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Superbug warning alarmist, say Indian docs

  Friday, 13 l 08 l 2010 Source:  The Straits Times   
By: Ravi Velloor

india medical tourismNEW DELHI: Warnings of a drug-resistant superbug reportedly found in some British patients who had treatment in India could well be prematurely alarmist, doctors here say.

The medical tourism industry’s response is even more blunt, calling it an attempt to discredit a business that earned the country an estimated 20 billion rupees (S$584 million) last year.

British newspapers have been awash with reports that 37 patients, mainly those who had travelled to India and Pakistan, had been infected with a superbug.

Called NDM-1, it is resistant to almost all known antibiotics and is capable of jumping from one bacterium to another. The United States yesterday said it had identified three patients with NDM-1.

NDM – short for New Delhi metallo-beta-lactamase – is an enzyme that can cause gastric diseases and multiple organ failure. The patients had travelled to the sub-continent for plastic surgery, transplants or cancer treatments.

“What is being projected here is just one viewpoint in science,” said Dr Sarath Gopalan, one of New Delhi’s top specialists in gastroenterology.

“Quite often, we do find that the context in which the interference was drawn is misinterpreted. We can never wave away medical research but it is also important to remember that there was a time when research purported to show that Malaysian palm oil was extremely harmful to the heart. The situation need not be as dire as it sounds,” he added.

Writing in the Lancet Infectious Diseases journal on Wednesday, a team led by Professor Timothy Walsh of Cardiff University wrote that the NDM-1 was becoming common in India, Pakistan and Bangladesh and was also being exported to Britain where patients return after treatment.

“India also provides cosmetic surgery for other Europeans and Americans, and it is likely NDM-1 will spread worldwide,” the scientists wrote.

The suggestion that foreigners travelling to India for medical treatment could be at risk has raised a storm of protest from the country’s medical industry. The industry is projecting earnings of about 95 billion rupees from overseas patients by 2015.

Chains such as Apollo, Max and Fortis – which recently almost succeeded in taking control of Singapore’s Parkway Group – are eyeing this lucrative sector, which draws patients from countries as far away as Iraq, Afghanistan and the US.

In addition to patients seeking Western-style cures, thousands more arrive for traditional treatments such as ayurveda and other rejuvenating therapies.

“I see this as something of a red herring,” said Dr Yatin Mehta, head of critical care and anaesthesia at India’s most modern hospital.

Called Medanta – The Medicity, the 1,200-bed facility came up last year in Gurgaon, the town where the British researchers are said to have identified one case of NDM-1.
“I think our hospital hygiene standards are better than those of the National Health Service in Britain. I would say hospital-acquired infections would be more common in Britain than in India.”

The Indian government has reacted cautiously to the news.

“Multi-drug resistance can be found anywhere in the world,” said Dr V.M. Katoch, Secretary for Health Research who also chairs the Indian Council of Medical Research. “It is unfair to blame India for that.”

Nevertheless, the study has focused attention on infection control in Indian hospitals. While no one doubts the skills of Indian surgeons or the diagnostical brilliance of Indian doctors, hospital hygiene and practice is one area that needs vast improvement, anecdotal evidence suggests.
The country also lacks policies on antibiotics usage. Neither is there a registry of hospital-acquired infections.

Dr Dilip Mathai, head of internal medicine at the nationally known Christian Medical College in Vellore, Tamil Nadu, says four in 10 patients admitted to Indian hospitals catch infections.

This extends their hospital stay, increases expenses and leaves side effects.

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