PORTUGAL has the highest incidence of tuberculosis (TB) cases within the European Union, a British Council-sponsored seminar heard recently. This is because the country has one of the highest rates of intravenous drug addicts infected with HIV and the resulting immune suppression can make patients prone to TB.
Government health and social agencies in Portugal were criticised for not working together in an organised and effective way as they do in countries like Germany and the UK. The leading question debated on World Tuberculosis Day, by a panel of distinguished international and Portuguese experts in the infectious diseases field, was why Portugal continues to be the leader in TB cases in Western Europe, when the disease is essentially preventable and curable.
Emília Valadas, from Lisbon University’s Faculty of Medicine, pointed out that, despite the fact that TB cases in Portugal were diminishing, the country still had 3.5 per cent more cases than other EU countries. According to numbers supplied by the General Health Authority (Direçcão Geral de Saúde), there were 3,000 cases registered in Portugal in 2004, with 271 cases of the disease reappearing in patients thought to be cured.
Statistically, Lisbon, Porto and Setúbal register 40 cases in every 100,000 people per year, with drug addicts (20 per cent) and those infected by the HIV virus continuing to make up the majority of the group. Immigrants, particularly those from the African continent and those living without medical assistance, make up a further 12 per cent, while prisoners and staff working in prisons count for 1.8 per cent. Men aged between 25 and 44 are statistically more at risk, while elderly people who were actively infected in the past also have a high chance of redeveloping the disease, as their immune system becomes less efficient. It is also believed that Portugal’s high tobacco consumption contributes to a general rise in respiratory diseases, as smoking debilitates the body’s immune system in its fight against disease.
Dr. Thomas Hanscheid, also from the Faculty of Medicine, said one of the problems with tackling TB is that diagnosis takes up to six to eight weeks to make because of the length of time it takes to culture and isolate the bacillus. “The other problem is that many people are already infected with TB and do not know they are carrying the disease because their immune system keeps it at bay,” he added. “If the immune system starts to fail, the disease activates or reactivates and the patient starts to develop TB.”
Tuberculosis is a bacterial infection transmitted via sneezing, spitting or coughing, which continues to kill two million people a year worldwide. It can attack any organ of the body, although the lungs are most often affected and treatment of the illness is carried out with antibiotics, like rifamicine administered in tablet and syrup form.
Emília Valadas outlined how the bacterium was first isolated more than 100 years ago by German microbiologist Robert Koch. She said that one-third of the world’s population is infected (actively or as carriers) with some form of the bacteria, with eight million new cases registered globally per year. Of this total, 2.3 million infected with the active disease die, with 95 per cent of cases occurring in the developing world.
Rosemary Hilhorst OBE, director of the British Council in Portugal, said that many people still believe TB is a menace from the past and, apart from the BCG vaccine administered at school, don’t know much about it. “If we are not careful, these infectious diseases could come back and become a problem for the future,” she stressed. “You don’t solve a disease like this once and for all. We must be vigilant and act on what we can do now.” C.G.
