Tuberculosis in the United Kingdom (Hansard, 23 June 1998)

§ Baroness Ramsay of Cartvale
My Lords, there has been a small increase in the number of cases in the United Kingdom since 1990, when there were 5,897. That increase peaked in 1993 at 6,564. The figures have now levelled out just below that number. Drug resistant TB remains at low levels in this country. This success reflects the excellent record of TB control which we have and are determined should continue.

Viscount Long
My Lords, I am grateful to the Minister for her Answer. Recently fizzy drinks were withdrawn from sale because a cancer ingredient was suspected. Does the Minister agree the chewing gum could equally be suspected of being a carrier of tuberculosis and other diseases, especially those from the eastern European countries, India and Persia? Who is monitoring the situation? Is it the EC matrons of Europe or some of our noble medical associations?

§ Baroness Ramsay of Cartvale
My Lord, I shall deal with the different strands in that question. The high rates of TB in Asia and Africa impinge on other countries. The noble Lord asked about the European Union. A collaborative pilot study of surveillance of TB in member states has been successfully completed and extended to include drug resistant TB. A series of annual meetings on TB has addressed best practice. Several east European countries are participating and contributing to the exercise.
As regards chewing gum, there is no medical or scientific linkage with TB. TB is spread by bacteria in droplets coughed out by an infected individual. Anything spat out by an infected person might have an effect, but it would contain saliva rather than droplets from the lung. I hope that your Lordships will forgive my being so explicit. There is no direct link between TB and chewing gum.

Lord Bruce of Donington
My Lords, is the Minister aware that it is within the memory of most noble Lords present that tuberculosis was virtually extinguished in the United Kingdom? Have not social conditions—those affecting the very poor, the homeless, those who are on the receiving end of most of the disabilities of modern life—been a significant cause of the recurrence of the disease which at one time we boasted we had almost eliminated?

§ Baroness Ramsay of Cartvale
My Lords, there was a decrease in notified cases from around 50,000 in 1950 to 5,745 in 1987. The number then peaked in 1993 at 6,564. However, the figures are still comparatively low. In 1996 there were 6,238 cases. The provisional figure for 1997—the numbers are always high because doctors register suspected cases and the figures have to be sorted out afterwards—was 6,430.
The noble Lord mentioned social conditions and poverty. The groups which are considered at risk of TB in Britain today are certain ethnic minority populations, especially from the Indian sub-continent and black Africa, older white people who were exposed to TB when they were young, homeless people and HIV infected individuals. Many of those groups are hard to reach. Homeless people often do not complete their treatment or are lost to the health service. Any social condition which reduces the level of people's health and their ability to withstand infection will increase a disease like TB which is transmitted by bacteria.

§ Baroness Masham of Ilton
My Lords, if it is right that drug resistant TB spreads, does the noble Baroness believe that there are sufficient specialised rooms with negative and positive pressurisation in which to treat infected patients?

§ Baroness Ramsay of Cartvale
My Lords, we are alive to the problem of drug resistant TB, although in Britain the number of cases is comfortingly low—43 were registered in 1994, 49 in 1995 and 60 in 1996. A programme is in place throughout the country; there are specialist clinics in every area; and TB patients are kept separate.
TB is the only disease whose exact timing of treatment was worked out a considerable time ago by British scientists. The treatment lasts six months. I am sure that the noble Baroness is well aware from her background and her membership of the Science and Technology Committee of this House that multi-resistant TB often occurs because people do not complete their prescribed programme of drugs. In Britain, we have several safeguards against that happening. I repeat that we have in place a concentrated programme and that we are alive to the problem of drug resistant TB. We are confident that we are still on top of the problem.

Noble Lords
Next Question!

§ The Lord Privy Seal (Lord Richard)
My Lords, I think that we should move on.