Drug-Resistant Tuberculosis

Drug-resistant "white plague" lurks among rich and poor

By Kate Kelland, Health and Science Correspondent | Reuters

http://news.yahoo.com/drug-resistant-white-plague-lurks-among-rich-poor-113851688.html

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INTERNATIONAL ALARM

TB is a bacterial infection that destroys patients' lung tissue, making them cough and sneeze, and spread germs through the air. Anyone with active TB can easily infect another 10 to 15 people a year.

In 2010, 8.8 million people had TB, and the Geneva-based World Health Organization (WHO) has predicted that more than 2 million people will contract multi-drug resistant TB by 2015. The worldwide TB death rate currently runs at between two and three people a minute.

Little surprise, then, that the apparently totally untreatable cases in India have raised international alarm.

The WHO has convened a special meeting on Wednesday to discuss whether the emergence of TB strains that seem to be resistant to all known medicines merits a new class definition of "totally drug-resistant TB", or TDR-TB.

If so, it would add a new level to an evolution over the years from normal TB, which is curable with six months of antibiotic treatment, to the emergence of MDR-TB, then extensively drug-resistant TB (XDR-TB).

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Like other bacteria, the TB bug Mycobacterium tuberculosis can evolve to fight its way past antibiotic medicines. The more treatment courses patients are given and fail to complete, the stronger and more widespread the resistance becomes.
"The doctors, the healthcare workers, the nurses, entire healthcare systems have produced MDR-TB. It's not a bug that has come from nature. It's not a spontaneous mutation. It came about because patients were treated badly -- either with poor quality drugs, or not enough drugs, or with insufficient observation so the patient didn't finish the treatment course," said Ditiu.

Ditiu is somewhat reassured that the WHO is meeting to look at recent extreme cases of drug-resistance, which will at least throw a spotlight on this often-forgotten disease. But she says while definitions are central to international guidelines and treatment protocols, they make little difference to sick people.

"What is much more important is the drama and tragedy of the human beings. Whether it's MDR, XDR or TDR TB, it doesn't make much difference to the patients. A lot of them will face a very, very unfortunate fate."
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