Killer TB Hits India

Just as India celebrated the one-year anniversary of what appears to be the last child to be infected with polio in that country, physicians there have reported the occurrence of a dreaded disease: a deadly form of tuberculosis that is completely resistant to any of the drugs typically used to treat it. They described patients with the incurable illness, called totally drug-resistant tuberculosis (TDR-TB), in the February issue of Clinical Infectious Diseases. This new finding makes India the third country in which TDR-TB has appeared. Cases of the disease turned up in Italy in 2007 and in Iran in 2009, though some researchers claim that TDR-TB is just a more severe form of extensively drug-resistant tuberculosis (XDR-TB), which has been found in at least 58 countries across the globe. A variety of factors could have led to the development of TDR-TB, including inadequate detection and diagnosis, improper treatment, and the lack of new first-line drugs to treat drug-resistant forms of TB. “The cases are a story of mismanagement,” Giovanni Migliori, director of the World Health Organization (WHO) Collaborating Centre for Tuberculosis and Lung Diseases in Tradate, Italy, told Nature. “Resistance is man-made, caused by exposure to the wrong treatment, the wrong regimen, the wrong treatment duration.”