Britain is the only country in Western Europe with rising rates of tuberculosis, and in London cases of the disease once dubbed "the white plague" have grown by nearly 50% since 1999, a commentary warned recently.
Britain has more than 9,000 cases of tuberculosis (TB) diagnosed a year and the problem is becoming particularly acute in the capital, which accounts for 40% of the nation's total diagnosed cases, wrote Alimuddin Zumla, a global TB expert from University College London.
The situation in London, he said, was reminiscent of outbreaks of multi-drug resistant TB in prisons in the United States in the 1990s - outbreaks that required a large financial investment to be brought under control.
Poverty-stricken areas at risk
TB - referred to as the white plague during Victorian times because sufferers' skin tone turned so pale - could come back with a vengeance in poverty-stricken areas.
"Poor housing, inadequate ventilation, and overcrowding - conditions prevalent in Victorian Britain - are causes of the higher TB incidence rates in certain London boroughs," Zumla said in a commentary published online by The Lancet.
He said that in Britain, as in all European countries, the disease was mainly concentrated in high-risk groups such as migrants, refugees, homeless people, drug users, prisoners and people infected with the HIV virus that causes Aids.
Highest level in 30 years
A report last month found that cases of tuberculosis in Britain reached their highest level for 30 years in 2009 with 9,040 cases, and the number of new drug-resistant TB cases had almost doubled in the past decade.
Zumla noted that the increase in the number of TB cases seen in Britain has largely been in non-UK born groups, but most of these were not in new migrants. Some 85% of cases born overseas had lived in Britain for two or more years and about half had lived here for five or more years - indicating that the disease is not being imported from elsewhere. - (Kate Kelland/Reuters Health, December 2010)