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Health Insight May 2001: Tuberculosis outbreak hits the UK

  A school in Leicester is experiencing the UK’s most serious outbreak of TB for twenty years. Over thirty cases have been diagnosed at the Crown Hills Community College in Evington, Leicester. Leicestershire Health Authority brought forward a screening programme for the 700 students and all teachers in the year groups who have had contact with those with TB. It is now screening close contacts of all diagnosed as having TB and the remaining pupils at the school. Dr Philip Monk, consultant in public health with the health authority, said, ‘We are dealing with a very virulent form of TB. At this stage, I feel that we are in control of the situation in the school. The problem is that this is probably indicative of a wider community outbreak and that will be much more difficult for us to get on top of.’ Some Leicester parents voiced anxieties at a temporary halt to BCG vaccinations two years ago which was caused by a shortage of vaccine, but the programme for school-children is now to resume.

The incidence of TB has increased in England and Wales over the past few years, with a current annual rate of 5000–6000 cases. For the year 2000, the Public Health Laboratory Service had a 10.6% increase in notifications over 1999. Surveillance data indicate that at least part of the increase is attributable to people originating from countries with a high incidence of the disease. The reason for the outbreak in Leicester is unclear, although it is thought that the fact that most of the children at the school are from the south Asian community could be important. There is a high incidence of the disease in south Asia, so children or their relatives could have been at risk of contracting it during visits to the region.

In response to the increasing spread of multidrug-resistant tuberculosis (MDR–TB) WHO has issued new guidelines for the control of these virulent strains of the disease. They were released at the end of March in London, at a meeting of the world’s top MDR–TB specialists.

Sources: Guardian 7 April, BMJ 14 April, BBC Online, Press release (WHO)

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