Extremely Drug Resistant TB (XDR-TB) diagnosed in Britain

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From The Times March 22, 2008

Extremely Drug Resistant TB (XDR-TB) diagnosed in Britain

Reid

Health officials are screening the close contacts of a man who has

become Britain's first case of a virtually untreatable form of

drug-resistant tuberculosis.

The man, believed to be a Somali asylum-seeker in his thirties, has a

rare strain, Extremely Drug Resistant TB (XDR-TB), which has a high

mortality rate.

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 that it poses a grave public health threat, especially in

populations with high rates of HIV and where there are few healthcare

resources.

Health chiefs said yesterday that close contacts of the patient, who

is in isolation at Gartnavel General Hospital, Glasgow, were being

screened. He has been in the hospital since January.

Dr Oliver Blatchford, consultant in public health medicine in Glasgow,

said yesterday: " It is no more infectious than ordinary TB but it does

require different treatment. The contacts of this case are being

screened in the same way as ordinary TB contacts. They will be

monitored closely to ensure that any further cases are identified

early and treated quickly. "

A health board spokesman added that the man had been admitted to

hospital at the end of January but was unable to give any personal

details or provide information about his condition.

It is understood that the man arrived at Heathrow last November and

when screened for infectious diseases was found to have TB scarring on

his lungs.

The condition was not active, however, and the man told doctors he had

recently had a six-month course of treatment for TB. After an

immigration interview, he was allowed to go to Scotland, where the

disease became reactivated.

XDR-TB poses a far greater 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. XDR-TB is a form of

MDR-TB that is also resistant to three or more of the six classes of

second-line drugs. Doctors can only try to contain the disease with a

cocktail of second-line drugs. In some cases, part of the lung can be

cut out.

This is the first case reported in Britain since the revised

definition of XDR-TB was published by the World Health Oorganisation

in 2006. Recent findings from a survey of data from 2000-04 found that

XDR-TB had been identified in all regions of the world but was most

frequent in the former Soviet Union and Asia.

Professor , the secretary of TB Alert in Britain, said that

drugs could contain the disease but not cure it. Treatment takes 12-18

months and is estimated to cost more than £100,000 per patient.

Global killer

— Skeletal remains show that prehistoric human beings had the disease

in 4000BC, and tubercular decay has been found in mummies from 3000-2400BC

— Two billion people, one third of the world's population, are

infected with the bacterium that causes TB

— Every 15 seconds someone dies from TB. Two million people die from

it each year

— Eighty per cent of TB cases are concentrated in 22 " high-burden "

developing countries, but no corner of the world is safe. The WHO

declared TB a global emergency in 1992

http://www.timesonline.co.uk/tol/news/uk/health/article3599420.ece

Source: Times database