TB: Plan to tackle rise in drug-resistant cases

The UK has been using opportunistic X-rays to detect undiagnosed cases of TB

A plan has been drawn up to try to tackle cases of drug-resistant tuberculosis in 53 European countries.

The World Health Organisation (WHO) has described the problem as "alarming".

Eastern Europe has the highest level of infection, while in Western Europe, London has the highest TB rate of any capital city.

The WHO estimates there are 81,000 cases of drug-resistant TB a year in Europe, although many countries are failing to diagnose it.

The plan aims to increase diagnosis and access to treatment. Experts believe it has the potential to save several billion pounds and 120,000 lives by 2015.

European problem

Russia, Ukraine and Azerbaijan are among the countries with the highest burden of illness.

TB cases in the UK are concentrated in large cities. There are 3,500 cases in London each year.

In 2009, there were 58 cases of drug-resistant TB in the UK. Resistance can arise if patients fail to complete their course of medication.

The Health Protection Agency's TB expert, Dr Ibrahim Abubakar, said: "Although the overall numbers are small, the trend has been for an increase in the past decade.

"We cannot be complacent. The cost of managing each case can stretch to several hundred thousand pounds.

"So it's significant - and while that person is infectious, other people can get TB.

"The larger numbers in Eastern Europe represent a failure to take action."

He urged GPs and casualty departments to be vigilant for possible cases.

TB is an airborne infection which still proves fatal in about 7% of cases. Almost half of patients with the multi-drug resistant form of the disease die.

The WHO has praised the UK's "Find and Treat" service, which uses a mobile X-ray van to screen homeless people and drug addicts for TB.

Dr Ogtay Gozalov, from the WHO's Europe office, said: "It's not just the vulnerable populations like migrants and prisoners - all of us could be exposed.

"If member states don't take action now, there could be a dramatic situation in the future."

Cocktail of drugs

Barrister Anna Watterson spoke of how she became ill with drug-resistant TB when she was a law student living in north-west London.

She made a full recovery but missed a year of studying and spent four months in hospital.

She said: "I had a cough I couldn't shake off. I lost weight and had night sweats.

"I visited my GP a few times but TB wasn't suspected because of my background and age - I was in my mid-20s.

"Once I'd been admitted to hospital, I started the standard three-drug regime.

"But six weeks later came the depressing news that none of the three antibiotics were effective. I had the impression the doctors were scraping the barrel.

"The next cocktail of drugs left me feeling unwell. I had bruises from injecting them, and one of the side-effects was sensitivity to the sun.

"As a pale-skinned redhead, this meant having to wear gloves when I went outside in the summer."