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HPA - New cases of TB reach highest level for 30 years as drug resistant TB doubles in the last decade

Cases of tuberculosis in the UK have reached 9,040 in 2009 - the highest number in the UK for nearly 30 years while the number of new drug resistant TB has nearly doubled in the past 10 years, from 206 cases in 2000 to 389 cases in 2009. These data are revealed in the Health Protection Agency's annual TB report, published today (Thursday). 

The HPA also reports that, although the proportion of multi-drug resistant cases of the disease remains low (1.2%), the number of cases has doubled in the last decade from 28 in 2000 to 58 in 2009. Patients may acquire drug resistant disease either as a result of spread of a drug resistant strain from another person or as a result of inappropriate or incomplete treatment.

Treatment for non drug resistant TB requires a six month course of multiple antibiotics. For drug resistant TB, however, the treatment is even more complicated and prolonged. For multi-drug resistant TB, for example, treatment may be required for 18 months or longer.

The Office for National Statistics recorded 334 deaths in England and Wales in 2008 where tuberculosis was the underlying cause. A total of 3,312 years of life were estimated to have been lost as a result of premature mortality from tuberculosis in 2008.

Dr Ibrahim Abubakar, head of TB surveillance at the HPA said: "We are concerned to see cases of TB at their highest levels since the 1970s. TB is a preventable and treatable condition but, if left untreated, can be life threatening.

"The key to reducing levels of TB is early diagnosis and appropriate treatment. Efforts to improve early diagnosis and control the spread of this infection must remain a priority and be increased in areas where prevalence is high. 

"It is important that health commissioners, especially in parts of the country with the highest rates of TB, prioritise the delivery of appropriate clinical and public health TB services."

This year nearly seven per cent of new TB cases were resistant to isoniazid, one of the key first line drugs in the treatment of TB.  In 2004 the Chief Medical Officer's national action plan set a goal of maintaining the proportion of drug resistant TB cases at below seven per cent.

Dr Abubakar added: "TB can affect anyone.  Cases are more common among populations centred in urban areas, as is the case with many other infectious diseases. The majority of cases are diagnosed in people who are non-UK born and who come from countries with a high prevalence of TB, reflecting the background levels of the infection in that country. Other groups more at risk of TB infection include homeless people and drug users, who may not have easy access to healthcare services.

"The HPA is calling for greater coordination of control activities so that completion of treatment can be ensured wherever the patient is located."

Dr Paul Cosford, executive director of Health Protection Services at the HPA said: "The HPA takes the increases we have seen in TB infection very seriously and is working closely with public health and NHS colleagues nationally and locally through Agency's Health Protection Units to tackle, and hopefully eventually eliminate, this disease.

"Although drug resistant and multi-drug resistant cases of infection represent only a  small proportion of TB cases overall, each resistant case requires careful and often prolonged treatment and care.  Drug resistance is increasingly an issue in a wide range of infections. Patients must ensure they take their full prescription as instructed and, most importantly, they must finish any course of treatment that has been prescribed.

"TB is sadly not a disease of the past and the figures today serve as an important reality check."

Notes to editors:

1. For further information on this press release please contact the Health Protection Agency's Centre for Infections press office on:

Georgina Fletcher  020 8327 6690
Louise Brown  020 8327 7080
Kate Swan   020 8327 7097
Alexandra Baker   020 8327 7098
Eleanor Bunch  020 8327 7751
Emma Gilgunn-Jones 020 8327 6647

2. TB is an infection caused by bacteria and usually affects the lungs, it is spread from person to person through coughs or sneezes but only some people with TB are infectious and even then, you need close and prolonged contact with them to be at risk of infection.
Symptoms of TB include the following:

  • Fever and night sweats
  • Persistent cough
  • Losing weight
  • Blood in your sputum (phlegm or spit) at any time

3. The Health Protection Agency began presenting data on TB infections for Scotland and Northern Ireland, as well as England and Wales, in the year 2000. Previous to that the public health service for England at the time only reported cases for England and Wales. To see the total number of notifications of TB in England and Wales from 1913 please visit: http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1225700804564

4. For a copy of the agency's report, which will be available from 10.00am on Thursday 4 November or available from the press office beforehand, please go to: http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/Tuberculosis/

5. For a copy of the CMO's National Action Plan from 2004 please visit: http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Aboutus/MinistersandDepartmentLeaders/ChiefMedicalOfficer/Archive/FeaturesArchive/DH_074748

6. For information on case studies please visit http://www.tbalert.org/

TB Data 2010 for press release (PDF, 62 KB)

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