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This is the VOA Special English Education Report.

Electronic books have changed the way many people read for pleasure. Now online textbooks are changing the way some students learn and some teachers teach.

More than one hundred seventy-five thousand students attend the public schools in Fairfax County, Virginia, outside Washington. Last year, the school system used digital books in fifteen schools. This school year, middle schools and high schools changed from printed to electronic textbooks in their social studies classes.

<!--IMAGE-RIGHT-->Luke Rosa is a history teacher at Falls Church High School. His students work on school laptop computers. He explains the idea to them this way.

LUKE ROSA: "I mean, it's just like a regular textbook, except it's got it all online."

Peter Noonan, an assistant superintendent of schools, says with electronic textbooks, publishers can quickly update the content with the latest information.

PETER NOONAN: "The world's changing consistently. And the online textbooks can change right along with the events that are happening."

Digital books also cost less than printed textbooks, he says.

PETER NOONAN: "Usually it's in the neighborhood of between fifty and seventy dollars to buy a textbook for each student, which adds up to roughly eight million dollars for all of our students in Fairfax County. We actually have purchased all of the online textbooks for our students for just under six million dollars."

So what do students think?

MELANIE REUTER: "I don't have to carry a textbook around, so that's nice."

MARIA STEPHANY: "I don't like it because the Internet sometimes, it's like, doesn't work."

BRIAN TRAN: "You can highlight your work. You can leave notes on your work and it'll all be saved onto your account. It's a lot better than a regular textbook."

Social studies teacher Michael Bambara says the e-book he uses in his government class is better than a printed textbook. He likes the way it has materials for students with different levels of reading skills.

MICHAEL BAMBARA: "Particularly this book, that I use in government has differentiated reading levels. So a person can individualize their learning and I can individualize their instruction."

But the students also need access to the Internet when they are not at school. About ten percent of students in Fairfax County do not have a computer or online access at home. Stephen Castillo is one of them.

STEPHEN CASTILLO: "Pretty much I go to, like, the library, I guess, or go to a friend's house."

Public libraries in the county have free Internet. There are also after-school computer labs as well as computer clubhouses supported by the county. Middle school student Slieman Hakim is happy about that. He says his family has to share a single computer at home.

SLIEMAN HAKIM: "All of my family works on a computer, my sister and me both do our homework on it. So I come here to do my homework. It's good."

Other school systems in the area are also considering online textbooks. In Prince George's County, Maryland, a survey showed that sixty percent of students have computer access at home. Curriculum Director Gladys Whitehead says an e-book test project is being planned.

GLADYS WHITEHEAD: "Next year we'll just have a pilot with probably one classroom and one subject area, so that we can see, you know, what issues will come up with complete online access."

And that's the VOA Special English Education Report. We have a related video at voaspecialenglish.com. I'm Christopher Cruise.

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Contributing: June Soh

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This is the VOA Special English Health Report.

In December, doctors in Mumbai, India, reported about a group of patients with what they called "totally drug-resistant" tuberculosis. Indian health officials have been investigating these cases. But there have been reports of untreatable cases of TB in the past. Doctors reported fifteen patients in Iran in two thousand nine and two patients in Italy in two thousand seven.

Tuberculosis is a bacterial disease that usually targets the lungs. It causes an estimated five thousand deaths each day, or about two million a year.

TB can be spread through the air when an infected person coughs or sneezes or even speaks.

Some forms of TB bacteria no longer react to one or more of the antibiotics commonly used to cure the disease. These are known as drug-resistant strains. Some resist even more drugs. The World Health Organization says sixty-nine countries have reported cases of "extensively drug-resistant" tuberculosis. The WHO says at least twenty-five thousand such cases are reported worldwide every year.

The agency's director-general, Dr. Margaret Chan, is concerned about the spread of drug-resistant TB.

MARGARET CHAN: "Call it what you may, a time bomb or a powder keg. Any way you look at it, this is a potentially explosive situation."

Officials say drug-resistant TB has been a growing problem in countries like India and China. In many cases, doctors misdiagnose patients or give them the wrong treatment or not enough treatment. Misuse of these antibiotics increases the danger that the bacteria will develop resistance to them.

Neeraj Mistry is a public health doctor. He says surveys show that very few Indian doctors are treating TB patients with the right drugs for the right length of time. Another problem is that patients may not take all of their medicine.

NEERAJ MISTRY: "The emergence of totally-resistant TB is a result of failed public health intervention strategies. When we deliver ineffective treatment regimens and when we don't have full adherence and compliance to treatment, it enables the emergence of resistance within the individual."

The WHO says new, stronger TB drugs could be available by the end of this year or early twenty-thirteen.

Researchers are also working on vaccines to prevent the disease. Dr. Ann Ginsberg works at the Aeras Global TB Vaccine Foundation. She says the development process takes a long time, partly because people often do not get sick for years after getting infected with TB.

ANN GINSBERG: "So when you do a vaccine trial, you have to vaccinate people and watch them for years."

And that's the VOA Special English Health Report. I'm Bob Doughty.

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Contributing: Vidushi Sinha