"Totally drug-resistant tuberculosis" case reported in India

India has reported the first case of "totally drug-resistant tuberculosis," a long-feared and virtually untreatable form of the killer lung disease. Similar highly resistant cases have been noted before. In 2003, two Italian women died and there were 15 cases reported from Iran in 2009. That same year, The Associated Press reported on a case of a Peruvian teenager who was infected at home but diagnosed while visiting Florida. Such kind of TB has mostly been limited to impoverished areas, and has not spread widely. But experts believe there could be many undocumented cases. No one expects the Indian TB strains to rapidly spread elsewhere. The airborne disease is mainly transmitted through close personal contact and isn't nearly as contagious as the flu. Indeed, most of the cases of this kind of TB were not from person-to-person infection but were mutations that occurred in poorly treated patients. The Indian hospital that saw the initial cases tested a dozen medicines and none of them worked. A TB expert at the U.S. Centers for Disease Control and Prevention said they do appear to be totally resistant to available drugs. "It is concerning," said Dr. Kenneth Castro, director of the CDC's Division of Tuberculosis Elimination. "Anytime we see something like this, we better get on top of it before it becomes a more widespread problem." Ordinary TB is easily cured by taking antibiotics for six to nine months. However, if that treatment is interrupted or the dose is cut down, the stubborn bacteria battle back and mutate into a tougher strain that can no longer be killed by standard drugs. The disease becomes harder and more expensive to treat. Tuberculosis is an age-old scourge that lies dormant in an estimated one in three people. About 10 percent of those people eventually develop active TB, which kills roughly 2 million a year, according to WHO. Each victim infects an average of 10 to 15 others every year, typically through sneezing or coughing. If a TB case is found to be resistant to the two most powerful anti-TB drugs, the patient is classified as having multi-drug-resistant TB (MDR). An even worse classification of TB — one the WHO accepts — is extensively drug-resistant TB (XDR), a form of the disease that was first reported in 2006 and is virtually resistant to all drugs. About 20 percent of the world's multi-drug-resistant cases were found in India, which is home to a quarter of all types of tuberculosis cases worldwide.