Tamping Down Tuberculosis in Russia

The methods for fighting the multidrug resistant TB epidemic in Russia

Merrill Goozner / Scientific American

HEADQUARTERS: A Napoleonic-era building that is Moscow's tuberculosis (TB) research hospital and the home of the Research Institute for Phthisiopulmonology (tuberculosis study). Since the 1990s, Russia has struggled to deal with a epidemic of TB, an infectious disease of the respiratory tract that can spread to other organs and

become lethal.

UNDER THE KNIFE: Surgery is still widely employed in Russia to treat TB, despite international controversy over its use. Professor Ivair Strelisi, chief of the TB Department of

Siberian State Medical University in Tomsk as well as chief surgeon at the hospital, examines a patient named Alexander Ryazonov. This 32-year-old had one lung partially removed two days before. About 10 to 15 percent of hospital patients ultimately get surgery, Strelisi said.

HARD TO REACH, HARD TO TREAT: A nurse administers drugs to a person infected with multidrug resistant (MDR) TB living in a tenement. Caregivers deliver medicine to public housing residents to

help ensure that the treatment, called "directly observed therapy, short course," or DOTS, is properly taken and that the drug regime is completed.

BREATH COLLECTOR: Prof. Strelisi shows off a so-called "clean room" facility where sputum--aerosolized, TB-carrying saliva and mucus--from the lungs can be tested.

ON THE ROAD TO RECOVERY?: Soli Asadov, a 36-year-old migrant worker from Uzbekistan, contracted TB two years ago, but admits he has not followed the regimen for treating the disease.

QUARANTINED IN CLOSE QUARTERS: Patients with MDR-TB are often housed in separate facilities to minimize the chances of infecting others with the hard-to-kill bacterium.

TB TECHNOLOGY: Jerald Sadoff, president and CEO of the Aeras Global TB Vaccine Foundation, stands before the nonprofit organization’s large-scale bioreactor, a device where

TB experiments can be carried out.

NOTHING TO SNEEZE AT: Careful records are kept of dispensed medications, and administrative staff often take extra precautions to avoid getting TB while on the job.