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London TB scare stories are based on more on racism than fact

The media panic about a rapid rise in new drug-resistant strains of TB in London supposedly linked to immigration is wrong and dangerous

Issue No. 2388

Myobacterium tuberculosis, the germ that causes TB, under an electron microscope

Myobacterium tuberculosis, the germ that causes TB, under an electron microscope (Pic: Centre for Disease Control)


The BBC helped fan a scare story about tuberculosis (TB) last month. 

Its Inside London programme made a big deal of appearing to be scientific and spoke to several TB specialists but its central claims are false.

TB is a serious disease that usually affects the lungs. It is spread in the air and if left untreated it can kill. 

Inside London reported on new strains of the disease that are resistant to many of the antibiotic drugs commonly used to treat it.

“The number of drug-resistant cases is rising so rapidly there is concern that London’s hospitals will be unable to cope,” said the panic stricken reporter.

Hospitals simply do not have enough beds in which patients can be isolated, the programme said. 

It added that the cost of treatment could reach hundreds of thousands of pounds per patient. 

Danger

Inside London concluded by aiding racist scares by calling for a new round of testing of migrants, which it reckons is where the danger lies.

This focus on migrants will be music to the ears of those who want stop “foreigners” coming to Britain—and using the NHS once they are here.

And, by claiming that TB rates in the London boroughs of Newham and Ealing are identical to “Third World countries, like Nigeria and Ghana”, the BBC also helped the impression that TB is a “foreigners’ disease”.

According to Public Health England’s authoritative annual report, Tuberculosis in London, TB rates in the capital are high but have stabilised after two decades of increase.

In 2012, 3,426 TB cases were reported among London residents, a rate of 41 per 100,000. There were over 3,511 cases the previous year.

The report shows that the majority of TB cases are among those born abroad.

Yet only 14 percent of 2012 patients entered the UK within the previous two years.

“Many TB patients who are originally from overseas have lived here a long time,” said east London GP, Kambiz Boomla.

“Some will have come into contact with the disease while young and developed a degree of immunity to it. But as we get older, our immune system starts to fail and dormant diseases can become active ones.”

Treatment

So demands for stricter border controls are not the key to stopping the spread of the disease—identification and treatment are.

What of the BBC’s fears of an explosion of drug-resistant TB?

Public Health England is clear—“Resistance to one or more first line anti-TB drugs reduced from 10 percent in 2011 to 8 percent in 2012.”

And, the proportion of patients who have a form of TB that is resistant to many of the normal antibiotics, “stayed constant at 1.8 percent,” said its report. 


Tory cuts and rhetoric are the real threat to disease control

There is no explosion of TB, drug-resistant or otherwise, but the Tories are making the spread of the disease more likely because it thrives on poverty and poor healthcare.

Malnourished people who work long hours and live in poor housing which they share with many others, are particularly vulnerable. It is no accident that prisons carry a very high incidence of TB.

Dormant or “sub-clinical” infections can become active as the body’s natural defences grow weaker.

When these conditions combine with Tory anti-migrant rhetoric that makes people afraid to seek medical care when they notice symptoms, the result can be undetected disease. Symptoms can include a cough that lingers, night sweats and sudden weight loss.

The way poor people are packed into tiny flats and houses means the disease gets a chance to spread, creating what public health scientists call “clusters”.

In four London boroughs more than a third of all cases were part of a cluster, with children under five years old being particularly vulnerable.

That’s why the Tories’ proposals to deny some migrants access to the NHS puts everyone at risk.

It also makes it more likely that someone being treated for TB will not complete their course of antibiotics—and that is a key way drug-resistant strains develop.

Research shows the people most likely not to finish their treatment are those vilified by the right as the cause of the crisis in the NHS—primarily people with drug and alcohol problems.

Public healthcare systems can only protect us all from disease by treating the whole population. That’s why Tory attempts to stigmatise some are a threat to us all.


Bolstering a racist myth 

The BBC compared TB rates in the London boroughs of Newham and Ealing with Nigeria and Ghana. 

They know many viewers will expect the disease to be especially bad in those countries—and that both boroughs have large migrant populations.

But with 108 and 72 cases per 100,000 respectively, the two countries are in the middle of the World Health Organisation table. They are much freer of TB than South Africa with 1,003 cases per 100,000 and Sierra Leone with 674.

The point of the comparison was not to show the scale of the problem. It was to help bolster a racist myth.


Funding public health is key 

Antibiotic resistant infections are a growing problem and multi-drug resistant TB is rising steadily worldwide, if not yet in Britain.

The results are deadly and that’s why there is no room for complacency.

The number of NHS outreach teams that seek out potential carriers to offer them care and treatment should be increased. Hospitals should be funded to make more isolation units available. 

There also needs to be a massive public health campaign that explains what symptoms to look for, what to do if you find them—and why TB is not just a “migrant’s disease”.


More tests the way forward

A massive testing programme for TB could help identify those people with active infections in areas where clusters of the disease occur. 

Some health bosses say the new IGRA blood test is too expensive to undertake a programme of testing. 

Yet compared to a long stay in hospital, the cost is tiny


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Background Check
Tue 28 Jan 2014, 18:48 GMT
Issue No. 2388
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