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

39 comments:

WitteringsfromWitney said...

Going to upset all and sundry now SR, but have to disagree......

The 'White Plague' will be known as the time that the Brits reclaimed their own country!

Apologies for going off-topic!

Apogee said...

Isnt this a great country. Having pretty well eradicated TB , we then go and import it from the third world
so we can cure all their cases as well, its unfortunate that the government in charge of our well being at the time forgot to screen all immigrants for this disease so we would know who the carriers were/are.
When are we starting mass x-rays?

Joe Public said...

@ Apogee

".....the government .... forgot to screen all immigrants ..."

Even those it knew about.

Michael Fowke said...

The writer Knut Hamsun cured himself of TB by sitting on the roof of a freight train for three days and nights with his mouth open.

I'll get me coat.

subrosa said...

You do love to be controversial WFW. ;)

subrosa said...

It's not only immigrants Apogee, it's travellers who pick it up on their trips to foreign lands.

But it is sad because it is a very infection disease and the cure is lengthy and none too pleasant I believe.

cynicalHighlander said...

TB has been on the increase for decades and people can carry it without showing any symptoms. I would suggest that any overcrowded conurbation will have the potential to explode with this disease as total eradication is nigh impossible.

subrosa said...

Something will have to be done about it Joe because if left unchecked, it could become worse than it was 100 years ago.

subrosa said...

Michael, that would be against health and safety nowadays I fear. Brave man though.

WitteringsfromWitney said...

Not really, SR. I just tell it like it is........

And that is controversial? Pity our politicos don't adopt the same method!

Oops - there I go being controversial again.......

subrosa said...

Obviously when they stopped the TB vaccination CH cases were bound to arise, particularly when we have open borders as we do.

I looked to see if I could find how many begin treatment but all I could find was a couple of doctors saying half their TB patients didn't return for further medication. There were no figures.

subrosa said...

Michael, why don't you have comments on your blog? Superb writing.

Michael Fowke said...

This is going to sound a bit pretentious, but I'm trying to create a work of literature, and comments would interfere with that.

Though I realize I'm cutting myself off from other bloggers.

Clarinda said...

I gather that Australia has the lowest incidence of TB in the world (4.1 per 100,000 last avaiable figure I could find 2007)- probably due to their very pro-active requirements for immigration screening prior to the issuing of visas etc. Those who prove positive are offered treatment thus protecting the wider population at the same time as hopefully curing TB in the visa applicant.
Why do we have to rely on Russia Today to provide data that is of significance to our general health especially when it is getting worse or perhaps it is not politically correct to identify the specific groups that have and spread TB in the UK?

Gordon the Fence Post Tortoise said...

I notice that some multinationals are now requiring a TB screen in addition to drugs and alcohol tests for employees and contractors.

Go figure.

Wrinkled Weasel said...

Michael Fowke is the only person in the world apart from me who has read a biography of Knut Hamsun.

I bang on about him all the time Mr Fowke, try searching my blog.

Apogee said...

Hi SR, part of the reason for the low incidence in Australia is that up to the mid 1970's TB x-rays were compulsory,Comply or else,and treatment was compulsory.

tris said...

Scotland should reclaim its own country.

We should immediately close the border with England, and demand that all be tested before they are allowed in.

And that includes the royal family and Mrs Parker Bowels. They are always galavanting all over the bloody world 1st class at our expense. God only knows what they bring back.

subrosa said...

It's not in the least pretentious Michael. As you don't list an email address none of your readers can communicate though.

Good luck with it. It's on my reader now.

subrosa said...

Yes I noticed information about Australian Clarinda and it was a little dated, but so many of these details aren't updated.

You're quite correct about their strict screening.

I too think it's shameful Russian Today has to publicise this. Is it perhaps that so many journalists are London based they may be concerned they too would be screened by a mass screening programme as Apogee suggested?

subrosa said...

I figure Gordon.

subrosa said...

