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Evening Standard
Evening Standard
World
Daniel Keane

Tuberculosis alert with cases in London at six-year high

Tuberculosis cases in London have reached the highest level in years, data shows, as experts warned that the world is “losing the battle” to eliminate the virus.

Figures released by the UK Health Security Agency (UKHSA) reveal that 471 tuberculosis (TB) infections were reported in the capital between April and June this year, the highest quarterly figure since 2017.

The number of cases in London is 176 per cent higher than any other region in England, laying bare the scale of the task facing health authorities in the capital to contain the spread of the disease. London also has the highest TB rate in western Europe, according to University College Hospital (UCLH).

TB symptoms include a cough lasting more than three weeks, fatigue, a high temperature and night sweats. The disease can be fatal if not treated properly.

Rates of the disease peaked in the 17th and 19th century when it accounted for around a quarter of deaths in Europe, according to the Center for Disease and Control and Prevention (CDC). Infections and fatalities have dramatically fallen in western countries due to improvements in sanitation but the disease continues to circulate in developing countries.

Clinicians working to treat TB on the frontline warned that London's homeless population and asylum seekers were at heightened risk of transmission.

Dr Al Story is the leader of UCLH's Find and Treat team, a specialist outreach programme that screens thousands of the most vulnerable patients for illnesses including TB and HIV. The testing service operates in a van outside Whitechapel Mission.

He told the Standard: “TB is a disease that clearly aligns to poverty and social deprivation. The homeless, people living with addiction and asylum seekers are at much greater risk of transmission than the general population.

“One of the challenges is that the symptoms of TB - such as a cough or night sweats - are quite non-specific and usually masked by the hardship of living on the street.

“This is also a population that really struggles to access NHS services. We need to start bringing treatment to people, rather than waiting for them to come to us."

Dr Story said that asylum seekers in the capital were particularly at risk of catching TB either in their home country or on the perilous journey to the UK.

“I treated a man recently who spent time in a prison camp in north Africa before being trafficked across Europe. He has been in a horrific and precarious state for several years. High rates of TB persist in many countries but there is also a huge risk of transmission associated with that journey.”

Dr Story added that global health authorities are "losing the war" to eliminate TB by 2050, a target set by the World Health Organisation (WHO).

“We are seeing the emergence of strains of TB that are not easily cured and requiring long courses of treatment with some pretty toxic drugs.”

The Find and Treat team has uncovered thousands of TB cases since its launch, but Dr Story warned that it would need to be scaled up across the country to bring down infections.

“The Covid pandemic was a clear illustration of what is possible when the world comes together to find a scientific solution.”

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