TB in its new avatar arrives in Bangalore

Following the discovery of four cases of Totally Drug Resistant tuberculosis (TDR-TB) in a Mumbai hospital three days ago, two confirmed cases with the deadly new strain of TB have been detected at the Rajiv Gandhi Institute of Chest Diseases (RGICD) in Bangalore. But the scarier scenario is this: one among them, a 56-year-old man (the hospital has not disclosed his name), has gone absconding, raising the threat perception many levels higher, considering that he could infect others with the deadly strain.

Shockingly, the RGICD has not intimated the state health department. Dr Shashidhar Buggi, director, RGICD, said, “If they ask us, we will let them know. We are a national institute; if the state government asks us for the reports, we will definitely give it to them.”

This spells another concern. While one of the confirmed TDR-TB patients has gone missing, state health department officials remain in the dark.

TDR-TB is a strain of tuberculosis which cannot be treated by any available drug. This means that a person afflicted by this strain faces 100% mortality rate—and, until death, can infect many others.

Both the TDR-TB cases in Bangalore were confirmed after the RGICD sent their sputum (phlegm) samples to Chennai’s Intermediate Reference Laboratory where the samples tested positive for the deadly TDR-TB strain.
The other patient suffering from the TDR-TB is a 29-year-old woman (name undisclosed).

“These patients were being treated for over two-and-a-half years. After eight months, when they were not responding to medication, we sent their sputum samples to the Intermediate Reference Laboratory in Chennai. It was then found that they had both become extremely resistant to the drug—a condition named Extreme Drug Resistance (XDR). When this condition continued for more than a year, it was confirmed that they had Multi Drug Resistance (MDR). Now it has been two years since they have been getting treatment and the tests have confirmed that they have TDR,” said Dr Buggi.

Over 498 cases of MDR alone have been registered with the RGICD since 2005, of which 230 have been treated and discharged. “In 2009, we had 114 cases; in 2010, there were 74 fresh cases. The number came down to 50 MDR cases in 2011,” he said. “We have sent samples of eight suspected TDR-TB patients to Chennai and are awaiting the results. The tests identify micro-organisms causing infections in the lower respiratory tract like TB,” he said.

When DNA tried contacting senior health officials, none of them were available.