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Creutzfeldt-Jakob Disease
Mr. David Shaw: To ask the Secretary of State for Health how many of the (a) possible and (b) proven CJD cases being examined relate to individuals who have had (i) contact and (ii) extensive contact with (1) dogs and (2) other domestic animals. [23529]
Mr. Horam: The national Creutzfeldt-Jakob disease surveillance unit has not so far identified contact with domestic animals as a possible risk factor for CJD.
Dementia
Ms Harman: To ask the Secretary of State for Health what was the incidence of encephalitis, dementia and Alzheimer's disease in (a) under and (b) over 65-year-olds in each of the last 10 years. [23426]
Mr. Bowis: Information on the incidence of dementia and Alzheimer's disease is not available centrally. It is estimated that there are currently around 600,000 sufferers from dementia. Information on the number of notifications of all forms of encephalitis is not available centrally. Information on the number of notifications of acute encephalitis can be found in the annual reference volumes in communicable disease statistics--series MB2--copies of which are available in the Library.
Solid Services Review
Mr. David Atkinson: To ask the Secretary of State for Health what are the terms of reference and objective of his review of social services; when he expects it to be completed; and if he will make a statement. [24135]
Mr. Bowis: The Department is working with local government interests to clarify trends in, and the factors generally influencing, social services costs, expenditure and service level and to improve the presentation of relevant data and their helpfulness to local social services authorities in their assessment of their own performance compared to national trends.
Tuberculosis and Creutzfeldt-Jakob Disease
Mrs. Lait: To ask the Secretary of State for Health what is the incidence per head of population of (a) tuberculosis and (b) Creutzfeldt-Jakob disease. [23772]
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Mr. Horam: The provisional notification rate for tuberculosis--excluding chemoprophylaxis--for England and Wales for 1995 is 10.9 per 100,000 of the population (source, Office for National Statistics).
Data to the end of 1994 on Creutzfeldt-Jakob disease are published in the CJD surveillance unit's fourth annual report, copies of which are available in the Library. Provisional data so far suggest that the incidence in 1995 will be lower than in 1994.
Tuberculosis
Mrs. Lait: To ask the Secretary of State for Health what change there has been in United Kingdom TB cases in the last 20 years. [23771]
Mr. Horam: The number of notifications of tuberculosis in the United Kingdom in 1975 was 12,620 and in 1995 was 6,249--provisional. This is a decrease of 50 per cent.
Mrs. Dunwoody: To ask the Secretary of State for Health how many cases of tuberculosis occurred in the United Kingdom in each year between 1982 and 1993.[24358]
Mr. Horam: The number of notifications of tuberculosis in the United Kingdom is published in table 3.31 of the "Annual Abstract of Statistics". Information for the years 1982 to 1993 is set out in the 1994 and 1995 editions and is shown in the table:
| Year | Number of notifications of tuberculosis in the UK(15) |
|---|---|
| 1982 | 8,453 |
| 1983 | 7,795 |
| 1984 | 7,041 |
| 1985 | 6,647 |
| 1986 | 6,857 |
| 1987 | 5,745 |
| 1988 | 5,778 |
| 1989 | 6,059 |
| 1990 | 5,897 |
| 1991 | 6,078 |
| 1992 | 6,441 |
| 1993 | 6,564 |
| 1994 | (16)6,229 |
| 1995 | (16)6,249 |
(15) Annual Abstract of Statistics. Source: Scottish Health Service Common Services Agency; Department of Health and Social Services (Northern Ireland); and Office of Population Censuses and Surveys.
(16) Provisional.
Mrs. Dunwoody: To ask the Secretary of State for Health when he intends to introduce a system for identifying and screening population groups at high risk from tuberculosis; and if he will make a statement. [24350]
Mr. Horam: Those population groups at highest risk from tuberculosis include close contacts of patients with infectious tuberculosis, immigrants from countries with a high prevalence of tuberculosis and their families, and homeless people who sleep rough or who use open access hostels for the homeless. Screening of contacts of patients with infectious tuberculosis and of new immigrants from countries with a high prevalence of tuberculosis is already part of United Kingdom policy. The interdepartmental working group on tuberculosis has considered how
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prevention and control measures amongst high-risk groups, including the homeless, might be improved and its report on this aspect has recently been presented to Ministers. In addition, the Department of Health, working with the Home Department, is presently reviewing port of arrival arrangements for screening of new arrivals entering the United Kingdom from countries where the incidence of tuberculosis is high.
