Canadian doctors say that offering more support to physicians in India who are struggling to treat patients with a serious strain of tuberculosis could help protect people here.
"The rich countries should help the resource-poor countries to increase TB control," said Dr. Monica Avendano, a TB specialist at West Park Health Care Centre in Toronto. "It's just a plane ride[away]."
Unless TB is dealt with in Southeast Asia and the former Soviet republics, "we will continue to have this emergency worldwide," she added.
The physicians in Mumbai reported 12 TB patients with a strain that was resistant to a dozen drugs. Three of the patients have since died.
"In TB, we often use this phrase that TB anywhere is TB everywhere given how connected the world is," said Dr. Madhukar Pai of McGill University in Montreal, who has been studying the Indian TB control program.
The infection destroys lung tissue, causing patients to cough up the bacteria that spreads through the air to others in close contact for a prolonged period.
Normally, TB is cured by taking antibiotics for six to nine months to kill all of the germs. But if the incorrect treatment is given or patients don't take all of the medicines prescribed, resistance can develop that can take up to two years to treat.
In Canada, most cases of TB occur among immigrants in Toronto, Montreal and Vancouver. The Public Health Agency of Canada said there have been five cases of extensively resistant TB in this country.
"A case of multidrug-resistant TB, it will be minimum half a million dollars," to treat, Avendano said.
TB control in India
A study by doctors in Mumbai two years ago found only five out of 106 private practitioners in the city who were asked to write prescriptions for multidrug-resistant TB were able to do so correctly. Source: PloS One
The Indian cases are a result of incorrect prescribing and misuse of antibiotics that aren't regulated there, Pai said.
"Every time you mismanage TB, that progressively amplifies drug resistance," Pai said.
One case of tuberculosis that goes undiagnosed and untreated will infect about 14 people a year and of those, one or two will eventually develop the infection, Avendano noted.
Not enough is done to prevent TB in Canada, Avendano said.
Torontonian Wes Gerlee knows how long and difficult it can be to get non-resistant TB under control. Gerlee was confined to the tuberculosis unit at West Park hospital for six months while he was treated with antibiotics for TB he believes he contracted in a homeless shelter.
"My daughter was afraid that I will not make it, my friends didn't think I would make it and the staff admitted that if I survive it would be a miracle," recalled Gerlee, who is also diabetic and a smoker.
Gerlee's weight dropped from about 245 pounds to below 120 pounds.