TB & Outbreaks Week (10.07.03) - Friday, December 19, 2003

The figures are small compared to the 1960s when just under 2,000 TB cases were diagnosed in children under 15 each year. Cases in children born abroad increased from 41 in 1988 to 42 in 1993 to 97 in 1998. The most recent data comparable to the study show there were 469 total cases in children in 2001, with less than one-third of cases in children known to have been born abroad.

"These figures may reflect recent patterns that have been observed in other developed countries of a rise in cases of TB in people who are born in areas of the world where the disease is now epidemic," said an HPA spokesperson.

"Current guidelines for the control and prevention of TB in the UK recommend screening of new immigrants as part of a coordinated local control policy," the spokesperson continued. "Screening should consist of a health interview and a Heaf test to measure people's immunity to TB and in some instances a chest X-ray. Screening in this way can identify people with active TB disease who require treatment, people who are infected with TB who can be prevented from developing the disease using prophylactic antibiotics, and people who have no immunity to the disease and can be protected by immunization. This is particularly important for children.

"However," the spokesperson noted, "many individuals develop their TB after being in the UK for some time and the disease is not evident at the time of arrival. Raising the awareness of the symptoms of TB in foreign-born people and those who work with them, and good access to health care for prompt diagnosis and treatment are crucial."

WHO estimates that one-third of the world's population are infected with TB, but only a small proportion of those infected will go on to develop active TB. Although it is a leading killer worldwide, with proper treatment almost all TB cases can be cured.

The study, "A Decade of Change: Tuberculosis in England and Wales 1988-98," appeared in the Archives of Disease in Childhood (2003;88:772-777).
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