First U.S. case of XXDR-TB

Jan 7th, 2010 9:48 AM UTC
By Rena Pacheco-Theard

The U.S. recently reported its first ever case of extremely drug-resistant tuberculosis (XXDR-TB), a form of TB that is resistant to all first- and second-line drugs, making it nearly impossible to treat.

Oswaldo Juarez, a Peruvian student who was in Florida to study English, was diagnosed with the disease and discharged from A.G. Holley State Hospital in July 2009 after 19 months of intensive treatment.

Drug resistance is caused by overuse or misuse (e.g., stopping treatment early or using counterfeit or expired drugs) of medicine. In the continuum of resistance, TB’s stages are as follows: simple TB (TB), multi-drug-resistant TB (MDR-TB), extensively drug-resistant TB (XDR), and extremely drug-resistant TB (XXDR-TB). Only a handful of XXDR-TB cases, the most severe form of TB, have ever been diagnosed.

The AP quoted David Ashkin, the physician who treated Juarez, as saying, “When he first came in we really had to throw everything and the kitchen sink at him … It was definitely cutting edge and definitely somewhat risky because it’s not like I can go to the textbooks or . . . journal articles to find out how to do this.”

This case illustrates the rising global challenge of growing drug resistance and the spread of infectious disease. Infectious diseases like tuberculosis know no borders and put citizens around the world at risk. As Dr. Thomas Frieden, Director of the U.S. Centers for Disease Control and Prevention noted, “We are all connected by the air we breathe, and that is why this must be everyone’s problem.”

An estimated 1.3 million people worldwide die from tuberculosis every year – nearly 360,000 of these deaths occur in sub-Saharan Africa.

TAGS: Policy News, Tuberculosis