20 January 2012
It’s not totally drug–resistant tuberculosis but XXDR TB that has hit Mumbai. After over 10 days of hectic activity, Union health officials on Wednesday pronounced that Mumbai’s Hinduja Hospital had been “premature’’ in labelling 12 patients as TDR–TB patients.
“It’s XXDR TB,’’ said the Delhi team led by Dr Ashok Kumar who is deputy director general (TB) in the Union health ministry. The team underlined that there is “no situation of totally drug resistant TB’’. XXDR TB stands for extensively drug–resistant TB as against XDR (extremely) and MDR (multi–) versions. “There is no doomsday situation in India,’’ said the Delhi health ministry team.
To settle the medical arguments completely, the state government will send all the 12 samples to Bangalore’s National TB Institute. “The samples will be sent on Thursday morning,’’ said Dr P Gaikwad, who is the state TB in–charge. Wednesday’s press briefing marked the culmination of a medical drama that began in January’s first week with Hinduja Hospital, Mahim, publishing a medical research paper in Clinical Infectious Diseases about the emergence of TDR–TB in 12 patients. With the world watching India, a public health exercise began that involved tracing every patients and their families.
Wednesday’s conclusion was tinged with hope and recovery—mainly for the 12 original TDR–TB patients. While three died between October 2011 and now, two are outside Mumbai’s jurisdiction. “Of the seven patients in Mumbai, four tested negative and three who tested positive are responding well to treatment,’’ said Jayant Bantia, Maharashtra’s chief additional secretary (public health).
The seven were subjected to the basic TB test called sputum microscopy in various municipal labs in the city. And the medicines that appear to be working for them are special drugs that are outside the defined purview of TB treatment. “These patients are under salvage treatment using drugs that are meant for other conditions,’’ said Dr R K Jindal, one of the experts in the central team. Some of these salvage drugs are usually used to treat conditions such as leprosy or staph infections.
The nine surviving patients have been absorbed by the Revised National Tuberculosis Control Program (RNTCP), said Bantia. “Even the two patients from outside Mumbai (namely from Ratnagiri and Bhayander) have been absorbed by RNTCP. The state government will take care of their treatment costs,’’ he added.
The salvage treatment can cost up to Rs 5 lakh for the entire treatment, as against Rs 2 lakh for the MDR treatment. The expert, who is attached to PGIMER in Chandigarh, said that there is nothing defined in the World Health Organization’s armament as TDR–TB. “There will always some drug that works on patients,’’ he said.