The United Kingdom is the only country within Western Europe where the rates of tuberculosis (TB) have been rising, and Global TB expert Professor Alimuddin Zumla (UCL Infection & Immunity) has pulled the alarm signal.
Ever since 1999, TB cases in London have increased by over 50 percent, and today, more than 9,000 cases are diagnosed every year (40% of all UK TB cases).
The current situation in the British capital is very similar to the multi-drug resistant TB outbreaks in prisons in the United States in the 1990s, which were brought under control after a very large financial investment.
“Poor housing, inadequate ventilation and overcrowding, conditions that were prevalent in Victorian Britain a century ago, are causes of the higher TB incidence rates in certain London boroughs,” said Professor Zumla.
“In all European countries TB is mainly concentrated in high risk groups such as migrants, refugees, homeless, drug users, prisoners and HIV-infected groups.”
Speaking of the recent London TB Service Review Assessment, the Professor said that “this review, if implemented by the UK NHS, would allow standardization of TB clinical policy and practice and improve responsiveness of London’s TB services needs.
“This will require a serious political and financial investment if the tide is to be turned against the current return of the ‘White plague’ to London.”
At the beginning of the 20th century, the death rate from TB started to decrease in London, due to the improvement of living standards like nutrition, better housing and economic status.
Also, since the introduction of anti-TB drugs in the early 1960s, along with the improved health services and BCG vaccination, TB control was successful.
Twenty years later, in the early 1980s, tuberculosis was considered vanquished in the UK, so the National Health Service (NHS) TB services were scaled down considerably.
The problem today is that it seems TB has returned to the capital, increasing the numbers of infected people by almost 50% since 1999, from 2,309 cases back then, to 3,450 cases in 2009.
In 2006, Professor Zumla established the UCL London TB Link Project, and the growing tuberculosis rates among the homeless population have brought it the necessary visibility.
It also led the University College Hospitals NHS Foundation Trust to establish Mobile X-ray units, that offer access to care to the more disadvantaged part of the population.
Professor Zumla called for the urgent implementation of the recommendations from a recent UK TB review, in order to regain control of this situation.
His advice was published today in The Lancet.