§ Mr. KeetchTo ask the Secretary of State for Health what steps he is taking to monitor(a) links between human TB and bovine TB and (b) the incidence of TB; and if he will make a statement. [43683]
§ Ms JowellThere are established procedures for reporting, investigating and treating cases of tuberculosis, including the screening of contacts. Guidance on these matters is contained in the reports of the Interdepartmental Working Group on Tuberculosis, which were published in July 1996, copies of which are available in the Library, and in the publications of the British Thoracic Society and other specialist groups. Additionally, Veterinary Officers notify local authority environmental health officers when a restriction of movement order is imposed on a herd of cattle which has shown positive reactors, so that contact tracing can ensue.
Cases due to M-bovis infection, the strain which infects badgers and cattle, are identified through culture of the infecting organism. Around 30 to 40 cases of human tuberculosis each year are confirmed to be due to M-bovis infection. These are mainly in older people who were exposed to bovine tuberculosis before sterilisation of milk and routine testing of herds for tuberculosis were introduced and are not thought to be due to recent transmission. However, as cases of bovine TB in cattle are increasing in the United Kingdom, this is something we are monitoring carefully.
Tuberculosis is a notifiable disease. The incidence of cases is monitored nationally and by health authorities, and surveillance of laboratory confirmed cases is conducted on a routine basis by the Public Health Laboratory Service (PHLS). There were 5,913 notifications of tuberculosis reported in England and Wales in 1997 (provisional figure).
The PHLS has taken steps to improve surveillance of tuberculosis, including resistant strains, and local initiatives by health authorities have been undertaken to improve completeness of notifications. In addition, the Department is funding the PHLS Communicable Disease Surveillance Centre to conduct a further 5-yearly survey of notifications of tuberculosis during 1998 to provide a more detailed picture of the disease in England and Wales.