Doctors in India have identified a new form of tuberculosis that is resistant to all drugs. They’re calling it totally drug resistant TB (TDR TB), for obvious reasons. This isn’t good news. Tuberculosis, in my opinion, has now gone from probably the most dangerous infectious disease in the world to definitely the most dangerous infectious disease in the world. Tuberculosis is a bacterial disease, treated with antibiotics. As has been documented in other places, over time many kinds of bacteria develop resistance to antibiotics. TB bacteria have been especially adept at this. We’ve already seen multi-drug resistant TB, and extensively drug resistant TB. Totally drug resistant tuberculosis was the logical progression, and we’ve reached it. So far, India doctors have identified at least twelve cases of totally drug resistant TB. That doesn’t sound like much until you discover they were all at the same hospital. That indicates there are probably hundreds more cases being treated in smaller hospitals and clinics which don’t have the capacity to identify totally resistant strains of TB. This awful news leaves us with a lot of what-do-we-do-next questions. How do we handle the people who have TDR TB? How do we keep it from spreading? Is this a sign we’re taking the wrong approach to fighting the disease? Here’s hoping we can find some kind of answers.