Marshall Islands in health emergency over TB outbreak

January 30, 2010

An outbreak of drug-resistant tuberculosis in the Marshall Islands has been declared a public health emergency, as the government Saturday considered invoking special powers of quarantine.

The number of people in the western Pacific nation with the drug-resistant disease has risen from six to 10 in less than two months and there are fears it will spread further with health officials tracking an estimated 500 contacts.

"We are in the process of doubling the bed capacity" in the TB isolation unit, said Majuro Hospital chief of staff Marie Lanwi-Paul.

"It's still too early to tell how many will need to be isolated for drug-resistant TB," the doctor said.

Rachel Powell of the US Centers for Disease Control, which is working with the to coordinate the response to the newly identified strain, described the escalating situation as "a ."

" poses a serious threat to our ability to treat and control TB," she said.

Marshall Islands Health Minister Amenta Matthew said she was drafting legislation to give the director of health power to quarantine people who did not voluntarily comply with TB prevention requirements.

She said the development of drug-resistant TB was due largely to the refusal of patients to take medicines despite the counselling efforts of physicians.

"Currently, there are patients who continuously move around the community with TB disease posing the threat of exposing others to the disease," she said.

Health authorities took one patient to court last week for failing to take treatment and remain in isolation.

The judge, lawyers, witnesses and the defendant were required to wear face masks to prevent the spread of TB during the hearing, but the session ended without an immediate result, allowing the patient to remain in the community.

Matthew's proposed legislation would do away with the lengthy court process and she said the nation would be better served if the director of public health had the authority to put patients in isolation as required.

The Marshall islands, a western Pacific archipelago of around 55,000 people, is a former US-administered territory and its residents can travel to the United States to live without a visa under a Compact of Free Association.

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