"A chilling account of...the global resurgence of this disease..." - "The New York Times". "Tuberculosis - a nineteenth century disease - has come back with a vengeance..."Timebomb" is the extraordinary story of courage and cowardice in confronting the global TB epidemic." - Donna E. Shalala, former Secretary of Health and Human Services, President of the University of Miami.
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"Tuberculosis--a nineteenth century disease--has come back with a vengeance. ... Timebomb is the extraordinary story of courage and cowardice in confronting the global TB epidemic."
From the Author
TB’S DANGEROUS SECRETS
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. --This text refers to an out of print or unavailable edition of this title.
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First Sentence
On September 2, 1998, a crowd of passengers in an air-conditioned departure lounge in Paris stirred restlessly, waiting for their flight from Charles De Gaulle Airport to John F. Kennedy Airport in New York. Read the first page
Front Cover | Copyright | Table of Contents | Excerpt | Index | Back Cover
On September 2, 1998, a crowd of passengers in an air-conditioned departure lounge in Paris stirred restlessly, waiting for their flight from Charles De Gaulle Airport to John F. Kennedy Airport in New York. Read the first page
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Customer Reviews
Most Helpful Customer Reviews
4 of 5 people found the following review helpful
By Linda Oskam
Format:Paperback
For those of you unfamiliar with tuberculosis: TB is a life-threatening disease that is caused by bacteria. It is treatable, but the treatment is lengthy (at least 6-8 months) and relatively costly (around $900 in the US). If patients do not receive the correct combination of antibiotics, or if they stop treatment prematurely, they may develop (or transmit) multi-drug-resistant tuberculosis, a disease which is nearly impossible to treat, treatment requiring up to 2 years of taking very expensive (up to $250,000 for 1 case of multi-drug-resistant TB) antibiotics that have a lot of side effects.
In Timebomb Lee Reichman gives a very clear description of all the factors involved in Tb, its treatment, the ways in which such treatment may fail and the dire consequences of failure. He also gives personal account of his experiences with multi-drug-resistant tuberculosis, with an emphasis on the situations in the United States and Russia. In the beginning of the 1990s there was an outbreak of (multi-drug-resistant) tuberculosis is New York: a team of very dedicated public health officials, doctors and community health workers fought the outbreak by treating patients as much as possible at home and were capable of reversing the situation, be it at very high costs (1 billion dollars in excess spending on health care). These costs would have been unnecessary if policy makers had in the past realized the threat that TB poses to the society once you become complacent.
In Russia, on the other hand, doctors are far more influential and there are a lot of very perverse incentives that stigmatise patients to such an extent that they actually do not come forward with their TB: they are locked in hospitals for up to 2 years for treatment and 1 in every 5 TB patients is operated upon, even when these operations are absolutely not necessary. And in prisons everything goes wrong that can go wrong with regard to transmission and control of TB and the emergence of multi-drug-resistant TB: overcrowded prisons, interrupted treatment and amnesty for TB prisoners that have not finished their treatment, And all this combined with an unjustified national pride that prohibits the Russians to ask for help or to accept evidence-based interventions that are promoted by the World Health Organization.
I have worked in a few of the prisons in Russia myself to try and improve the diagnosis of TB and the descriptions are very recognizable for me. I wish I had read this book before I started that job, because it had given me a better understanding of the forces I had to fight against.
In Timebomb Lee Reichman gives a very clear description of all the factors involved in Tb, its treatment, the ways in which such treatment may fail and the dire consequences of failure. He also gives personal account of his experiences with multi-drug-resistant tuberculosis, with an emphasis on the situations in the United States and Russia. In the beginning of the 1990s there was an outbreak of (multi-drug-resistant) tuberculosis is New York: a team of very dedicated public health officials, doctors and community health workers fought the outbreak by treating patients as much as possible at home and were capable of reversing the situation, be it at very high costs (1 billion dollars in excess spending on health care). These costs would have been unnecessary if policy makers had in the past realized the threat that TB poses to the society once you become complacent.
In Russia, on the other hand, doctors are far more influential and there are a lot of very perverse incentives that stigmatise patients to such an extent that they actually do not come forward with their TB: they are locked in hospitals for up to 2 years for treatment and 1 in every 5 TB patients is operated upon, even when these operations are absolutely not necessary. And in prisons everything goes wrong that can go wrong with regard to transmission and control of TB and the emergence of multi-drug-resistant TB: overcrowded prisons, interrupted treatment and amnesty for TB prisoners that have not finished their treatment, And all this combined with an unjustified national pride that prohibits the Russians to ask for help or to accept evidence-based interventions that are promoted by the World Health Organization.
I have worked in a few of the prisons in Russia myself to try and improve the diagnosis of TB and the descriptions are very recognizable for me. I wish I had read this book before I started that job, because it had given me a better understanding of the forces I had to fight against.
