Tuberculosis--a missed opportunity?

The recent publicity surrounding tuberculosis (TB) in both the medical and the lay press, particularly in reference to a number of outbreaks of the disease in British schools, is a timely reminder of a 'forgotten' disease that has never really gone away. Following a marked decrease in notification rates in developed counties in the 1960s and 1970s, TB control and treatment programmes were downgraded in the West, and soon both medical professionals and the lay public ceased to be able to identify early symptoms of the infection. Meanwhile, poorer countries continued to struggle to provide even basic medical resources, and death and sickness from TB continued unchecked. More recently, however, there has been a rise in the number of new cases of TB in industrialised nations, together with the emergence of multi-drug-resistant strains of the bacillus. This article reviews these and other aspects of the effectiveness of both UK and international TB control programmes.