TUBERCULOSIS IN LONDON - A REVIEW, AND AN ACCOUNT OF THE WORK OF THE LONDON CONSULTANTS IN COMMUNICABLE DISEASE-CONTROL GROUP WORKING PARTY

Tuberculosis (TB) has been recorded in London for centuries but report s have declined over the last 100 years, with a 10-fold decrease betwe en 1948 and 1987. However, from 1987-1993 notifications of TB in Londo n rose by 34%, compared with 15% nationally. This rise, together with concerns about undernotification and the emergence of multi-drug resis tance in New York, led to establishment of a London Consultants in Com municable Disease Control Working Party on TB to review current survei llance data. Notifications to the Office of Population Censuses and Su rveys from the London Boroughs declined by approximately 6.5% per year from 1982-1987. If this had continued until 1993 there would have bee n 3579 fewer notifications than actually received. The proportion of c ases in the 15-44 age group rose markedly in males. The proportion of notifications in those aged 65 and above was higher in the Thames Regi ons outside London, where the total TB notifications declined by 3.5% over the same period. Recommendations were made to improve TB surveill ance in London; and a city-wide surveillance function was established in 1994 to collate and monitor data on TB.