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U.S. health officials have quarantined an airline passenger who may have exposed others to a potentially dangerous form of tuberculosis. The unusual decision was made after the passenger took flights from the U.S. to Europe, then to Montreal, Canada before reentering the United States. The man has what's called 'Extremely Drug Resistant' tuberculosis. Passengers and crew from both flights have been urged to be tested for the infection. XDR-tb is an especially virulent form of the disease that is resistant to standard drug treatment.

The World Health Organization says about nine million people around the world have TB and 1.6 million die from it every year. The greatest burden is in South and East Asia, followed closely by Africa and the Western Pacific regions, all adding up to 85 percent of the world total.

But TB persists and mutates into drug-resistant strains harder to cure because many patients fail to finish taking their medicine. For years, the World Health Organization has promoted directly observed therapy by local health care workers who go to patients' homes to make sure they take their pills. But in poor countries with weak health systems, health workers to do this are in short supply.

As a result, bacterial resistance to at least two common TB drugs is spreading, requiring newer, more expensive, and more toxic compounds to do the job.

"One of the biggest challenges is we know it's out there, but we don't know how much of it is out there," says Joann Carter. She is with the non-governmental group RESULTS, which helps fund medical projects in developing countries. She notes that an even more dangerous TB strain has developed recently. The bacterium has mutated further into a form resistant to most of the older and newer drugs. This so-called extremely drug resistant strain, or XDR tuberculosis, was first noticed in South Africa, fueled by the HIV epidemic that weakens patients' ability to fight such diseases.