TB in Leicester: Out of Control, or Just One of Those Things?

The authors pondered whether the recent TB outbreak in Leicester is "a one off event due to unusual circumstances or a sign of a growing problem in a local community which may be common to other urban communities in the United Kingdom?" Leicester's overall TB rate has changed little in recent years: 52 cases per 100,000 were reported in 1998, compared to 10.9 per 100,000 for the rest of England and Wales. And the Leicester outbreak is not related to the two-year lapse in the national schools' BCG immunization program, since 80 percent of children at the school, including most of those with active disease, have been immunized: "BCG provides only partial protection against tuberculosis."

"The outbreak in Leicester adds a further warning about the importance of establishing and maintaining effective services for the diagnosis, treatment, and surveillance of tuberculosis. In particular, adequate numbers of specialist nurses are needed as they provide the backbone of local tuberculosis services. But it is not just a question of resources. Prompt diagnosis of cases depends on being alert to tuberculosis as a possibility, particularly in people from high risk groups," the authors wrote.

"The breakdown in health services, the spread of HIV infection, and the emergence of multidrug-resistant tuberculosis in many parts of the world are contributing to the worsening impact of the disease. ...It is crucial, however, that as well as maintaining its own effective tuberculosis services, the UK continues to work in partnership with countries where the disease is highly prevalent to help control the global problem of tuberculosis."

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