XDR TB case renews call for better diagnosis, medications

The ease with which the infected person traveled internationally highlights gaps in infection control and border security systems.

By Victoria Stagg Elliott, AMNews staff. June 18, 2007.

The case of a man with extensively drug-resistant tuberculosis who traveled to Europe and through Canada before reporting to public health officials for treatment in New York has renewed calls for better technology to diagnose this disease and determine more quickly if it is drug resistant.

This process currently takes weeks or even months. The individual, 31-year-old Atlanta lawyer Andrew Speaker, traveled to Europe knowing he had TB but not that he was infected with a highly resistant strain.

"We need to be able to detect it rapidly and not wait another four to eight weeks to develop a sensitivity profile," said Richard Wenzel, MD, MSc, president of the International Society for Infectious Diseases.

From 1993 to 2006, 49 XDR TB cases were recorded in the U.S. Many more have been noted around the world. The American Medical Association has policy calling for significant increases in federal funding for tuberculosis control and research to curtail its spread and encourage development of new and effective diagnostics, drug therapies and vaccines. The AMA also is a liaison member of the federal Advisory Council for the Elimination of Tuberculosis.

Experts say there is an urgent need to develop new medications to address increasing drug-resistant infections.