Tuesday, 18 January 2011
The Return of the White Plague
Tuberculosis is a common and often deadly infectious disease. In the past 100 years Britain has taken great steps to erradicate this crippling disease. By the early 1980s TB was considered to be conquered in the UK and NHS tuberculosis services were scaled down considerably, after having controlled the disease by the introduction of antituberculosis drugs and BCG vaccination plus improved health services.
Travel and migration has allowed it to resurface as a public health problem in all European countries and there were over 14.6 cases reported per 100,000 population in 2009. The UK is the only European country in which incidence rates continue to rise.
In London TB has returned 'in force' with 3450 cases diagnosed in 2009 (almost 40% of all UK cases) compared to 2309 in 1999. This is likely to be an underestimation as sputum microscopy and culture only detects up to 70% of active cases. Drug-resistant TB is also becoming a problem in the capital, with 172 isoniazid-resistant cases and a further 58 multi-drug resistant cases reported in 2009.
There is an interesting podcast here in which Dr Marc Lipman (UCL Medicine) discusses the challenges of tackling the disease in London, its development over time and why TB is still prevalent today.
Video courtesy of RFB