Alcoholics may hold key to eradicating TB in Scotland

Figures show that up to 10 per cent of the TB cases each year are among patients who abuse alcohol.

As efforts continue to try to wipe out the disease, health protection experts will meet at the start of next year to discuss how they can help this high-risk group by identifying illness earlier and making sure they receive effective treatment.

The recently published annual report of Scotland’s TB Action Plan revealed that 408 cases of the disease were identified in 2012 – a drop of 9 per cent from the previous year.

However, the report concluded that TB still posed a “considerable threat” to the population of Scotland and continued action was needed to ensure early detection of cases, effective treatment and prevent transmission.

Dr Syed Ahmed, from Health Protection Scotland (HPS), said more than half of TB cases identified in Scotland were among people born outside the UK, in countries where the infection is more common.

Of those born here, he added, many would be older people exposed to TB at a time when it was more widespread in the UK.

“It is only when that infection develops into disease that you have symptoms such as coughing and breathlessness,” he said.

“So if you test people for infection, you will find that a significant proportion of people in their 50s and 60s will have evidence of previous infection but are living fairly healthy lives without it causing any problem.”

Dr Ahmed, a consultant in health protection, said while people’s immune systems often kept the infection under control, alcohol misuse might cause it to develop into disease in later life.

He said this was a key risk factor in new cases of the disease emerging.

“What happens is, if in their 50s, 60s or earlier, they consume an excessive amount of alcohol, combined with the fact they may also be homeless and not have a very good diet, this can cause the reactivation of their old TB infection and they will develop the disease,” he said.

The HPS meeting, to take place in January, will look at how people with alcohol problems can be diagnosed if they have TB at an earlier stage, with greater awareness of the potential problem among doctors.

Dr Evelyn Gillan, chief executive of Alcohol Focus Scotland, said: “Most people recognise the links between heavy drinking and liver cirrhosis, but there is much lower awareness of the increased risk of infectious diseases facing those who drink harmfully.

“It is concerning that Glasgow has both the highest number of TB cases and the highest rate of alcohol-related deaths in Scotland. “This action plan makes a number of welcome recommendations to reduce TB cases in Scotland.”