Lantana, Florida-cough at first, a little cold --
Season hacker who refused to leave.
Then there is fever.
They bathe and freeze 19-year-old Osvaldo Juarez's skinny bodyyear-
Old Peruvians visited to learn English.
His lungs clucked, his chest tightened, and he was sore every time he panted.
Breathe at 4. m.
Juarez felt a warm knot in his throat.
He ran into the sink in the bathroom and spit out a mouthful of blood.
He said to himself, "I'm going to die because it's really bad when you cough up blood.
"It's really bad, not just for him.
Doctors say the constant hacking of Juarez is a sign they have both feared and looked forward to over the years --
The country's first case of infectious and aggressive drugs in particular
The form of drug resistance of tuberculosis.
AP reporter learned about his situation, has not been announced so far, as six
A month later, the global challenge to drug resistance has soared.
The pressure of Juarezso-
Known as extreme drugsresistant (XXDR)TB —
According to the doctor, I have never seen it in the United States.
David Ashkin, one of the leading TB specialists in the country.
Tuberculosis is so rare that only a few others in the world are considered to have tuberculosis.
"These are the things we really fear because I'm not sure how we treat them," Ashkin said . ".
40 years ago, the world thought it had conquered TB and any other disease through new magic drugs: antibiotics. U. S.
William H. surgeon
Stewart announced that it was time to end the book on infectious diseases and announce the victory of the war over the plague.
"Today, all the deadly infectious diseases on Earth
Including tuberculosis, malaria and HIV.
It is changing at an amazing rate and hitchhiking in and out of the country.
Reason: excessive use and misuse of drugs that should have saved us.
Just as drugs are human solutions to dangerous diseases, their problems are human.
From counterfeit drugmakers to the unintended consequences of providing drugs to the poor without proper monitoring of treatment, this has contributed globally.
Here's what AP found :-
In Cambodia, scientists have confirmed the emergence of a new drug.
The form of resistance to malaria threatens the only treatment against a disease that has killed 1 million people every year. —
New and harder in Africato-
HIV-treated strains were detected in about 5% of new patients.
HIV resistance has soared to 30% worldwide. —
Drugs in the United States
Last year, drug-resistant infections killed more than 65,000 people, more than the sum of prostate and breast cancer.
In Norway alone, more than 19,000 people have died from the infection of golden yellow grapes. in Norway, antibiotics are strictly restricted.
"Drug resistance is starting to become a very big problem.
In the past, people were no longer worried about TB, and TB returned.
We need to make sure this doesn't happen again . "
FBI Director Thomas FriedenS.
The Centers for Disease Control and Prevention, who himself contracted TB while taking care of the drug
Drug-resistant patients at a clinic in New York in early 1990.
"We are all connected by the air we breathe, which is why it must be a problem for everyone.
"On April, the World Health Organization held the first drug Conference, which sounded the alarm.
Beijing conference on tuberculosis prevention and control.
The information is clear-
The disease has spread to all continents and is increasing rapidly.
To make matters worse, who estimates that only 1% of drug-resistant patients received appropriate treatment last year.
"We have seen a huge outbreak of resistance," said Dr . "Laurie Hicks. ———
Doctors are confused about the TB.
He's never had tuberculosis before.
Where did he get it?
Did he pass it on?
Can they stop it before it kills him?
At first, mainstream doctors tried to treat him.
But the disease has already chewed the golf ball.
He has a big hole in his right lung.
TB bacteria can float in the air for a few hours, especially in places where there is little sun or fresh air.
So whenever Juarez coughs, sneezes, laughs or talks, he spreads the deadly bacteria to others.
"You think you're killing people like you can kill a lot of people.
That's the worst part, "he said.
According to WHO, TB is the world's number one infectious killer for adults, with one person in every three people dormant.
Among them, 10% will develop active TB, and about 2 million people will die from TB every year.
Simple TB treatment simple-
It's as cheap as a $10 session for six to nine months.
But if the treatment is stopped for a short period of time, the bacteria will fight back and mutation into a more difficult bacteria.
