MUMBAI—A top Mumbai pulmonologist has told the Indian government he has seen 12 cases of tuberculosis in this city that are totally resistant to all of the current treatments, forcing India to confront weaknesses in its programs to combat this contagious, potentially fatal lung disease.
Zarir Udwadia, one of Mumbai's leading private pulmonologists, reported the first four cases in a letter in December to the Clinical Infectious Diseases magazine, a publication of the Infectious Diseases Society of America. He said in an interview that he has now seen and tested a total of 12 patients at Mumbai's Hinduja National Hospital and Medical Research Center since late last year who are resistant to all forms of treatment. Three of the patients have died, he said.
"While this handful of cases is worrying, it's just the tip of the iceberg," said Soumya Swaminathan, senior deputy director of the National Institute for Research in Tuberculosis, part of the Indian Council of Medical Research, the government's network of biomedical research institutions. "The bottom line is we need to take TB much more seriously."
Indian health officials met in Mumbai Wednesday with Dr. Udwadia and other pulmonologists to develop a plan of action. The municipal official who convened the meeting to develop the plan, Manisha Maiskar, couldn't be reached for comment.
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.
What's more, there's a debate within the public health community about whether to even label TB infections as totally drug resistant. The World Health Organization hasn't accepted the term and still considers the cases to be what's now called extensively drug-resistant TB, or XDR. However, Dr. Paul Nunn, a coordinator at the WHO's Stop TB Department in Geneva, said there is ample proof that these virtually untreatable cases do exist.
The Indian hospital that saw the initial cases tested a dozen medicines and none of them worked, a pretty comprehensive assessment. A TB expert at the U.S. Centers for Disease Control and Prevention said they do appear to be totally resistant to available drugs.
Zarir Udwadia, one of Mumbai's leading private pulmonologists, reported the first four cases in a letter in December to the Clinical Infectious Diseases magazine, a publication of the Infectious Diseases Society of America. He said in an interview that he has now seen and tested a total of 12 patients at Mumbai's Hinduja National Hospital and Medical Research Center since late last year who are resistant to all forms of treatment. Three of the patients have died, he said.
"While this handful of cases is worrying, it's just the tip of the iceberg," said Soumya Swaminathan, senior deputy director of the National Institute for Research in Tuberculosis, part of the Indian Council of Medical Research, the government's network of biomedical research institutions. "The bottom line is we need to take TB much more seriously."
Indian health officials met in Mumbai Wednesday with Dr. Udwadia and other pulmonologists to develop a plan of action. The municipal official who convened the meeting to develop the plan, Manisha Maiskar, couldn't be reached for comment.
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.
What's more, there's a debate within the public health community about whether to even label TB infections as totally drug resistant. The World Health Organization hasn't accepted the term and still considers the cases to be what's now called extensively drug-resistant TB, or XDR. However, Dr. Paul Nunn, a coordinator at the WHO's Stop TB Department in Geneva, said there is ample proof that these virtually untreatable cases do exist.
The Indian hospital that saw the initial cases tested a dozen medicines and none of them worked, a pretty comprehensive assessment. A TB expert at the U.S. Centers for Disease Control and Prevention said they do appear to be totally resistant to available drugs.
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