December 20, 2010
London: Tuberculosis Cases Have Increased 50 Percent in Last Decade, Lancet Says
By DONALD G. McNEIL Jr.

London is the tuberculosis capital of Western Europe, according to a recent article in the medical journal Lancet, which said that cases there increased 50 percent in the last decade.

The situation is “reminiscent of the unexpected outbreaks of multidrug-resistant tuberculosis in New York and California prisons in the early 1990s,” wrote Dr. Alimuddin Zumla, an infectious-disease specialist at the University College London Medical School.

In the 17th century, tuberculosis — called “the white plague” for its victims’ pallor — is thought to have killed 1 percent of London’s population each year, a far higher death rate than in Africa now, where the epidemic has soared along with AIDS. By 1980, it was considered conquered in Britain by antibiotics, the BCG vaccine and better housing, and the National Health Service cut back on surveillance.

Now, most of the new cases are in immigrants. Last year, 28 percent were in people who arrived from Africa, and 27 percent in people from India.

As in Victorian London, it is more common in districts with poor housing. But it is also very common among the estimated 3,600 homeless who sleep in London’s streets and parks nightly, who are also at higher risk because they more often have drug and alcohol problems, mental illness and AIDS.

And it is becoming more common in prisons, where drug-resistant strains are being diagnosed among both prisoners and guards.

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