Treatment drugs can cost $100,000 or more per year
As much as anti-TB saysdrug-resistant (MDR)
A wide range of drugsresistant (XDR)and XXDR.
At present, there are about 500,000 cases of multi-drug resistant tuberculosis worldwide every year.
Three years ago, 52 of the 53 people diagnosed with XDR tuberculosis in South Africa died. Drug-
Drug-resistant TB is a time bomb ".
Masae kaw, head of Francis J.
The Curry National TB center in San Francisco, "This is an expensive, deadly, weak human problem and the biggest threat to our current TB control strategy.
Juarez received three months of ineffective treatment at a hospital in Fort Lauderdale.
He was then sent to A on December 2007. G.
Holly State Hospital, 60-year-
Large old building surrounded by brown concrete-
Just south of West Palm Beach at the link fence.
"They told me that my treatment will be two years and I have only one chance in my life," said Juarez . ".
"They told me that if I went to Peru, I would probably live for a month and then I would die.
"Holly is the last one in the country.
Now manage new and deadly forms of isolated hospitals for the disease, permanent TB nursing homes.
Tuberculosis has been detected in the spine of 4,400-year-
Mummies of ancient Egypt
In the 1600 s, it was called the "white plague" for making the patient pale ".
In the later centuries, when it was fed through the body, they called it "consumption ".
"1850, about 25% of Americans and Europeans die from TB, often waiting in isolated nursing homes before rest and nutrition.
On 1944, a patient with severe tuberculosis received a new magic antibiotic and recovered immediately.
New drugs are coming soon.
They work so well that when they were in their 1970 s in the United States, people thought the disease was a problem of the past.
Once public health officials have identified TB as having disappeared, the disease is becoming more and more likely to be ignored or misdiagnosed.
Without public funds, it is making a comeback among the poor.
Migration and travel then flourish, breaking the invisible wall to curb TB.
Drug resistance has emerged globally.
Doctors treat TB with the wrong combination of drugs.
The clinic ran out of medicine.
When the patient feels better, they shorten the treatment time and even share the pills with other family members.
There are two ways to obtain drug-resistant TB.
Most cases are due to inappropriate medication.
But it can also spread like a simple TB, cough or sneeze.
In their 1980 s, HIV and AIDS reappeared TB cases.
TB remains the biggest killer of people living with HIV today.
For decades, drug manufacturers have failed to develop new drugs to treat TB because profits do not exist.
With the emergence of drug-resistant TB, some private pharmaceutical companies have begun to develop new treatments, but it may take 24 years to obtain a complete treatment plan in the market.
At the same time, who estimates that each victim will be infected with an average of 10 to 15 people per year before death. A. G.
Holly started doing business again. ———
Holly's corridor is long and dark, and the fluorescent tubes give a harsh white light on the monotonous walls.
A room is filled with bulky machines that used to shrink the lungs and sometimes insert table tennis.
Antique cabinets are equipped with metal tools for spreading and removing ribs
Tuberculosis has been rampant and 500 hospital beds have been filled.
There are only 50 beds available today, but most of them are full.
More than half of the patients were in court.
Was ordered for treatment after refusing to take medicine outside.
Juarez came voluntarily.
At first, when he left the room, he was isolated and forced to wear a mask.
He can only touch his Peruvian family in a photo posted on the wall.
He misses his father, his brothers and sisters, his dog, his parrot, especially his mother.
"I was very upset," he said . "
"I have these things in my head.
"He spent countless hours alone in a sterile corner reserved for patients who stayed for a long time --
Known as the "penthouse" as it is larger, arranged by a wall of windows.
His mood was cold and hot.
Out of frustration, he holes in the wall, plays loud reggaeton music with thum Bang and fights with other patients.
He covered the small window of the door with a picture of an evil clown, not allowing the nurse to look inside.
He made friends with new patients, but after many of them came, cured and left, he was forced to stay for a long time.
In the early days, the treatment of Juarez was similar to chemotherapy.
Three times a day, the intravenous drug was injected into his blood, and he took another 30 pills, some of which turned his skin into dark brown.
He swallowed them with a spoonful of apple sauce, yogurt, ice cream and chocolate pudding, but once they hit his stomach, the disgusting wave sometimes makes him vomit.
