Deadly TB strain in new EU countries

Tuberculosis patients in some of the countries joining the European Union in May are 10 times more likely to have the most deadly strain of the disease than the rest of the world, a new report showed today.

A World Health organisation survey of more than 67,000 TB patients in 77 countries, published in Brussels, identifies three new member states – Latvia, Lithuania and Estonia – as among those in eastern Europe and Central Asia where multi drug-resistant TB, known as MDR-TB, is rampant.

An East European TB patient is already known to have infected six Dutch nationals, two of whom have developed pulmonary tuberculosis.

Now British MEP John Bowis, the Conservative health spokesman in the European Parliament, said action must be taken to step up measures against MDR-TB: “Drug-resistant TB is already a major problem in the UK and is rampant in the Baltic States to whom we open EU and UK borders in May,” he said.

“It is urgent that we act nationally to protect our citizens from this new health scourge.”

The WHO estimates there are 300,000 new cases of MDR-TB worldwide, with 79% of cases being “super strains“, resistant to at least three of the four main drugs used to cure TB.

Curing “normal” TB is cheap and effective – a six-month course of medicines costs around €8.10. But treating drug-resistant TB is a hundred times more expensive.

As well as singling out some Baltic States, the WHO study identifies Kazakhstan, parts of the Russian Federation, Uzbekistan, China, Ecuador, Israel and South Africa as hotspots for MDR-TB.

And it points out that the highest prevalence of the disease coincides with one of the world’s fastest growing HIV infection rates in Eastern Europe and Central Asia.

Dr Mohamed Aziz, WHO technical expert and leading author of the report, said: “The more we survey, the more MDR-TB we find. It has now been identified in every region and almost every country surveyed in what is the largest drug resistance surveillance project of its kind.

"Yet the true burden is unknown and may well be higher in unsurveyed areas, stressing the need for full expansion of drug resistance surveillance.”

Meanwhile Dutch experts say they cannot rule out new cases following the “large” outbreak triggered in eastern Europe, which they describe as “a striking case in point of the alarming situation in Eastern Europe.

“This development represents a dangerous precedent for Dutch tuberculosis-control efforts,” said Jaap Broekmans, Director of the KNCV Tuberculosis Foundation in the Netherlands.

Patients with multi drug-resistant tuberculosis do not respond to the two most important drugs used to treat tuberculosis, and their chances of recovery are poor, according to the WHO.

In Russia a patient with normal tuberculosis has a 78% chance of recovery, but the odds fall to just 10% for patients with MDR-TB.