Though multidrug-resistant tuberculosis was basically conquered in the US in the 1990s, it's now at epidemic levels in other parts of the world—and the US is not prepared, reports the Wall Street Journal in an extensive look at the disease. As TB strains get more drug-resistant abroad—a totally drug-resistant strain was recently discovered in India—multidrug-resistant TB (MDR) levels are slowly increasing again in the US. But TB funding and specialized TB care are going down, not up, there is no effective vaccine, and the drugs available for treatment are decades old—and difficult to come by. In one disturbing example of the lack of resources, Tennessee's TB-control officer often has to drive infected patients, wearing surgical masks, in his own car while he wears a respirator with all the windows rolled down.
The Journal takes a look at one case that shows how difficult it is to prevent TB from spilling over the border: Natalie Skipper, 34, got MDR while volunteering at a South Africa hospital. A TB test she had to take before returning to work at her Tennessee hospital came back negative, but that can happen if the infection is recent. It took doctors—who don't often have TB on their radar these days—more than a year to diagnose her. In that time, she had come into close contact with 110 people, who had to be tested. One was infected. "I'm seeing a resurgence of complacency," says one expert at the CDC of the current situation. Adds another expert, "We cannot be safe in the US [while MDR is an] epidemic in the rest of the world." Click for the Journal's full piece.