Congratulations WW. Now I remember where I previously read about Knut Hamson.

subrosa said...

Hi Apogee, Clarinda suggests screening does still go on there prior to immigration approval.

subrosa said...

Tris, I've never heard you being so opinionated about something. I take it you're not keen on the new Duchess of Cornwall?

Groompy Tom said...

Strange times we live in. It seems all these 'old-world' diseases are now back in vogue.
I see Rickets even made a come back last year. Lovely!

http://www.ealinggazette.co.uk/columnists/ealing-columnists/2009/10/20/constituency-matters-rickets-return-64767-24972707/

JuliaM said...

Considering the prevalence of public spitting in London (truly the most disgusting habit), I can't say I'm surprised....

Gordon the Fence Post Tortoise said...

JuliaM @05:57

I just returned from a working visit to India, I'd forgotten... it's almost like being at a punk concert in '79.

subrosa said...

Argh Julia, fortunately there's no problem with that here. Sounds horrific.

subrosa said...

What's happening Tom? We used to have a public health department. Now we spend billions on instilling fear into folk about dying from the flu when diseases we spent years eradicating are rising.

The cost of treatment for these isn't cheap - or too pleasant I believe.

Gordon the Fence Post Tortoise said...

fwiw, the preferred test for TB at the corporate level is Quantiferon Gold which sounds like Laboratoire Garnier a hair product... $50-ish a pop

As to public health, we have a rebranded "Director of Public Health and Wellbeing" on our freshly re-branded local council.

There are, I strongly suspect, many more folk polishing the "corporate" image and jumping onto faddish bandwagons in our public bodies than foot soldiers actually getting coughed on and reporting back...

Joe Public said...

@ Tris 00:48

A closed border works blocks ways.

You weren't hoping for a semipermeable membrane were you?

subrosa said...

Thanks for that Gordon. Too late for us to do such testing. I suspect many who do have TB aren't registered with a GP.

tris said...

Hum... I bet you have SR. I’m always being opinionated!! It’s my way

You’re right though. I hate the silly cow, at least the last one vacuous though she was, did some good, and she shook that dismal lot up.

Actually she came as close to overturning them as I can remember, but she had to die, or more likely get killed to do it.

But this daft old bat is a tart; as of course is her odious husband. She was sleeping with Big Ears from day one. She eventually managed to get her hands on his money for herself and her real children. They have gone through some ceremony which appears to confer the money and some silly titles...well lots of silly titles on her. It is not recognised by the church her husband hopes to head up one day, but still the Archbishop was summoned to bless the wedding. What a position to put him in. Selfish set of inborn ingrates.

And as soon as she secured the money, titles et al, she announced she didn't like the heat, and she didn't like the cold, and she didn't like to be away from London and her grandchildren for too long, and she doesn’t like holidays in Scotland preferring to be in Greece (where she might not have noticed, but it is usually hot) with her friends. I suggest Paris for her next holiday.

She only costs about £50 million a year to keep and keep secure, the least the bitch could so is some bloody work.

subrosa said...

She played the game tactically Tris and won. Unfortunately.

tris said...

Yep. Greedy old tart.

Still, you do have to say: Imagaine putting up with being round that foul, ugly, self important prat big ears, and his awful family all these years.... It's a big price to pay for a few billion.

subrosa said...

Somehow I think I could cope Tris. ;)

Jo G said...

Re the spitting habit: plenty Scots men do it too, certainly in Glasgow. Its the filthiest habit ever.

On the TB issue, I think there is no doubt immigration has to take a large chunk of the blame. It really is terrifying.

subrosa said...

It's done in Dundee to Jo, a lot. Then again footballer do it so why not I was asked once.

This is a problem which will be kept under the carpet until it an epidemic and then too late for many. We don't have the isolation units etc they had 50 years ago.

tris said...

Joe. I've no interest whatsoever in crossing that border. I head North to Iceland, or overfly to Paris when I want out of here.

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