Prisonlike hospitals aren't the place to treat drug-resistant tuberculosis

January 13, 2009

Here’s a taste of my piece in Slate this week about two recent studies that show that MDR and XDR tuberculosis patients don’t have to be locked up in hospital isolation wards to be cured.

In the 1990s, scientists noticed that the deadly class of bacteria that causes tuberculosis had outsmarted the limited drugs available to treat it and taken on new and deadlier forms. Since then, the pandemic of drug-resistant TB has escalated. 2008 saw the highest number of people infected with drug-resistant TB in history at 1.5 million in 114 countries, according to the World Health Organization. Some medical experts have even called drug-resistant TB a potential form of biological warfare because of the ease with which the bacteria can piggyback on airborne droplets into people’s noses and mouths.

As TB specialists grapple with how best to treat an infectious illness that often defies medication, they have ruled that patients with its two most dangerous forms—multidrug-resistant, or MDR, which is resistant to two or more first-line antibiotics, and extensively drug-resistant, or XDR, which is undeterred by two first-line drugs and two or more second-line drugs—must be quarantined, at least while still contagious, as their treatment is carefully monitored.