Swiss, Japanese scientists unite to tackle TB

Scientists from Switzerland and Japan, in Seattle for an international research conference, yesterday announced a plan to unmask and defeat a largely hidden killer.

One-third of the world's population is infected with tuberculosis, including about 100,000 people in Seattle and King County, but most are unaware of it partly because the standard diagnostic lab test for TB is cumbersome and difficult to interpret.

Yesterday, the Foundation for Innovative New Diagnostics, a Swiss non-profit organization, and Eiken Chemical, a Japanese biomedical firm, announced plans to collaborate on developing a rapid, simple and inexpensive TB test.

"It's a travesty that we're still using such antiquated (diagnostic) technology," said Dr. Peter Small, chief of tuberculosis programs for the global health mission at the Bill & Melinda Gates Foundation. Lack of accurate and easy TB testing, Small said, contributes to the spread of this disease that kills 2 million per year.

"With this, we should be able to cure the vast majority of TB cases," said Mark Perkins, chief scientific officer for the Foundation for Innovative New Diagnostics, formed with a $30 million grant from the Gates Foundation to promote the development of affordable lab tests of infectious diseases in poor countries.

While most cases of TB are easily treated and cured -- though only after months of a daily drug regimen -- the bacterial illness continues to spread worldwide. In some areas, TB has become drug resistant, requiring more than a year of treatment to clear it.

"TB is not uncommon anymore," said Dr. Masa Narita, chief of tuberculosis control at Public Health -- Seattle & King County. Recent outbreaks of active TB in local schools are evidence of this, Narita said, adding that this year's caseload appears to be higher than last year's so far.

Of the 50 or so cases of active TB, he said his agency has had to deal with only three people with multidrug resistant disease. But each case costs about $9,000 to manage and the multidrug ones can each cost up to a quarter-million dollars. And those are just the recognized, active cases of the disease.

In poor countries lacking in health care resources, those with TB often die. It remains one of the world's biggest killers with half the cases in India and China. Accurate and early diagnosis can help stem the spread of the disease and reduce the death toll.

"The big hurdle is detecting those people who need treatment," said Perkins. He and Small noted that there are other projects (some of them also supported by the Gates Foundation) aimed at reducing the expense and complexity of TB treatment as well.

The standard method for diagnosing TB is examining sputum in a microscope and, if needed, culturing the bacteria in a lab. Microscopy requires expertise and often misses early infections. The lab culture requires facilities lacking in many parts of the world and takes four to six weeks to determine infection.

"There is an urgent need for a fast, easy and cost-effective way to diagnose tuberculosis," said Dr. Giorgio Roscigno, chief executive of the Foundation for Innovative New Diagnostics.

Eiken has developed a unique method of "molecular amplification" testing that it believes can detect TB DNA directly from clinical samples in less than two hours with minimal equipment. TB is primarily spread by coughing among people in close contact. The AIDS epidemic has helped fuel its spread by making many more people susceptible to the infection, which is often the primary cause of death for people with HIV.

The collaboration between FIND and Eiken was announced at the 40th Annual U.S.-Japan Tuberculosis and Leprosy Research Conference.

P-I reporter Tom Paulson can be reached at 206-448-8318 or tompaulson@seattlepi.com.