BBC News - 17 January 2012
Tuberculosis which appears to be totally resistant to antibiotic
treatment has been reported for the first time by Indian doctors.
Concern over drug-resistant strains of TB is growing, with
similar 'incurable' TB emerging in Italy and Iran.
Doctors in Mumbai said 12 patients had a "totally drug resistant"
form of the infection, and three have died.
The Indian Health Ministry is investigating the cases and has
sent a team of doctors to Mumbai.
TB is one of the world's biggest killers, second only to HIV
among infectious diseases.
Normally a patient with TB is given a six to nine month course of
antibiotics to eradicate it.
However, new strains of the bacterium have developed which are
increasingly resistant to the antibiotics most commonly used to
Partially drug-resistant TB can now found in countries across the
world, and "multi-drug resistant" strains affect countries such
as Russia and China.
The Indian reports will fuel concerns over the ability of doctors
to contain the disease in years to come.
The doctors at the Hinduja National Hospital in Mumbai who
discovered it said they had treated patients for up to two years
with a battery of drugs, to no avail.
The patients came from slum areas of the city, they said, where
close contact between people meant further spread was likely.
The American Centers for Disease Control (CDC) confirmed that the
Indian strain did appear to be completely resistant.
Dr Kenneth Castro, director of its Division of Tuberculosis
Elimination, said: "Anytime we see something like this, we better
get on top of it before it becomes a more widespread problem."
Patients who do not finish their lengthy course of treatment also
present the bacterium with the perfect environment for developing
However, there have been repeated calls for the pharmaceutical
industry to make more efforts to develop fresh antibiotics.
Dr Ruth Mcnerney, a senior lecturer at the London School of
Hygiene and Tropical Medicine and a trustee of charity TB Alert,
said the new cases represented a "serious threat" to global
efforts to control TB.
"What we're seeing is probably just the tip of the iceberg. We
don't know how widespread this is because so few people are
tested for drug resistance."
She said the high prevalence of TB in India, coupled with high
population density within its cities, meant that the new type of
TB could be a bigger problem than previous "totally resistant"
"It's going to take a massive effort and change in political will
to get to grips with this - not just from the Indian government
but from everyone else. This is a global problem, not just an