Timebomb: The Global Epidemic of Multi-drug Resistant Tuberculosis [Hardcover]

"The book serves an important function, relaying statistics and TB hot spots, proposing funding and international standardized treatments. Government officials, researchers and nonprofit health organizations will likely cast this as the authoritative book on the subject." "Publishers Weekly

"Like other recent works on the threat of infectious diseases such as Laurie Garrett's "The Coming Plague, Timebomb has the power of fiction and it is sometimes easy to forget that it is not. Unlike the Garrett book, which is more a collection of short dramatic stories collectively telling a big picture about our coexistence and evolution with microbes, Reichman selects one story and presents it in novel form with better material that most science fiction. The book is organized in a clear and riveting manner.

Within the narrative style, the book is rich with up-to-the-minute details and references that add to its depth. An incredible account of politics and disease dynamics occurring at all levels, "Timebomb helps us realize that controlling or eradicating TB is not just about science and facts; likely if it were, TB would have long been relegated to the history books."-- "Nature Medicine Magazine

Tuberculosis, supposedly defeated by antibiotics half a century ago, has returned in a highly contagious and fatal new form that cannot be treated with conventional drugs. Multidrug-resistant TB (MDR-TB), could cause some 10 million deaths over the next decade and is thriving in theovercrowded prisons of the former Soviet Union.

As "Timebomb explains in unnerving detail, the virtual collapse of the world's borders means that refugees, tourists, immigrants, business travelers, and others can spread the TB bacillus very efficiently. London, for example, has experienced a 100% increase in reported cases in the past 10 years. Written by the world's preeminent TB expert and an award-winning medical and health writer, "Timebomb details the evolution and the current state of the MDR-TB epidemic, interweaving the science of MDR-TB with personal stories of people whose lives have been threatened by the deadly bacteria.

Of the world’s six billion people, two billion are infected with latent TB, including 15 million in the United States.

There are 8.4 million new cases of active, usually infectious TB every year, and the number is growing.

TB kills 2 million people every year. More people will die of TB this year than any year in history.

Every TB death is unnecessary. TB is preventable and curable. When treated with appropriate antibiotics, even patients with drug-resistant TB can usually be cured.

TB is an airborne disease that usually affects the lungs. You get it by breathing. TB has already been spread on long air flights.

46% of US infections are foreign-borne.

TB is the leading infectious disease killer of adults, usually in their most productive years between 15 and 54.

TB kills more women than any cause related to pregnancy and childbirth.

Each person with TB infects up to 20 others before he or she is treated or dies.

The World Health Organization declared TB a global health emergency in 1993, the only time it has ever made such a declaration for any disease.

TB and AIDS are deadly twins. TB promotes progression of AIDS and AIDS promotes progression of TB. TB is the leading cause of death in people with AIDS.

A long but effective treatment regimen, endorsed by the World Health Organization, is used in 128 countries, but only 23% of TB patients actually get this treatment.

Bad treatment of TB leads to multi-drug-resistant TB (MDR-TB), which if not fatal, requires up to 2 years of very expensive treatment with often toxic drugs. Multi-drug resistant TB has already been found in 43 states and the District of Columbia.

Russia has the world’s worst multi-drug-resistant TB problem, focused in its over crowded prisons. Almost every prisoner is infected with TB and 100,000 have active, usually infectious TB. When released (often with no follow-up) they infect families and communities.

Russia continues to reject the global standard treatment for TB and relies on its 50-year old methods.

Multi-drug-resistant TB has already spread from Russia to the West.

Two billion people­­ one-third of the world's population­­are infected with latent tuberculosis. Ten percent of those infected will develop active TB in their lifetimes. A scourge supposedly defeated by antibiotics half a century ago, tuberculosis kills more people today than ever before in history. And the numbers aren't getting any better. Worse yet, this ancient disease is undergoing a metamorphosis, adapting to our misused medications, growing stronger, becoming unbeatable­­becoming multi-drug- resistant.

Dubbed "Ebola with wings," tuberculosis flies through the air that we breathe. It is predicted to kill 30 million people over the next decade. It percolates in hot spots all over the globe, from Brazil to China, from India to Russia. It thrives in the congested prison systems of Siberia, where 30 men and the infection are crowded into a single, airless, smoke-filled cell and there's no infection control for staff and employees. Since the economic collapse of the Soviet Union, high crime rates, the rising tide of HIV/AIDS, and political unrest have combined to make Eastern Europe a breeding-ground for multi-drug-resistant tuberculosis (MDR-TB). And every day, international flights touch down on the doorstep of the western world, potentially carrying the deadly disease into small towns and bustling metropolises.

With clarity and unnerving detail, authors Dr. Lee Reichman and Janice Hopkins Tanne take us into the world of MDR-TB­­inside the dank prisons where the disease is breeding, and into the high-tech labs where the battle is being fought. We take a front-row seat in an operating room where the removal of a TB-devastated lung is rendered in gripping detail. We follow an outreach worker on her daily rounds in a dangerous and disease-ridden city. And we travel deep inside the bacterium itself to observe how it attacks, grows, and too-often triumphs within the human body.

When governments cast a blind eye to blatant warning signs, when pharmaceutical companies won't develop new drugs for "unfashionable" diseases, it is time for the alarm to be sounded. An urgent call to arms, Timebomb reveals the unheard-of true story behind the global epidemic of MDR-TB, and of the men and women who are laboring on the frontlines, in real-life biowarfare, pitting science against the clock.

In the scientific race to defuse the ticking bomb of multi-drug resistant tuberculosis­­it may be too late.

"The tuberculosis crisis is getting worse fast, even as I write these words. Russia has created a disastrous TB epidemic in its prisons and is spreading it with the release of hundreds of thousands of prisoners each year. AIDS cases are increasing faster in Russia than anywhere in the world, and AIDS and TB are like gasoline and a match. The World Health Organization has identified 22 TB hot spots around the world. The threat is at our doorstep and we can no longer ignore it. The timebomb is about to explode, and we are not ready."
­­from the Introduction

Tuberculosis has been with us for 10,000 years, yet it kills more people today than ever before. Two billion people one-third of the world's population are infected with latent tuberculosis. Ten percent of those infected will develop active TB in their lifetimes. A disease supposedly defeated by antibiotics half a century ago, TB has returned­­in a new shape and with a far more deadly arsenal. Multi-drug resistant TB can be impervious to our outmoded drugs. It is predicted to cause 30 million deaths over the next decade­­and you get it simply by breathing.

Written by one of the world's preeminent TB experts and an award-winning medical writer, Timebomb details the evolution and current state of the multi-drug resistant TB epidemic. From the overcrowded prisons of Siberia to the streets of New York City, the authors sound the alarm on this global epidemic and herald the work of the men and women who are laboring on the frontlines, waging real-life biowarfare, in a scientific race to defuse the ticking bomb.

Lee Reichman, M.D., M.P.H. is the executive director of The New Jersey Medical School's National Tuberculosis Center.

Janice Hopkins Tanne is an award-winning medical and science writer whose work has appeared in New York Magazine, Parade, and Redbook.