A new class of killer germs stalks India

New forms of bacteria are causing severe respiratory ailments in India but most doctors don't recognise them, experts say.

Although easily treated, doctors frequently misdiagnose ''atypical pneumonia'' and administer inappropriate antibiotics, leading to complications and even death.

''No concrete data exist in India for atypical pneumonias caused by the three known types of bacteria -- the legionella, mycoplasma and chlamydia -- but these are responsible for up to 40 per cent of all pneumonias in the west,'' said Dr Charles Chan, a specialist from Toronto General Hospital, Canada.

Because the Indian climate is right for the proliferation of such bacteria, incidence of such illness could be even higher, said Dr Ashok A Mahashur, head of the department of chest medicine at KEM Hospital, Bombay.

Dr Mahashur said the germs may be more widespread than thought and causing more respiratory diseases, especially since they are infectious. The number of cases might be rising daily, he said.

Dr Chan said that since atypical bacteria could not be cultured like the well-known or typical varieties and since the symptoms they cause are similar to known respiratory diseases like pneumonia, they were wrongly tackled.

"A lot of physicians do not recognise them and give drugs for treating typical bacteria, endangering lives," he said, adding that the mortality rate for one kind of atypical bacteria, legionella pneumophila, was as high as 20 per cent.

Once diagnosed following a blood test for its antibodies, atypical pneumonia could be treated with a class of drugs including clarithromycin, Dr Chan said.

While young and healthy people could be affected by atypical pneumonias, Dr Chan said the bacteria could be reactivated even in older people, causing simple sore throat, progressing to bronchitis and then to pneumonia. The legionella prefers drinking water tanks, the mycoplamsa preferred the through, shifting hosts through sputum.

Dr Mahashur said pneumonia, which impairs vital lung functions, affects more than one million persons every year. The disease continues to rank among the five leading causes of death in India.

Pneumonia due to legionella pneumophila seems to occur more frequently among men, persons over 50 and patients requiring dialysis or transplantation. Smokers and those with lung disease such as chronic bronchitis, emphysema or those with diabetes seem are more at risk, he said.

The chlamydia bacteria account for about four to 12 per cent of all pneumonias, with primary infection occurring in early adulthood and reinfection in later life.

Dr Chan said the United States, recognising the severity of the disease, had enforced guidelines for diagnosis and treatment of atypical pneumonias in 1992.While a similar set of guidelines had been drawn up for the Asia-Pacific region, they were yet to be adopted, he said.