Most Helpful Customer Reviews on Amazon.com (beta)
Amazon.com:
4.3 out of 5 stars
6 reviews
9 of 9 people found the following review helpful
5.0 out of 5 stars
Public health, politics, and personalities
27 Oct 2001
By Alice Alexander
- Published on Amazon.com
Format:Hardcover
I liked Lee Reichman's new book "Timebomb" on so many levels. As someone who writes about public health issues for a living, I already knew there was big trouble brewing in Russian prisons, where a virtually incurable form of TB has been brewing for years. The trouble is that TB treatment, though highly effective, is fraught with troubles, among them the extremely lengthy and often unpleasant course of treatment; and the acute lack of resources in the very places they're needed the most. What this book does is flesh out, in finely-wrought detail, why these problems have proven so intractable, and why Russia continues not to do the right thing. You can hold this book up as a mirror for any number of other gigantic, slow-moving demons now stalking the planet, from global warming to over-population to the AIDS epidemic ravaging sub-Saharan Africa, and see why we're in the state we're in. As "Timebomb" so tragically depicts, even the best solutions can get distorted in the lenses of culture, ego, and plain old human inertia. I'd heartily recommend "Timebomb" as a must-read to anyone in public health, as well as to anyone interested in how public health works. Recent terrorist attacks on the country make it all the more relevant, sometimes chillingly so. --Alice Alexander
6 of 6 people found the following review helpful
5.0 out of 5 stars
A Riveting and Absorbing Book!
24 April 2002
By Barron Laycock
- Published on Amazon.com
Format:Hardcover
This shocking book focuses on the emerging public health threat associated with the rise of multiple drug resistant (MDR) strains of tuberculosis, especially in the former Soviet bloc of countries. In an age when worldwide travel can be accomplished in days if not hours, the connectivity between what is transpiring in the underdeveloped world and within our own borders is more striking than ever before. Therefore, we must recognize the threat posed by the emergence of such strains, and prepare to deal with the almost inevitable outbreaks of such strains of TB as they begin to occur in modern western societies.
This is not an easy read, but it is a quite fascinating and eye-opening one. The spread of MDR tuberculosis with the populations of Russia and the former satellite countries is shocking, and the total number of individuals latently infected now number some two billion people, or over one third of the total world population! Given the inability of modern medicine to counteract the course of the disease or to easily cure people infected with these new strains, the threat posed by them for people in all countries cannot be over-dramatized. Tuberculosis is indeed highly contagious, spreading freely through the air from infected individuals when they speak, cough, or sneeze. The authors refer to it as the "Ebola with wings", making a tacit reference to this most deadly form of hemorrhagic fever which is quite lethal when contracted, but which is thankfully more difficult to spread since (unlike tuberculosis) it is not airborne.
The predictions of its consequences are dire indeed; MDR tuberculosis is anticipated to kill 30,000,000 in the next decade alone. It festers in the more humid and warmer reaches of the earth, from Brazil to India, from Russia to China, and it is especially dangerous in those area of the world that have the poorest existing public health infrastructures. The economic collapse of the former USSR condemned millions to conditions of enforced cohabitation with infected individuals in the most congested, least sanitary, and most poorly equipped social structures in the world. Given such an alarming rise ion incidence and prevalence of the disease entity, the risk for cross-cultural contamination is only a short air-flight away from a looming public health disaster in the small towns and mega-cities of Europe and North America. Indeed, it is hard to engage in hyperbole here to overestimate the threat.
This book is indeed a call to arms, a plea for enlightened action on the part of governments, public health agencies, pharmaceutical research conglomerates, and the general public in order to avoid the terrors that await us if we sit by without doing all we can do to ensure better safeguards and better screening find, isolate, and treat infected individuals before they can lay the groundwork for a tragic and unstoppable epidemic. This is an important and worthwhile book, and one that I heartily recommend.
5 of 5 people found the following review helpful
5.0 out of 5 stars
Timebomb: The Global Epidemic of Multi-Drug Rfesistant Tuber
3 Mar 2002
By Deborah F. Harkins
- Published on Amazon.com
Format:Hardcover
Anthrax, shmanthrax. To come down with good, productive anxiety, read about "Ebola with wings"-drug-resistant TB. And no, tuberculosis is not a thing of the past: It's here, it's now, it kills 2 million people every year. Several chapters of this book read like a detective novel. Timebomb starts by showing us Nicolay, a Russian, as he flies into New York in 1998, coughing highly infectious, drug-resistant TB bacteria into the plane's air. Then Timebomb looks into risky-to-work-in TB labs; a Siberian prison (where much of the world's TB is generated); a lung operation; the Russian medical system that's failing to control the bug; and takes us along on the dangerous rounds of an unsung heroine, a public-health worker. The book is not only well written, it's about a threat that individual members of the public can actually do something about-if they know the problem exists.
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4.3 out of 5 stars
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