There is now a TB strain that is totally drug resistant (TDR-TB) to add to the extensively drug resistant (XDR-TB) strain, identified in 2006, and the Multidrug-resistant TV (MDR-TB), which emerged in the early 1990s. Those in the U.S. and Europe who have any of these difficult to treat strains of the old disease that was once thought conquered, have recently been in South Africa, but it has also emerged in India (2012), Iran (2009) and Italy (2007).
In the U.S. MDR-TB accounted for 1.3% of the 10,528 cases of TB in 2011, and there were 6 cases of XDR-TB. One woman who returned to TN from South Africa with XDR-TB had a strain that took 2 years to treat, including 90 days in isolation. Eventually, she was cured. Most people in the U.S. who have TB are foreign born, or were born into communities where the foreign born live. Others at risk are homeless (aka undomiciled in NYC), substance abusers, and people with HIV.
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