TB Is Rare in Wales, but We Still See 200 Cases a Year; While Much Research and Expertise Is Focused on Major Conditions Such as Cancer, Heart Disease and Stroke, Have Infectious Diseases Been Left Behind? Lorna Bennett, of Public Health Wales, Looks at How Much of a Threat Tuberculosis and Hepatitis Pose to Today's Population

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TUBERCULOSIS - or TB - kills more people across the world than any other infectious disease. A particular problem in resource poor countries, TB is thought to cause around two million deaths globally every year.

The World Health Organisation reports that about one-third of the world's population is infected with tuberculosis (TB) bacteria. Only a small proportion of those infected will become sick with TB. About 80% of the reported TB cases in 2010 occurred in only 22 countries.

In Wales, TB is fortunately less of a problem. As living conditions and diet have improved over the last 100 years, TB, which is often associated with poor and overcrowded housing, has declined.

However, TB has never completely disappeared in Wales and Public Health Wales is still notified of around 200 new cases each year.

Often, these cases will be in people who have links to countries where TB is a larger problem.

There has been some publicity and panic around the recent emergence of new strains of TB, which are resistant to antibiotics and cannot be treated.

Cases of such infection remain very rare in the UK and only account for around 1% of newly diagnosed cases.

Dr Lika Nehaul, consultant in communicable disease control for Public Health Wales, said: "There are a lot of misconceptions about TB that mean people in Wales can become very frightened of it.

"People think it is now an extremely rare disease that is very contagious and only ever occurs in Wales if someone from abroad has brought it with them. They also often think that TB can no longer be treated and will prove fatal.

"In fact, we still see around 200 cases of TB in people resident in Wales each year, but it remains difficult to catch and easy to treat.

"In the vast majority of cases, a course of antibiotics taken for six months is enough for patients to make a full recovery.

"If someone has TB, we will want to investigate the people they live with or work closely with, as it is usually caught from people living in the same household, or a close social contact."

TB usually affects the lungs and causes a cough, fever, weight loss and sometimes blood-stained phlegm.

The effective control of tuberculosis depends on early detection of cases (especially infectious TB of the lung) and prompt treatment.

The TB vaccine (BCG) does not prevent infection, and therefore does not help in controlling the spread of TB. Its use is now recommended in the UK for people, especially young children, who are most at risk of exposure to TB in other people, particularly within their family.

All cases of TB diagnosed in Wales are notified to Public Health Wales, who work with clinical TB teams to ensure that anyone who has come into close contact with patients is traced, investigated and treated.

Although anyone can catch TB, it is more common in people who live in poor housing, are dependent on drugs and alcohol, have a chronic health condition or have a poor immune system due to treatment for an illness such as cancer or HIV.

The number of people with hepatitis B or C infection can be considered relatively low in Wales compared to other parts of the world. …