LONDON (Reuters) — Tuberculosis is
becoming concentrated among immigrants, drug addicts, and the poor
and homeless in Western Europe's big cities despite progress in
reducing national rates of the disease, experts said on Friday.
The contagious lung infection, once known as the
"white plague" for its ability to render its victims pale, skinny
and feverish, is being well tackled at national levels, they said,
but is persisting in high-risk, marginalized groups.
In a study of European Union (EU) cities with populations of more
than 500,000, the researchers found that on average the rate of
tuberculosis (TB) in big cities was twice the rate of the national
TB incidence.
In Britain, data from the government's health agency, Public Health
England (PHE) show that more than 8,750 TB cases were reported 2012,
and 3,426 of them — or 40 percent of the national total — were in
London.
"Although we have long understood that TB affects specific groups
and is often concentrated in urban areas, what we are now witnessing
is a marked change, where rates of TB are showing an overall
reduction nationally while still increasing within big cities," said
Ibrahim Abubakar, a professor of infectious disease epidemiology at
University College, London.
His study found the highest TB rates in big cities in countries with
generally low rates of the disease were in Birmingham and London in
Britain, followed by Brussels in Belgium and Barcelona in Spain.
These cities' rates were all "higher or considerably higher compared
to their national TB notification rates, it found.
TB is often seen as a disease of the past — but the emergence over
the past decade of "superbug" strains that cannot be treated even
with numerous drugs has turned it into one of the world's most
pressing health problems .
Of all infectious diseases worldwide, only HIV — the human
immunodeficiency virus that causes AIDS — kills more people.
In 2011, 8.7 million people fell ill with TB and 1.4 million died
of it. The World Health Organisation (WHO), which declared TB a
global emergency in 1993, says up to 2 million people may be
infected with drug-resistant strains by 2015.
In the relatively wealthy countries of western Europe, TB mainly
affects certain high risk urban groups such as those who originate
from high TB burden areas of Asia and Africa, homeless people and
people who abuse drugs or alcohol.
TB symptoms include fevers and night sweats, persistent coughing,
weight loss and blood in the phlegm or spit and it is spread though
close contact with an infectious person.
Abubakar, whose work was published in the online journal
Eurosurveillance, said elimination of TB in European big cities
would require control measures focused on the particularly
vulnerable marginalized urban populations.
"And efforts to target TB must drive right down to local and
regional level where unique experience of how to reduce the
infection can be shared and built upon," he said.
A study published last August found that TB inflicts annual direct
health costs of more than 500 million euros ($670 million) on
European governments, and costs another 5.3 billion euros in
productivity losses.
The contagious lung infection, once known as the
"white plague" for its ability to render its victims pale, skinny
and feverish, is being well tackled at national levels, they said,
but is persisting in high-risk, marginalized groups.
