seeking healthcare in Australia,” Dr McBryde said in her report.

Cairns-based TB expert Graham Simpson, who worked in the Torres Strait clinics, said anything experts tried to do now to prevent a rise in the number of XDR-TB cases would be “too little, too late”.

“This outbreak is what we have been worried about for years,” said Dr Simpson.

Health officials gathered to discuss the issue at a Torres Strait Cross Borders Health Issues Committee meeting from October 30 to 31 in Cairns.

In a media statement, Queensland Health said there was “no outbreak of TB” anywhere in the Torres Strait. It released figures showing 11 cases of TB had been diagnosed amongst Australian residents so far this year in Cairns, Cape York and the Torres Strait, as well as 13 reported cases amongst PNG nationals visiting Queensland.

Chief health officer Jeannette Young said the risk to the general public was “very low”.

“No Australian residents of the Torres Strait have been diagnosed with MDR-TB (multi-drug resistant TB) or XDR-TB,” Dr Young said. “To become infected with TB generally requires long-term, prolonged exposure to the disease.

“A short-term exposure is not generally sufficient to result in any infection.”

In August this year, Queensland Health confirmed a case of XDR-TB in a PNG citizen holidaying in Cairns. Data from 2009 showed 11 of the 31 cases of MDR-TB detected in Australia at that time were patients from PNG receiving treatment at clinics in the Torres Strait.

Local Federal MP Warren Entsch said that with MDR-TB cases already evident in the Torres Strait and turning up in Cairns, the threat of the spread of XDR-TB was “present, real, and cannot be ignored”.

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