TB cases soar in London

London is facing a severe shortage of specialists to cope with the rising tide of tuberculosis cases, according to figures published today.

The prevalence of the disease has hit a 13-year high and in north London there has been an outbreak of drug-resistant TB. However, across the capital the number of specialist nurses required to treat the disease falls short of minimum standards set by the British Thoracic Society.

In Barnet, Enfield and Haringey, some of the worst-affected areas, consultant physicians are expected to cover a population more than twice the recommended size. Experts today warned that urgent action is needed to tackle the staff shortages in order to curb the spread of the disease.

A report published by the Joint Tuberculosis Committee and the BTS today reveals that only one sixth of districts have sufficient staff to deal with current levels of TB - and none of them are in London.

The audit of units across the country found there had been no increase in staffing levels since 1998, despite a 12 per cent increase in TB over the same period. The recommended caseload is one nurse per 50 notified cases. In London the target has been reduced to one nurse per 40 cases, in recognition of the high concentration of patients, but that has not yet been achieved.

Professor Peter Ormerod, who was involved in compiling the report and is professor of respiratory medicine at Blackburn Royal Infirmary, said: "These data demonstrate the continuing under-provision of essential frontline staff to treat tuberculosis in the community. The rise in TB has continued unabated since 1987 and we desperately need to address this staff shortage to deliver the care and service we need to halt the spread of tuberculosis across the UK."

The latest data from the Public Health Laboratory Service shows that more than 40 per cent of all new cases of TB diagnosed between June and September this year occurred in London - 748 of 1,760 cases. Last year, 6,572 new cases were identified - almost an 11 per cent increase since 1997 - and more than 2,800 were in London.

Dr John Harvey, of the BTS, said: "Recent outbreaks of TB have shown that we cannot be complacent about this disease - it has leapt back out of the history books and we must beat it. It is vitally important that we continue to invest in 'contact tracing' and treating tuberculosis both to ensure that patients get the care they deserve and to prevent TB spreading from person to person across the UK.

"This Government needs to wake up to the very real threat the recent and continuing rise of tuberculosis poses to the country - and take urgent action to stem this rise. We urge the Government to increase staffing levels to at least these minimum requirements to provide adequate care for patients with TB."

A report from Barnet, Enfield and Haringey reveals a recent outbreak of drug-resistant TB, which can cost £65,000 a patient to treat. There is a shortage of both consultants and specialist nurses in the area - with physicians covering a population of around 166,000, rather than the recommended 80,000.

The British Thoracic Society estimates that it would cost £5million a year to provide the extra specialist nurses and consultants needed in London.

A major problem in London is that the disease is often diagnosed among asylum seekers who are a transient population and often do not complete courses of antibiotics, which need to be taken for six months or more.

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