A new alert has been raised over London's tuberculosis epidemic. A senior government advisor Tuesday called for the return of the sanatorium, in which patients are isolated in a bid to control the spread of the disease. Rates of TB in some London boroughs are now at Third World proportions, and cases of its more dangerous drug-resistant form are increasing, warned Professor Francis Drobniewski, head of Britain's TB unit. Rates of TB are at a 10-year high. Last year, there were 6,838 cases in England and Wales, and more than 3,000 of those were in London.

Drobniewski said TB is also spreading from poverty-stricken areas to more middle class ones. He attributed this to a small minority of patients who are refusing treatment and are infecting others. At a conference organized by the British Medical Association to discuss London's TB crisis on Thursday, Drobniewski will make the controversial proposal that patients who persistently refuse treatment should be forcibly detained in secure units.

Drobniewski will also call for the return of sanatoriums to treat other vulnerable groups -- such as the homeless -- in isolation. He will suggest a system of small units with private grounds where patients could receive treatment for up to six months without coming into contact with uninfected people.

"We need to balance the rights of the individual against the interests of the public's health, and I would always err on the side of the individual," Drobniewski said. "But some people have chaotic lives and they may benefit from choosing to go into a sanatorium where they will get food, shelter, and treatment. For the small minority of people who refuse all treatment options, it may be that we need to have a way of detaining them in a similar way to the Mental Health Act," he said. "We would not force treatment on them, but they could be detained in secure units to prevent them from infecting other people."

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