Can EU Stop TB? ECDC Sets Out Plan Of Action As Report Shows Nearly 90,000 Cases Annually In Union

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Respiratory / Asthma
Article Date: 25 Mar 2008 - 1:00 PDT

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Tuberculosis (TB) has been a treatable disease since the 1950s. Why then are tens of thousands of people getting TB each year in the EU? In the run up to World TB Day (24 March), the EU funded EuroTB network has released data showing that nearly 90,000 TB cases were reported in the EU in 2006. The Stockholm based European Centre for Disease Prevention and Control (ECDC) has published an action plan to better control - and ultimately eliminate - TB in the EU. Produced at the request of the EU Commissioner for Health, the one of the plan's central aims is ensuring rapid detection and effective treatment of TB cases. This is seen as key to stopping TB and preventing the further emergence of Multidrug-Resistant TB (MDR-TB), or even Extensively Drug Resistant TB (XDR-TB). These hard to treat forms of TB are becoming more common in the EU, with most of the 27 EU countries reporting cases of MDR-TB. While national governments will be the main players in improving TB prevention and control, the plan foresees an important role for the EU as a catalyst for action. The ECDC plan has been communicated to the European Commission and Member States, who will now examine how to take it forward.

The Director of the European Centre for Disease Prevention and Control, Zsuzsanna Jakab, said: "TB has declined slightly in the EU in recent years, but we are a long way from stopping this disease. We have a window of opportunity in the next few years to really drive down TB rates. It will be easier to do this now, while multi-drug resistant TB (MDR-TB) is still rare in most EU countries, rather than to let the situation deteriorate."

"Most TB infection takes place in local communities, among people who are in close and sustained contact with each other. But, as with other infectious diseases, international spread of TB is also a problem. People can become infected while visiting other countries, and of course people moving from one country to another can take TB with them."

87,806 cases of TB were reported in the EU-27 countries in 2006, down slightly from the 91,578 cases reported in 2005. Nonetheless, the rate of TB cases being reported in the EU amounts to nearly 18 cases per 100,000 population. While this is low by international standards, the EU is still a long way short of eliminating TB, which is defined as having fewer than 1 case per million population. Progress in reducing the rate of TB cases has been slow. The rate has declined by some 4% since 2002.

Targeting further control and elimination of TB

ECDC's Framework Action Plan to Fight TB in the EU provides a roadmap to control, and ultimately eliminate, TB in the EU. Though most of the activities set out in the plan rely on national efforts, a catalyst role for EU organisations and other partners is proposed. This will include a mapping of national TB prevention and control efforts in order to identify synergies, good practices and potential gaps. The plan identifies four key areas for action: Ensuring prompt and quality TB care for all; Strengthening health systems; Development and assessment of new tools; Building partnerships and international collaboration. ECDC developed its action plan following a request from the European Commissioner for Health in March 2007 (see: European Commission press release IP/07/350 of 20 March 2007).

New initiatives resulting from the TB action plan will build on the work already being done at EU level on TB prevention and control. The EU has been supporting the gathering of Europe-wide data on TB cases and networking TB experts across the continent since 1996. It also supports countries by, for example, facilitating the tracing of people and other such actions when cross-border outbreaks occur that require multi-country investigation.

TB in the EU - a mixed picture

The TB epidemic still differs significantly across the EU, though with some signs of convergence. The highest TB rates still tend to be found in the Baltic and Eastern European countries of the EU. However, the TB rate is falling in most of these countries. In the EU15, the TB rates are generally low, but not always declining. In these countries, TB infection tends to be concentrated among vulnerable populations: immigrants from countries with a high TB burden, travelling communities, the urban poor, prisoners and immune suppressed people (e.g. people living with HIV). Across the EU, given the tools available, TB is not always detected quickly or treated effectively, and this can lead to a higher frequency of complicated forms of the disease such as MDR-TB. Cases of MDR-TB have been reported in most of the EU-27 countries.

A TB special edition of ECDC's scientific journal Eurosurveillance is published. This contains articles on the latest European TB data and on the TB situation in the EU. For further information see http://www.eurosurveillance.org

European Centre for Disease Prevention and Control