Public Health


It's MORNING EDITION from NPR News. I'm Steve Inskeep.


And I'm David Greene, sitting in for Renee Montagne.

Curing tuberculosis was one of the first big victories gained from the use of antibiotics. But now doctors are reporting strains of TB that can't be killed by any available drug. NPR's Richard Knox has more on this latest development.

RICHARD KNOX, BYLINE: Doctors in Mumbai have found a dozen TB patients who can't be cured by any of the first and second choice drugs available to treat the disease. They have what specialists call totally drug resistant TB.

DR. RICHARD CHAISSON: Totally drug resistant TB is a term that has been coined to describe TB that has become resistant to just about everything we have in our armamentarium.

KNOX: That's Dr. Richard Chaisson, a TB expert at Johns Hopkins in Baltimore. India's not the first place doctors have seen this worst-of-all-possible TB bugs. Back in 2003, two women in Italy had it. Two years ago, 15 cases were reported in Iran.

But Chaisson says India is the perfect incubator for this invincible new type of TB. He and other experts say India's notorious for having private practitioners who are unschooled in treating TB, especially resistant forms. One recent study found only one private doctor in 20 knew the right drugs to prescribe in the right doses. And improper treatment allows the most dangerous strains to thrive.

CHAISSON: Whatever doesn't kill the bugs can make them stronger and make them resistant to our treatment.

KNOX: The appearance of totally resistant TB in India is a bellwether. That country already has the world's largest number of people with less-than-totally-resistant TB. And all of them are at risk of becoming untreatable. So far, nobody has shown that the dangerous new bug is spreading from person to person. But it would be surprising if it didn't.

CHAISSON: What we've learned over the years is that drug resistant TB is every bit as transmittable as drug susceptible TB.

KNOX: Yet Chaisson says it's unlikely a tourist to India would get totally resistant TB. The numbers are still small, and it requires intimate contact. But the problem will certainly grow. India's public TB control program has just begun to cover the expensive drugs needed to treat any resistant TB. So there are lots of people who have TB that's just on the brink of becoming totally resistant.

Richard Knox, NPR News.

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