TB in the UK being spread by Indians? Indian doctors take exception to Lancet's charge on latent TB

By Syed Akbar
Hyderabad, April 22: City health experts take strong exception to the medical charge that Indians harbouring tuberculosis germ in its latent form are responsible for the spread of TB in the United Kingdom. The UK is regarded as the TB capital of the world and a team of researchers based there now blames it on Indians.
This is the third serious medical allegation against India by the Lancet, a UK-based peer reviewed medical journal, in the last eight months. Two earlier studies by Lancet have stirred up the medical and health authorities in the country forcing the Indian Council of Medical Research to take up a comprehensive research on the superbug, wrongly named New Delhi Metallo beta lactamase. The present study is on tuberculosis being allegedly spread by Indians visiting the United Kingdom.
"The Lancet team in a way wants all Indians visiting the UK to be screened for latent tuberculosis. Though there are tests to identify latent TB, the results are not always accurate. If the team prevails on the UK health authorities, then Indians visiting the UK may be asked to undergo special screening for latent TB, or asked to produce health certificates that they are free from TB," said senior microbial scientist Dr Niyaz Ahmed.
Tuberculosis is of two types, active and latent. In active TB, the disease is manifest and the infected person is capable of spreading it to others. A person carrying latent TB does not show the TB symptoms or infect others. About 15 per cent of people carrying latent TB bacteria, Mycobacterium tuberculosis, develop active TB some time in their life.
"The charge is baseless and deliberate attempt to defame India. The Lancet studies have not conclusively proved that India or Indians are responsible, either in the superbug theory or now on latent tuberculosis," observes Dr senior biologist Dr Duggaraju Srinivas Rao.
The Lancet study has targeted people carrying the latent TB bacteria, particularly those from Indian sub-continent, holding them responsible for the spread of the disease in the UK. "Continuing rises in tuberculosis notifications in the UK are attributable to cases in foreign-born immigrants. National guidance for immigrant screening is hampered by a lack of data about the prevalence of, and risk factors for, latent tuberculosis infection in immigrants," Prof Ajit Lalwani and his team pointed out in the latest issue of the 
Lancet.
The Lancet team suggested two "most cost-effective strategies" to screen individuals from countries with a tuberculosis incidence of more than 250 cases per 1,00,000, and more than 150 cases per 1,00,000. India falls under the category of more than 150 TB cases per 1 lakh people.
"It can be true in theory. But it needs to be closely analysed to generalise and say that Indians are the main reason for the spread of TB in the UK," argues Dr N Lavanya, infectious diseases expert.