"We currently have 12 confirmed cases, of which three are dead," says Zarir Udwadia of the Hinduja National Hospital and Medical Research Centre in Mumbai, and head of the team whose diagnoses of four cases has just been published.
The emergence of the disease in such a densely populated city is a major concern as it could spread so easily.
"We know one patient transmitted it to her
told New Scientist.
"It's estimated that on average, a tuberculosis patient infects 10 to 20 contacts in a year, and there's no reason to suspect that this strain is any less transmissible," he
For patients, the outlook is grim.
"Short of quarantining them in hospitals with isolation facilities till they become non-infectious - which is not practical or possible - there is nothing else one can do to prevent transmission," says Udwadia
blames the emergence of totally untreatable TB on poor management of the MDR strain.
"Years of mismanagement of MDR-TB at government and private care levels resulted in amplification of the level of resistance till we finally ended up with this untreatable strain," he
surveyed 106 private practitioners in a Mumbai suburb and found that only five of them would prescribe the correct prescription if approached by a MDR-TB patient.