Drive launched to tackle alarming rise in TB cases

Doctors urged to watch out for symptoms in patients as disease of the past makes a comeback
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A steep rise in cases of tuberculosis in Britain has forced the Government to launch a campaign to curb the disease that killed two million people around the world in 2001.

Yvette Cooper, the minister for Public Health, will announce the initiative today. The killer disease, caused by Mycobacterium tuberculosis, was thought to have been conquered a decade ago by modern drugs but has made an alarming comeback.

A new study shows that the rate of tuberculosis in children living in London rose 130 per cent between 1988 and 1998. Immigrant communities are worst affected and almost half the children were born overseas, according to the study, published today inArchives of Disease in Childhood.

There were 50,000 cases of tuberculosis in the UK in 1950, but the number fell to an all-time low of 5,745 in 1987. Since then the number has risen steadily to over 7,000 in 2000.

Ms Cooper said: "Although tuberculosis cases in the UK are fairly low, we have seen a rise, especially in London, as part of the worldwide resurgence of TB. If it is diagnosed early, it can be treated so as not to spread further."

The five-week government campaign will be aimed at raising awareness of the symptoms of the disease among health professionals and ethnic minority communities.

Professor Francis Drobniewski, director of the mycobacterium reference unit at the Public Health Laboratory Service, said: "One factor driving the spread of TB in developed countries is migration. Provisional data ... shows us that 63 per cent of TB cases in the year 2000 were in people born overseas. Understanding the level and patterns of drug resistance is also essential in controlling the spread."

In the past few years London has become a hotspot for the illness, with an average of two deaths and 50 new cases reported every week. But many cases go undiagnosed because doctors do not expect to encounter TB and miss the signs.

Last year, a series of outbreaks struck schools around the country. In May 2001, 24 children at a private nursery in south London tested positive after a teacher fell ill with the disease. Two months earlier, health officials announced there had been 50 cases at Crown Community College, Leicester ­ believed to be the worst outbreak of tuberculosis in 20 years in any school in that city.

Yesterday, to mark World TB Day, charities and specialists called for extra resources to be invested in the fight against the disease. The charity TB Alert said only one London borough out of 21 with a significant tuberculosis problem and five out of 22 councils in the rest of the country had enough specialist TB nurses to meet the NHS's own standard.

Paul Sommerfield, the chairman of TB Alert, said: "Government and health authorities must find the relatively small sums of money needed to ensure there are sufficient TB nurses. They are the frontline control against this deadly infectious disease."

Professor Peter Ormerod, a specialist in TB and spokesman for the British Thoracic Society, said: "The continuing rise in tuberculosis since 1987 can no longer be tolerated. Last year's high-profile outbreaks ... have highlighted the fact that we may be dropping our guard.

"There is a desperate need for more resources ... at a local level. Adequate numbers of specialist doctors and nurses are essential to monitor, prevent and control the disease."

Three members of one family fall victim to scourge of the Victorians time

Lillian Snowdon has no idea how she and her family came to be struck down by the disease that is making a comeback a century after its highpoint in Victorian Britain.

Her son Neville, 26, a butcher in Newcastle, was the first to fall ill. As a smoker, he was used to coughs and colds in winter but when he started getting pains in his chest two years ago he went to the GP and tuberculosis was diagnosed.

Neville was put on the standard six-month course of drugs and made an uneventful recovery. But for his mother, whom he used to visit every day until she moved from Newcastle to London three years ago, the disease was more serious.

Mrs Snowdon was diagnosed in January 2001. It is likely that she had been incubating the disease after catching it from her son – the bacillus can lie dormant for 10 years or more – but it is also possible she caught it after moving to London. By the time it was spotted both lungs were affected and she had extensive disease. She spent eight weeks in isolation at Hammersmith Hospital, with the drugs given through a tube inserted through her chest and directly into an artery.

"Mine was full-blown TB – it escalated. I tried taking the drugs orally but I couldn't keep them down. So they inserted the [tube] and once that was in and the drugs started to get through I felt better," she said.

The worst part of the treatment was the isolation, she said. "Everyone who came in, all you could see was their eyes. They wore masks and rubber gloves. You realise contact is very important."

After she was discharged from hospital in March last year, nurses visited her at home every day until August to administer drugs. Almost nine months after being diagnosed, she was pronounced cured.

Her daughter, Isla, 22, who lives with her, was also found in screening to have been infected although she displayed no symptoms. She and her brother Anthony, 28, both had precautionary treatment.

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