From U.S. News:
A new paper published earlier this week in the Centers for Disease Control and Prevention's Emerging Infectious Diseases journal warns that the first cases of "totally drug-resistant" tuberculosis have been found in South Africa and that the disease is "virtually untreatable."
Like many bacterial diseases, tuberculosis has been evolving to fend off many effective antibiotics, making it more difficult to treat. But even treatable forms of the disease are particularly tricky to cure; drug sensitive strains must be treated with a six-month course of antibiotics. Tougher cases require long-term hospitalization and a regimen of harsh drugs that can last years.
... TDR has previously been found in India, Iran, and Italy, but appears to be most prevalent in South Africa.
... Bishai says van Helden's paper suggests that "TDR is extensive in South Africa."
"It's gone relatively unrecognized," he says. "This is evidence that it's emerged and is spreading—we're playing with fire here."
Drug-resistant TB isn't just a South African problem. In the early '90s, there was an outbreak of MDR in a New York City hospital. During that outbreak, 32 patients caught MDR over the course of a few months and 29 of them died. That outbreak was eventually controlled, but more than 100 cases of MDR have been detected in the United States over the past eight years, and there have been high-profile outbreaks in Peru, Russia, and India over the past decade.
Despite the high death rate during the New York City outbreak, public health officials were able to keep MDR from escaping into the general population, a task that took a concerted effort and many millions of dollars, van Helden says. South Africa, doesn't have that luxury.