Mumbai pulmonologist warns of totally drug-resistant TB

A top pulmonologist from Mumbai recently told the Indian government that he diagnosed 12 cases of tuberculosis in the city that are completely resistant to all current treatments.

Zarir Udwadia reported the first four cases in a December letter to the U.S. publication Clinical Infectious Diseases. He has now seen and tested a total of 12 patients who have resisted all forms of treatment. Three of the patients have died, the Wall Street Journal reports.

"While this handful of cases is worrying, it's just the tip of the iceberg," Soumya Swaminathan, the senior deputy director of the National Institute for Research in Tuberculosis, said, according to the Wall Street Journal. "The bottom line is we need to take TB much more seriously."

While India has made strides in fighting tuberculosis, reducing the number of deaths from TB from 500,000 in 1997 to 280,000 in 2010, patients are discontinuing their medication after the symptoms subside, which leads to resistance. Side effects of the medicine such as nausea have discouraged them from completing the full course of treatment. In addition, many private doctors routinely prescribe the wrong medicines.

"Two or three treatment errors is all it takes to create multidrug resistance," Swaminathan said, according to the Wall Street Journal. "(The) bottom line is that once a patient becomes resistant to the main TB drugs, it becomes practically untreatable."

India, Swaminathan warned, must quickly raise its program of tuberculosis-prevention to a new level with more accountability at the local level, increased funding and more labs nationwide to test for drug resistance.