Doctors in India have made reports of their countries initial cases of resistant TB. This strain of tuberculosis is a long feared form of the killer lung disease that is virtually untreatable.
Such cases have also been documented in both Iran and Italy since 2003. In most cases, the disease has been limited to areas of great poverty and not spread widely. However, it is possible that there are many cases yet undocumented.
There is little fear of the strains of Indian TB to spread to other locations. The disease is primarily transmitted by close personal contact and is less contagious than the flu. Most of the reported cases did not transfer from one person to another, but the mutations occurred in patients receiving poor treatment.
The World Health Organization refuses to accept the term drug resistant TB infections. It still considers these cases extensively drug-resistant. However, one of the coordinators at WHO’s Stop TB department located in Geneva says there is plenty of evidence of virtually untreatable cases.
Dozens of medicines were used on the initial cases in India, and none worked. According to the US Centers for Disease Control, these cases appear to be very resistant to the drugs available.
Information about tuberculosis disease shows it ordinarily cured by a six to nine month course of antibiotics. Interruption of the treatment or giving the patient less than the recommended amount of antibiotic allows the bacteria to return in a mutated form that is tougher than ever to kill and resistant to treatment. Tuberculosis and treatment becomes much more difficult and expensive to treat.
In the resistant cases, 12 patients failed in the initial treatments and when treated for an additional two to three years did not respond. Three of these patients have died and the remaining patients have not been successfully treated.
Private doctors that prescribed inappropriate drugs have been blamed for the increased resistance in three of four patients in one study. These patients were given inappropriate doses or the wrong types of antibiotics. Little hope is seen for the remaining nine patients. There is a single case of a mother passing the disease to a daughter and all patients are poor slum dwellers. HIV in patients results in faster deaths.
The patients with this strain of TV are part of the untouchables so there is little fuss being made over the problem. Local doctors fear that the disease will begin to spread among families.
WHO is working with local doctors to improve diagnostics and regulate TB treatment among the private sector.
In 2009, a Peruvian teen was infected in Peru and diagnosed when visiting Florida. After 18 months of treatments using experimental medications in high doses and a cost of $500,000, the teen was successfully treated. However, such resources are unthinkable in many of the developing countries such as India.
Studies of the causes of tuberculosis find that it is lying dormant in one of three people. About 10% of these patients will eventually develop the disease. India is home to 25% of the TB cases in the world and about 20% of the multi-drug resistant cases.