Mrs. Dunwoody: To ask the Secretary of State for Health when he intends to implement a programme for more rapid and effective testing of infective tuberculosis cases. [24248]
Mr. Horam: The current programme for identification of infectious tuberculosis cases uses the best available reliable and verified tests. Patients with tuberculosis are infectious to others when they have tubercule bacilli in their sputum. There are readily available and rapid laboratory procedures for the identification of such cases--sputum smear positive. Sputum smear negative cases are generally not infectious to others. Effective laboratory tests are available for identifying such cases; however, these take longer than sputum smear positive tests and more rapid tests are currently under development.
Mrs. Dunwoody: To ask the Secretary of State for Health if he will list, for each year since 1985, the number of cases of multi-drug-resistant tuberculosis reported in the United Kingdom, and if they are primary or secondary resistance cases; and if he will make a statement. [24347]
Mr. Horam: Until recently, no system existed for the routine collection of national data of cases of multi-drug-resistant tuberculosis. Information on the general trends of such drug resistance has been maintained through the regular five-yearly surveys of tuberculosis notifications conducted by the public health laboratory service--PHLS. Information from the surveys are shown:
| Year of survey | Number of newly notified cases of multi-drug- resistant tuberculosis (MDRTB) |
|---|---|
| 1983 | 0 cases of MDR TB out of 981 TB patients surveyed |
| 1988 | 1 case of MDR TB out of 840 TB patients surveyed |
| 1993 | 2 cases of MDR TB out of 832 TB patients surveyed |
| Year | Number of case of MDR TB |
|---|---|
| 1985 | 9 |
| 1986 | 12 |
| 1987 | 7 |
| 1988 | 15 |
| 1989 | 11 |
| 1990 | 8 |
| 1991 | 14 |
The review highlighted the need for fuller monitoring of this problem and in 1994 a surveillance scheme--Mycobnet--was established by the PHLS communicable disease surveillance centre to monitor drug resistance in isolates of mycobacterium tuberculosis. Data from the first year of Mycobnet will be published shortly.
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The most important measure in preventing the emergence of drug-resistant tuberculosis, including multi-drug-resistant tuberculosis, is to ensure that patients with tuberculosis are fully and correctly treated. The United Kingdom's excellent record in tuberculosis control has resulted in multi-drug-resistant tuberculosis in the UK remaining at low levels. To help ensure that this remains the case, as well as improving surveillance, an expert working group has been established under the auspices of the interdepartmental working group on tuberculosis to make specific recommendations for the prevention and control of drug-resistant tuberculosis.
Mrs. Dunwoody:
To ask the Secretary of State for Health if he will make a statement on the current control and surveillance measures on tuberculosis in the United Kingdom. [24351]
Mr. Horam:
National guidelines for the prevention and control of tuberculosis in the United Kingdom have regularly been produced by the British Thoracic Society. They were last updated in 1994. The measures recommended in the guidelines have been reviewed by the interdepartmental working group on tuberculosis and its recommendations for best practice were recently presented to Ministers and will be published shortly.
The three main measures for controlling tuberculosis in the United Kingdom continue to be:
Mrs. Dunwoody:
To ask the Secretary of State for Helath what measures he intends to make adequate and appropriate treatment for tuberculosis more widely available; and if he will make a statement. [24349]
Mr. Horam:
There are specialised chest clinics in every area supported by doctors experienced in the treatment of tuberculosis. It is the responsibility of health authorities to ensure that the provision of services is appropriate for the needs of their population.
2 Apr 1996 : Column: 183
National surveillance of tuberculosis through the routine notification system has in recent years been supplemented by more detailed five-yearly surveys of notifications to give a clearer picture of trends in different population groups. Recommendations from the interdepartmental working group on tuberculosis for the future surveillance of tuberculosis are currently the subject of a wide consultation exercise.
reducing the pool of infectious cases by promptly identifying and treating them;
preventing progression to active disease in certain individuals by chemoprophylaxis;
increasing immunity to tuberculosis through bacille- Calmette-Guerin immunisation of schoolchildren and certain high-risk groups.
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