Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
South African Press Association - September 1, 2006
The strain was discovered in South Africa's KwaZulu-Natal province, and is classified as extremely drug-resistant. Drugs from three of the six second-line medicines used as a last line of defence against TB have proved useless against the new strain.
"We are extremely worried about the issue of extreme drug resistance," said Paul Nunn, coordinator of the WHO's drug-resistance department. "If countries don't have the diagnostic capacity to find these patients, they will die without proper treatment."
Though even the most drug-resistant strains of TB have proven to be treatable with three classes of drugs, those drugs are more expensive and toxic to the human body.
The WHO and its partners, including the United States Centers for Disease Control and Prevention, plan a two-day meeting next week in South Africa to discuss the new TB strain in Africa and better ways to diagnose and treat it, Nunn said.
Tuberculosis is a respiratory illness spread by coughing and sneezing. Nearly two billion people worldwide are thought to be infected.
High mortality rates among TB patients in South Africa, however, prompted medical researchers to survey the cases, and ultimately to find the new strain.
Drug resistance is a common problem in TB treatment, but the new strain appears particularly virulent: 52 of the 53 patients infected all died within about three weeks of being tested for drug resistance.
"Genetic processes are constantly throwing up mutations of tuberculosis viruses, so this may have arisen due to some particular quirk of the environment, the way they were treated, or their genetic background," said Paul Fine, a professor of communicable diseases at the London School of Hygiene and Tropical Medicine.
In general, drug-resistant viruses are not as easily transmitted as those that are drug-sensitive.
Worldwide, about 2% of TB cases are classified as being extremely drug-resistant. Little information is available on extreme drug resistance in Africa, but it is believed to be increasing.
The high prevalence of HIV/Aids in Africa also complicates the issue of treating extremely drug-resistant TB. "It's urgent to make the diagnosis when HIV is involved, because if you don't make it, the combination of HIV and TB will kill," Nunn said.
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