Tuberculosis in Europe Still a Problem

According to a joint press release from the European Centre for Disease Control (ECDC) and the World Health Organization (WHO)/Europe, between 2010 and 2014, the number of tuberculosis (TB) cases in Europe decreased by 4.3%, meeting one of the Millennium Development Goal targets of reducing the prevalence of TB in the continent by 2015. Since approximately 340,000 Europeans had infections in 2014, in order to meet its ultimate goal of eliminating the prevalence of TB altogether, Europe still has to overcome many obstacles.

There are many factors that go into eliminating a disease from a country or continent, the most important of which is ensuring the availability of treatment. When treatment is not readily available, such as in high-risk populations (homeless, substance and alcohol abusers, as well as migrants from countries with high prevalence of TB disease), a high rate of multidrug-resistant (MDR) TB can be seen.

The WHO regional director for Europe, Zsuzsanna Jakab, PhD, estimates that, in 2014, one quarter of the 480,000 MDR-TB patients around the world were in Europe. She states, “The most vulnerable groups, including poor and marginalized populations and migrants and refugees, are at greater risk of MDR-TB. Because of their living conditions, TB is often diagnosed late, and it is harder for them to complete a treatment course. If we really want to eliminate TB from Europe, no one must be left behind.”

Andrea Ammon, MD, MPH, acting director for the ECDC, also notes that social conditions come into play in diagnosing TB. For some, symptom recognition is challenging, as is access to health care. Dr. Ammon feels that if TB in these vulnerable groups is not addressed, the elimination of TB will take longer than planned. “This is why ECDC is issuing scientific advice today to support countries in reaching poor and marginalized populations that are particularly vulnerable to TB,” she stated.

However, no association has been found between immigrant entrance into Europe and the number of European civilians presenting with TB. In addition, since TB is not easily spread, the ECDC and WHO approximate a low percentage of transmission from the migrant population to European civilians.

The ECDC and WHO recommend that migrants, refugees, and residents be provided with universal health care, while WHO advises that all populations at an increased risk for TB be screened for the disease. Furthermore, refugees and migrant entrance into the EU should not be denied on the basis of a TB test.

The CDC advises that individuals believed to be exposed to TB should contact their health care provider or local health department and notify them of when they were exposed (if it is known).