In May 1978, the U.S. Centers for Disease Control and Prevention (CDC) reported a patient was first diagnosed with drug-resistant tuberculosis. The available information suggests that Patient 1 transmitted quadruple-drug-resistant organisms to three others knew one another and had interacted closely. Patient 1, who ultimately died, infected Patients 2 and 4 with multi-drug-resistant tuberculosis and may have infected Patient 3; two additional deaths resulted.

Noncompliance with therapy recommendations as well as poor communication among health care providers in various institutional settings contributed to treatment failures in Patients 1, 2, and 3.