updated 6/1/2007 7:37:02 PM ET 2007-06-01T23:37:02

An Atlanta lawyer with a drug-resistant strain of tuberculosis is under federal quarantine at a hospital in Denver. The Centers for Disease Control and Prevention is trying to determine how the 31-year-old man was exposed to the rare form of the disease. Read on for more information.

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What is XDR TB?
Extensively drug-resistant tuberculosis (XDR TB) is a rare type of multidrug-resistant tuberculosis (MDR TB). It is resistant to almost all drugs used to treat TB.

How is XDR TB spread?
Regular TB and XDR TB are spread the same way. TB germs are spread through the air when a person with the disease of the lungs or throat coughs, sneezes, speaks, or sings. Germs can float in the air for several hours, depending on the environment.

TB is not spread by:

  • shaking someone’s hand
  • sharing food or drink
  • touching bed linens or toilet seats
  • sharing toothbrushes
  • kissing
  • smoking or sharing cigarettes

Why is XDR TB so serious?
Because XDR TB is resistant to the most powerful first- and second-line drugs, treatments are much less effective. Persons with HIV infection or other conditions that weaken the immune system are especially vulnerable to XDR TB. They are more likely to develop the disease once they are infected and face a higher risk of death once they develop the disease.

Who is at risk for getting XDR TB?
Drug-resistant TB (MDR or XDR) is more common in people who:

  • do not take their TB medicine regularly
  • do not take all of their TB medicines as told by their doctor or nurse
  • develop active TB disease again, after having taken TB medicine in the past
  • come from areas of the world where drug-resistant TB is common
  • have spent time with someone known to have drug-resistant TB disease

How can I prevent myself from getting TB?
Avoid close contact or prolonged time with known TB patients in crowded, enclosed environments like clinics, hospitals, prisons or homeless shelters.

Can the TB vaccine (BCG) help prevent XDR TB?
There is a vaccine for TB disease called Bacille Calmette-Guérin (BCG). It is used in some countries to prevent severe forms of TB in children. However, BCG is not generally recommended in the United States because it has limited effectiveness for preventing TB in adults.

Can XDR TB be treated and cured?
Yes, in some cases. Some TB control programs have shown that cure is possible for an estimated 30 percent of affected people. Treatment effectiveness depends on the extent of the drug resistance, the severity of the disease, and whether the patient’s immune system is weakened.

What are the symptoms?

  • Sickness or weakness
  • Weight loss, fever and night sweats
  • Coughing
  • Chest pain
  • Coughing up blood

Symptoms of TB disease in other parts of the body depend on the area affected.

What should I do if I have been exposed to someone who has XDR TB?
Contact your doctor or local health department about getting a TB skin test or the QuantiFERON®-TB Gold test (QFT-G), a blood test. You can also contact 800-CDC-INFO.

How long does it take to find out if you have XDR TB?
If TB bacteria are found in the sputum (phlegm), the diagnosis of TB can be made in a day or two, but this finding will not be able to distinguish between drug-susceptible (regular) TB and drug-resistant TB. To determine the strain, the bacteria need to be grown and tested in a laboratory. Final diagnosis for TB, and especially for XDR TB, may take from six to 16 weeks.

Is XDR TB a problem in the United States?
The risk of acquiring XDR TB in the United States appears to be relatively low. However, it is important to acknowledge the ease at which TB can spread. As long as XDR TB exists, the U.S. is at risk and must address the threat.

How many cases of XDR TB have been reported in the United States?
In the United States, 49 cases of XDR TB have been reported between 1993 and 2006.

Is it safe to travel to countries where cases of XDR TB have been reported?
Although drug-resistant cases of TB are occurring globally, they are still rare.

All travelers should avoid high-risk settings where there are no infection-control measures in place. Documented places where transmission has occurred include crowded hospitals, prisons, homeless shelters and other settings where susceptible persons come in contact with persons with TB disease.

Why haven’t we heard about XDR TB before now?
Isolated cases of very highly resistant TB have been around the world for several years. Drug resistance has taken many years to develop. Over time, countries have improved their laboratory capacity to test for drug resistance and their ability to track the number of cases. With more cases being identified, the problem was more closely examined, defined, and given a name.

Source: Centers for Disease Control and Prevention

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