As of last spring, according to the WHO, there were about 440,000 cases of MDR-TB per year, accounting for 150,000 deaths, and 25,000 cases of XDR. At the time, the WHO predicted there would be 2 million MDR or XDR cases in the word by 2012.
Epidemiologist Carole Mitnick of Harvard Medical School in Boston, Massachusetts, agrees that TDR-TB is not new, and points to the history of XDR-TB. “When XDR-TB was first named, it was a phenomenon that had existed but hadn’t gotten much attention before. TB in general doesn’t receive a lot of attention,” she says.
As the full form of TDR-TB suggests, none of the known TB combination drugs work on the patient. All 12 showed resistance to 12 drugs. "The TB bacilli have obviously mutated. The emergence of TDR-TB has grave implications for public health," said Hinduja Hospital's Dr Zarir Udwadia, whose observations have been published in the latest issue of the US-based Clinical Infectious Diseases (CID) peer review journal. His team started isolating TDR-TB cases among patients with pulmonary TB in October 2011.
Dr Amita Athawale, who heads KEM Hospital's chest department, said TDR-TB was a reality in India. "The cases we clinically isolate are just the tip of the iceberg," she said. TB is one of the biggest killers in India, along with heart attack.