He will then have to force them all down again.
"When he first came in, we really had to throw him everything and the kitchen sink," said Ashkin, the hospital's medical director, some of his drugs against Juarez at high doses are not usually used for TB.
"It's definitely cutting-edge and there's definitely a certain risk because I can't go to the textbook or. . .
Find out how to do this in journal articles.
"17 years after dealing with complex cases --
Including tuberculosis in the brain and spine
Ashkin has never seen such a case of resistance.
He thinks he has to remove a part of his lungs.
Ashkin dialed a phone call from Peru to talk to the young man's father.
It's a rare disease that is hard to define, says Ashkin.
Your son is one of the two people in the world who are known to have this pressure, he said.
"What happened to another person?
Asked his father. "He died. "———
Juarez's adventures in the United States turned into a medical nightmare.
Some 60 million people visited the United States. S.
Every year, most people do not receive TB screening until they arrive.
Only refugees and immigrants will be inspected.
Top categories of multi-medicine
Drug-resistant patients in the United States
82% of cases identified in 2007was foreign-
According to the CDC, the patient was born.
The results of these tests are amazing, Dr.
Angel Contreras, who screened the Dominican people who tried to enter the United States through an immigration visa.
High multi-drug resistance rate
He said TB in the republic of multi-republic and high HIV infection rates in neighbouring Haiti are becoming a health crisis.
"They are the perfect ingredients for dealing with disasters," he said . "
Peru, the hometown of Juarez, is also a hot spot for multi-drug treatment. resistant TB.
DNA fingerprints showed that his disease was related to similar strains found in China and China, but none of them had the same level of resistance.
"So the question is: is this an evolutionary pressure?
Is it more and more resistant? " asked Ashkin.
"I think the answer is yes.
"Doctors who struggle with these new strains inadvertently give the wrong drugs, so TB mutates and becomes more aggressive and resistant.
Poor countries also don't have the resources to determine if TB is a drug for patients. resistant.
Need sputum culture and medicine
Drug sensitivity test
A timely, costly process that must be performed in a competent laboratory.
Who are trying to make these methods High
Risk country and negotiate cheaper prices for second countryline drugs.
"There's a lot of multi-drug resistance and XDR-
Tuberculosis has not been diagnosed in South Africa, Peru, Russia, Estonia, Latvia and other places . "
Megan Murray, TB specialist at Harvard University
"We think this is a huge public health threat.
Experts believe that if rich countries do not help the worst
Hit place has developed a comprehensive TB program that puts everyone at risk.
"You're really looking at a global problem," he said . "
Lee Reichman is a TB specialist at the global TB Institute at the New Jersey Medical School.
"It's not a foreign issue and you can't shut out these TB people.
Now is the time for people to realize this. "———
Juarez lived alone in a bikini-covered room for a year and a half.
Dressed in Blonde, baseball cap and posters of Mount Everest.
He simply shut down and refused to take medicine for a few days until his family persuaded him to continue fighting.
He sat in bed in loose jeans and said, "I'm thinking, if I need to die, that's what I need to do . ".
"I think, 'I will never be better.
I will never leave here.
"When he is placed side by side, it is difficult to believe his CAT scan before and after treatment.
The dark hole is gone and there is only one small white scar tattooed on his lungs.
"They told me that TB has disappeared, but I know there is no cure for TB.
He said his English is now fluent and weighs 32 pounds more than when he first arrived.
"TB can come back.
I have seen people who have returned to the hospital twice, some of whom have died.
So, this is terrible.
Medical director Ashkin says his treatment costs Florida taxpayers an estimated $500,000, and appears to be spending astronomical amounts on a non-US citizen.
But he questioned how the world could afford not to treat Juarez and other diseases similar to the deadly virus.
"It's an air-borne disease. . .
So when we treat that person, we are actually treating and protecting all of us . "
This is real homeland security.
At the age of July 21
19 months after check in
Juarez swallowed the last pill, packed up several small suitcases and pushed them down the long corridor of the hospital.
The last time the doctor saw him, he was coming out of the nursing home and entering the hot weather in South Florida.