Hard to treat TB case diagnosed in Britain

Mar 24 2008

Health officials in Britain say they are dealing with the country's first case of a rare strain of tuberculosis (TB) which is almost untreatable.

A man is currently in isolation at Gartnavel General Hospital in Glasgow and while doctors say there's no risk to the general public, they are screening those who came into close contacts with him in order to ensure that any further cases are identified early and promptly treated.

The man is thought to be a Somali asylum-seeker in his thirties and has the rare strain of extremely drug resistant TB (XDR-TB), which proves fatal in half of all cases.

The World Health Organisation (WHO) says that XDR-TB accounts for possibly only 2 per cent of the 9 million cases of tuberculosis in the world, but is nevertheless a grave public health threat, especially in populations with high rates of HIV and where there are few healthcare resources.

XDR-TB is a problem in South Africa and Russia and the former Soviet countries of Eastern Europe; last month, the WHO reported the highest-ever rates of drug-resistant TB.

Experts say XDR-TB is no more infectious than ordinary TB but it does require different treatment.

The man arrived at Heathrow last November and was admitted to hospital at the end of January but was unable to provide information about his condition; the TB was found when routine screening for infectious diseases revealed scarring on his lungs.

At the time the TB was inactive and he then told doctors he had recently had a six-month course of treatment for TB.

Following an immigration interview, he was allowed to go to Scotland, where the disease became reactivated.

XDR-TB is more of a challenge to doctors than MDR-TB (Multidrug Resistant TB), which is resistant to at least the two main first-line tuberculosis drugs, isoniazid and rifampicin, because it is also resistant to three or more of the six classes of second-line drugs.

Doctors are forced to try to contain the disease with a cocktail of second-line drugs and in some cases, part of the lung has to be cut out.

A recent survey of data from 2000-04 found that XDR-TB had been identified in all regions of the world.

Treatment takes 12-18 months and is estimated to cost more than £100,000 per patient and while it contains the disease it does not cure it.

According to the WHO one third of the world’s population, are infected with the bacterium that causes TB and 2 million people die from it each year.