TARTU, Estonia—All along the edges of Western Europe, new and hard-to-defeat strains of tuberculosis are gaining a foothold, often moving beyond traditional victims—alcoholics, drug users, HIV patients—and into the wider population.
Which is why Irina Nikolajeva, a petite 34-year-old former furniture saleswoman, spent the better part of four months in virtual lockdown here last year. She was resistant to all but one of 10 TB drugs. Nobody could figure out how she even caught the disease.
"NAKKUSOHT!" declared a bright red sign just steps from her tiny, bare isolation room. "DANGER OF INFECTION!" To see her 18-month-old daughter, she initially needed Skype. "I could see my child running around at home," Ms. Nikolajeva recalled. "She'd say, 'Hello, Mama.' "
Estonia's aggressiveness—and only recently, its success—in turning the corner against drug-resistant TB offers one of the few bright spots globally as the ancient plague mutates into new and more deadly forms. Indeed, experts say the country, with half the population of Chicago, could be a model for others. But there is one catch: It takes years and some pricey treatments just to gain the upper hand.
"The easy ones are treated," said Martin Kadai, a public health adviser at Estonia's ministry of social affairs. The toughest patients, he said, remain.
In Western Europe, drug-resistant strains of TB are starting to make a wider appearance. Last year, Britain reported 421 cases of drug-resistant TB, a 26% jump from the previous year. Most Western Europe cases can be traced to the TB-wracked eastern half of the continent. (In contrast, there were 124 case of drug-resistant TB in the U.S. in 2011.)
Nearby nations, including Serbia, Kosovo, Montenegro and hard-hit areas in Russia, have sought Estonian advice in their own fight against the disease—and they need it. The 15 countries of the former Soviet Union, as well as Romania, Bulgaria and Turkey, together harbor more than 85% of TB cases, and 96% of multidrug-resistant tuberculosis, or MDR-TB, found in Europe, according to the World Health Organization.