The latest figures from Public Health England show that 8,751 tuberculosis (TB) cases were reported in the UK in 2012, slightly lower than the 8,963 cases reported in 2011.
Rates of TB have stabilised at around 14 cases per 100,000 since the mid-2000s, following the increase in incidence seen in the previous two decades. However, despite considerable efforts to improve prevention, treatment and control, TB incidence in the UK remains high, compared to most other Western European countries. London retained the main burden of infection in 2012, with 3,426 cases accounting for almost 40% of the UK total, followed by the West Midlands with 12%. Almost three quarters of cases were in people born in countries where TB is more common. Of those born abroad, the majority of cases were from South Asia (60%) and sub-Saharan Africa (22%). In the UK-born population, those most at risk remain individuals from ethnic minority groups, those with social risk factors such as a history of homelessness, imprisonment or problem use of drugs or alcohol, and the elderly. Dr Lucy Thomas, head of TB Surveillance for Public Health England (PHE), said: “Efforts to control the spread of this infection must remain a public health priority. Early diagnosis and appropriate treatment are key to reducing TB levels in the UK and local health service commissioners must prioritise the delivery of appropriate clinical and public health services for TB, especially in areas where TB rates are highest. “To reduce the risk of active TB disease in people coming to the UK from high incidence countries, it is essential that new migrants have good access to screening and diagnostic services. Ensuring that NICE recommendations on screening for latent TB infection are implemented in a co-ordinated manner across the country is therefore very important.” Drug resistance to TB treatment remains a problem, although the proportion of TB cases showing resistance to the first line antibiotic isoniazid decreased slightly to 6.8% of cases in 2012. The proportion of multi-drug resistant (MDR) TB cases remained stable at 1.6% (81 cases). Most MDR TB cases (89%) occurred in those born outside the UK. Although the total number of UK TB cases born in Eastern Europe remained low, almost a quarter of these cases had MDR TB. Two cases of extensively drug resistant (XDR) TB were reported in 2012, compared with six in 2011, taking the total to 26 laboratory-confirmed XDR cases in the UK since 1995.
