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Tuesday, 22 October, 2002, 17:40 GMT 18:40 UK
Call for TB sanatoriums
Boston TB Secure Unit
In the US, some TB patients are detained for treatment
A government advisor is calling for sanatoriums to be brought back to tackle the looming TB crisis.

Some patients should be detained in secure units to protect the public, says the director of the specialist TB unit at the Public Health Laboratory Service (PHLS).

It would apply to the small minority of carriers who refuse treatment and have the more dangerous drug-resistant forms of the disease.

This may be one option for putting patients in a place of safety to minimise risk to others

Public Health Laboratory Service spokesperson
Building isolation units in private grounds is one way to stop sufferers infecting other people, says Professor Francis Drobniewski, a consultant at London's Kings College Hospital.

His suggestions will be aired at a conference to discuss London's growing TB problem on Thursday.

TB now affects as many as 7,000 people in England and Wales every year, almost half of them in the capital.

Setting up "mini-sanatoria" is one way to tackle the spread of TB, according to PHLS spokesperson Simon Gregor.

"For those with highly drug resistant infections not willing to be treated, this may be one option for putting patients in a place of safety to minimise risk to others," he told BBC News Online.

But he said there would have to be legal safeguards to protect patients' rights.

Detention system

TB is a disease of the respiratory system caused by a bacterium.

People with TB can pass it on to others by coughing.

Dr Marie Turner
Dr Marie Turner from the Boston TB Secure Unit: 'We need a place to bring patients'
Before antibiotics were discovered there was no cure and thousands of people spent months or even years in a sanatorium.

They were treated with a mixture of diet, sunshine, and gentle exercise in what has been described as a cross between a hotel and a hospital.

The disease was largely stamped out in the 1960s and 1970s through the use of drugs.

It is now making a comeback, however, partly because some strains have become resistant to antibiotics.

'Last resort'

Similar measures to those being proposed in the UK already exist in the United States.

TB patients in Boston who do not take their medicine are detained at Boston TB Secure Unit.

Doctors there say it is a last resort in treatment, but it is necessary.

Dr Marie Turner from the unit told the BBC: "We need to have a place to bring patients who are unable to take their medicine.

"If we don't have a place, and these patients remained infectious whilst in the community, they're going to infect other patients."

Proper facilities

Professor Martyn Partridge, chairman of the British Thoracic Society (BTS), rejected calls for the re-establishment of sanatoriums.

TB bacteria
TB symptoms include a persistent cough, fatigue, weight loss and fever
He said only people with multi-drug resistant TB required special hospital care with isolation facilities.

"Many of those currently contracting TB are disadvantaged or are recent immigrants to the UK.

"We need to ensure that we have adequate facilities and adequate specialist nurses to track people if they move around the country.

"We then need to ensure that there are sufficient health workers to supervise their therapy and to arrange tracing and examination of their contacts."

Liberal Democrat health spokesman Dr Evan Harris said the government had failed to tackle the growing menace of TB.

He dismissed the idea of compulsory treatment or detention, but said people needed access to improved health services.

"We also need a much more effective prevention and vaccination strategy for those in close contacts with TB sufferers, especially the many sufferers from the Indian sub continent."

The BBC's Matthew Hill
"It's difficult and costly for UK law to be enforced"
Prof. Francis Drobniewski, senior goverment advisor
"We do need to have facilities where people can voluntarily go for treatment"
See also:

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