Mass air travel brings TB threat to Britain

Air travel is putting Britain at risk from the spread of drug-resistant tuberculosis, which is among the deadliest and most difficult infectious diseases to treat, specialists said yesterday. They said investment in prevention would contain the condition more effectively than screening new arrivals.

Air travel is putting Britain at risk from the spread of drug-resistant tuberculosis, which is among the deadliest and most difficult infectious diseases to treat, specialists said yesterday. They said investment in prevention would contain the condition more effectively than screening new arrivals.

More than 300,000 people around the world are infected each year with tuberculosis (TB) that is resistant to at least two of the commonly used drugs, according to the World Health Organisation (WHO), making the condition 100 times more costly to treat than ordinary tuberculosis.

A WHO survey has found that 74 out of 77 countries and regions had cases of the resistant disease. Infection rates were up to 10 times higher in parts of Eastern Europe, central Asia, Israel and Ecuador. Information was found to be lacking on drug resistance in some other countries with a high incidence of TB, including Bangladesh, Indonesia and Nigeria.

Mario Raviglione, director of WHO's Stop TB department, said second-line drugs to treat drug-resistant TB were highly toxic, very expensive and often not available. Yet without them the disease was a death sentence. "It is in the interest of every country to support rapid scale-up of TB control if we are to overcome multidrug resistant TB. Passport control will not halt drug resistance - investment in global TB prevention will," he said.

The worst affected countries, according to the survey, are those of the former Soviet Union including Estonia, Kazakhstan, Latvia, Lithuania, parts of the Russian Federation and Uzbekistan, where up to one in seven new TB patients has drug-resistant disease. Increased migration from Eastern Europe has raised concerns about the threat to the health of the West but experts said introducing screening at borders would be ineffective.

Paul Sommerfeld, the spokesman for the Stop TB campaign based in the UK, said: "The crucial thing to bear in mind is that this is an airborne disease spread from person to person. It is not possible to isolate one part of the world from another. The first line of defence is efficient detection and proper treatment."

In many countries, shortage of drugs means patients cannot complete their course of treatment, contributing to the rise of drug-resistant forms of the disease. Curing normal TB involves a six-month course of drugs costing about $10 (£5.50) but treatment for drug-resistant forms costs from $500 to $6,000 and the drugs are less effective and more toxic, specialists said.

The survey covered 20 per cent of the world's population but experts said they feared the incidence of drug-resistant TB in the remaining 80 per cent could be higher.

Rising rates of HIV infection, which weakens the immune system, in Eastern Europe and central Asia, makes people more susceptible to TB.

Jack Chow, WHO's assistant director-general of HIV/Aids, TB and malaria, said: "With people's immune systems compromised, multidrug resistant TB has a perfect opportunity to spread rapidly and kill. As a priority to prevent the spread of all forms of TB, we need more investment in resources, programmes and health workers."