On January 17th doctors in Mumbai declared that a dozen patients at Hinduja National Hospital had contracted mycobacterium tuberculosis (TB) that did not respond to treatment.  If the claim is proven true, it will indicate a new era for the disease and represent a developing health risk.

TB is an infection caused by bacteria and usually affects the lungs, where it destroys tissue, although it can affect other parts of the body. It is spreads from person to person when someone who has TB of the lungs coughs or sneezes.  Only some people with TB in the lungs are infectious to other people and even then, close and prolonged contact is needed to be at risk of being infected.

New strains of TB are not a new phenomenon in themselves and have emerged over the years, with some already resistant to two of the best known treatments (Isoniazid and Rifampicin) and some resistant to additional intravenous drugs.  However, the level of reported resistance recorded in Mumbai is new and although it remains unclear whether the doctors' claims in Mumbai are accurate, the Indian government has sent a specialist team to investigate, according to the BBC.

Antibiotics have helped to control TB in much of the Western World and the ongoing mutation of the bacterium is often linked with patients who fail to complete a course of treatment, which then gives the bacterium a chance to adapt (as also noted in the Health Protection Agency's annual TB report).

It needs to be noted that the share of TB cases that are resistant to first line treatments is still small.  Out of 12m TB cases in 2010, some 650,000 (5%) were resistant to multiple drugs, according to the World Health Organisation.  However, it is true that resistant strains are becoming more prevalent in certain regions.  For example, in Belarus and parts of Russia, more than a quarter of new TB cases survive several drug treatments.  As of October 2011, 77 countries had reported at least one case of TB that was resistant to first and second line treatments.

Although the risk of contracting the disease is low, it may attract further media coverage.  We'll closely monitor developments and keep you updated, however, if you have any queries, or wish to discuss the disease or treatment options in any further detail, please don't hesitate to contact us at any time.