14 IN FOCUS
Tuberculosis in the age of Covid-19
Tuberculosis is associated mainly with the 19th century . But it is still present and there is a danger that it will be overlooked in the current pandemic . Radhika Holmström reports
As the world looked for the fi rst Covid-19
vaccination , researchers turned their attention to an already widely available and cost-effective inoculation : the Bacillus Calmette-Guérin ( BCG ) vaccine , used to prevent tuberculosis ( TB ). Studies had shown that the benefi cial nonspecifi c effects on the immune system of the BCG jab could protect against other viral infections such as coronavirus . As we now know the Pfi zer / BioNTech Covid-19 vaccine beat everyone else to it when the UK ’ s Medicines and Healthcare products Regulatory Agency approved its use in December last year . But the BCG vaccination is still being researched as a way to prevent Covid . And it is not surprising that scientists would look to an inoculation for TB . Both are diseases that primarily attack the lungs , and both have similar symptoms . Although TB has a longer incubation period , both diseases can cause cough , fever and diffi culty breathing .
The incidence of TB is relatively low in the UK and peaked at 8,919 cases in 2011 , according to Public Health England ( PHE ) fi gures . There was a 38 % drop in new diagnoses from 2011 to 2017 ( from 8,280 to 5,102 ), PHE data also show . However , the disease has not been eliminated and the World Health Organization ( WHO ) has called for a continuation of essential TB services during the pandemic . It has suggested that ‘ major disruption in TB case detection could result in an additional 400,000 lives lost ’ worldwide . While the fi ght against TB might help against Covid – with the BCG vaccine – Covid might be impeding the fi ght against TB as the world ’ s focus shifts to the virus .
The Covid effect PHE data between January and March this year reveal the number of notifi ed TB cases in England remained relatively consistent compared with 2019 ; however , there is a difference after that . Typically , the number of TB notifi cations increases from March to a peak during the summer months of June and July , before declining in the autumn and winter months . Although an increase in TB notifi cations was observed between May and July 2020 , these numbers were substantially lower than in 2019 . In August 2020 , there was a 26.1 % reduction in TB notifi cations compared with August 2019 – 283 versus 383 . In the third quarter of 2020 , 1,007 TB cases were notifi ed in England – but this was a 15.5 % nursinginpractice . com Winter 2021