New Drug-Resistant TB Strain Menaces U.S.

A tough new strain of tuberculosis is circulating around the world, including the United States. This form resists nearly all drugs used to fight TB. The U.S. has about a 100 cases, mostly from people arriving from other countries.

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RENEE MONTAGNE, host:

This is MORNING EDITION, from NPR News. I'm Renee Montagne.

RENEE MONTAGNE, host:

Today is the day to think about the disease tuberculosis. It's World Tuberculosis Day. In the United States, TB is at its lowest levels ever, but cases of incurable TB are on the rise around the world. That trend is worrying researchers at both the World Health Organization and the Centers for Disease Control and Prevention.

NPR's Brenda Wilson reports.

BRENDA WILSON reporting:

Over the last decade, cases of multi-drug-resistant tuberculosis in the United States had actually been declining. But in 2004, that changed. The number of cases went up 13 percent. The numbers are still small, but Dr. Kenneth Castro of the CDC says it's still a disturbing trend.

Dr. KENNETH CASTRO (Centers for Disease Control): It's a movement in the wrong direction. Why is it? I think we're seeing the global reality represented right here in our own midst. I believe that out of a 128 persons who fit this definition, most were foreign born.

WILSON: More than half of those with multi-drug-resistant TB in the U.S. came from Mexico, the Philippines and Vietnam. But Castro says there's an even more worrisome trend. A subset of TB cases in the U.S., about four percent over the last 10 years, have what is known as XDR TB, extensively drug resistant TB, a form of TB which Castro says is all but incurable.

Dr. CASTRO: For someone with garden variety TB that is not drug resistant, you should expect to treat them and cure them in six months. These persons take at least two years to achieve a cure, and in some instances, depending on the extent of the disease, they may also require surgery to remove that part of the lung that's most affected as a way to intervene.

WILSON: Worldwide there is no clear evidence of how widespread XDR TB is. Surveys in Latvia and Eastern Europe, for example, found up to 19 percent of drug resistant TB to be extensively drug resistant. Drug resistant TB emerged 15 years ago in the U.S. and led to a resurgence of the disease. Infusions of new money helped get it under control, but the CDC's TB budget faces a cut of 17 percent this fiscal year. WHO's Dr. Marcos Espinal says that's a disgrace.

Dr. MARCOS ESPINAL (Executive Secretary, Stop TB Partnership): We have a curable disease. We have plenty of new compounds, new diagnostic tests in the pipeline to be introduced. And I think it is time to act now. And certainly from an international point of view, I'm amazed that the budget of the CDC has been cut.

WILSON: The WHO says at least $50 billion is needed from the U.S. and other wealthy nations over the next ten years to tackle the worldwide epidemic which kills two million people each year.

Brenda Wilson, NPR News.

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