OT London is TB capital of Europe

[harry]

Glad I don't live near the filthy s*******le

[Nightjar]

It is nothing new, but it is more newsworthy than it used to be. They could have written the same story 20 years ago and it would have been just as true. When I needed new pictures of reactions to the Heaf test, it was an East London hospital who were able to help, as nobody else saw the strongest levels of reaction. The poorer parts of London is where immigrants have usually ended up over many centuries.

Around one person in three carries TB in its dormant form and you could easily be among them. You are of the right age to have been exposed as a child. In most cases, the body's own defences keep it in check but, when those defences are reduced, for example by living in extreme poverty, it is able to become active.

[Timothy Murphy]

Do you a citation for that? It seems to me very unlikely, since according to

5 to 10 percent of those with dormant TB develop full TB. So if your figure is correct I would expect 1.5 to 3 percent of the population, say 1 million in the UK, to develop TB, which obviously is not the case.

This too seems to me unlikely. Childhood infection in the past was mainly due to drinking unpasteurized milk, which is impossible for most people today. (I take it you are referring to the UK.)

[michael adams]

Urban badgers.

Simples.

michael adams

...

[whisky-dave]

meerkats !

[Davey]

On the other hand, Londoners can now be happy in the knowledge that they don't live anywhere near you! No, I'm not one.

[Nightjar]

The authorities in the UK hope that the figures in the UK are lower than the global average, but don't have exact figures. However, if it is, it will be the younger generations who have benefited. OTOH, when I took an active interest in the matter, which is more than a decade ago, it was stated in a talk to TB nurses, which I attended, that one UK AIDS victim in three died of TB, which suggests that the number of those with latent TB is probably not far off the global average.

Harry is retired and hence quite old enough to have been exposed to infected milk. He will also have been alive when more than one person in a thousand developed TB every year, many of whom will have directly infected others. I have latent TB and that is almost certainly due to exposure to an infected person; a friend of my father's.

[Timothy Murphy]

That document is concerned with the whole world. I assume, from the title of the thread, that the discussion is about TB in the UK.

According to there were just under 8,000 cases of TB in the UK in 2013. Since according to

5 to 10 percent of those with dormant TB develop full TB, this suggests that about 60,000 people in the UK have dormant TB, which is much smaller than 1 in 3.

The exact figures of those with TB in the UK are published each year. The number with dormant TB can be calculated with reasonable accuracy, as above. Incidentally, the number with TB in London had been falling steadily in 2014 when the last report was published.

I don't believe the number has been anything like that in the last 70 years.

You have to be fairly ill with TB to be infectious, and the disease would be recognized long before that.

Incidentally, TB is not a serious illness today unless the patient has some other condition like AIDS. Since the discovery of streptomycin in 1943, or rather its introduction into the UK in the early 1950s, the death rate from TB among young people has been practically zero.

[polygonum]

Drug-resistant TB is serious.

[dennis]

Its also hard to catch. You have to spend time in close proximity to a contagious case.

If you don't share offices, transport, homes, etc. the chances are pretty close to zero.

However if its a family member you might want a mask or two.

[harry]

I am also old enough to have been tested as we all were back then. I was negative. Most milk back then was delivered to the door by local farmers. Unpasteurised. They made a big thing of that too.

[harry]

Brought here by migrants.

[News]

In message , harry writes

I was born in '52, and can remember unpasteurised milk being delivered by the dairy. There was always a choice, apart from the usual milk, of goat's milk, unpasteurised etc. Cannot remember which one came in a tall, thin bottle, with a beer bottle type flip top. Was that goat or unpasteurised?

[Huge]

Neither. That was how UHT was bottled.

[Bob Martin]

The only milk I can remember in "a tall, thin bottle, with a beer bottle type flip top" was sterilized.

[charles]

I remember the crown cork on milk - but on standard milk bottles - so a much larger neck than a beer bottle

[Dave Plowman (News)]

Must be a regional thing. Only crown cork tops I remember came on sterilised milk. Which would fall foul of trade description these days as it tastes nothing like milk. ;-)

Glass milk bottles I were a kid had a cardboard disc as a seal before the aluminium foil type arrived.

[whisky-dave]

Not usually for TB to be drug resistant it needs to be exposed to the drugs and in poorer couintries this doesn;t happen. In the UK it is common for people to stop taking their presecibed drugs when they think they are better, this is where the 'bugs' etc.. can build up a resistance to such things as TB. In areas where no drugs given out the TB can't become drug resistant.

[Tim Streater]

Doesn't have to. It has to taste like *sterilised* milk. Arf, arf :-)

[Nightjar]

It is never a good idea to make assumptions about my posts.

That is 8,000 new cases every year. Do you think that the other 90-95% of people with latent TB spontaneously cure themselves, or do they simply increase the size of the reservoir?

Your calculations appear only to tell us how many new cases of latent TB can be expected each year. An estimate of the total number would require a knowledge of the average age at infection, the average life expectancy of people with latent TB and the incidence rate of TB for all the years that covers.

The overall trend for the incidence of TB has long been downwards, but there have been short term spikes before.

70 years ago, the rate was around 140 per 100,000 population. It only dropped to 100 per 100,000 in 1955.

Today, probably. Before the NHS, the people at highest risk - those living in poverty - simply wouldn't have been able to afford to go to the doctor. The ethos that you only went to the doctor if you were very seriously ill persisted into the 1950s and even the 1960s. It really wasn't that unusual to see people hacking and coughing, in a most alarming way, when travelling on public transport in that era. Of course, most of them claimed it was simply smoker's cough and never bothered to seek medical advice.

I don't think I would describe a disease that, in its simplest form, requires a course of up to six months on a cocktail of at least three drugs, all of which have unpleasant side effects in the doses used, as not serious.