Tuberculosis in asylum seekers

seekers Asylum seekers entering the United Kingdom through Heathrow Airport have a high prevalence of pulmonary tuberculosis and are more likely to contain drug resistant Mycobacterium tuberculosis isolates than the general UK population. The issue of asylum seekers is universally controversial, with recent reports in the UK suggesting an inward flow of 2 million people in the next 10 years—a figure rejected by the government as inaccurate and by campaign groups as scaremongering. All political asylum seekers seen by the Health Control Unit (HCU) at Heathrow Airport between 1995 and 1999 were categorised according to age, sex, smear and culture status, region of origin, and sensitivity of the M tuberculosis isolate. A total of 55 276 asylum seekers were referred to the Heathrow HCU over the study period, of which 41 470 received a chest radiograph. Of the 441 subjects who had radiographs suggestive of pulmonary tuberculosis, 256 were sent to hospital for immediate assessment. The available records (two patients absconded and two records disappeared) revealed active tuberculosis in 100 patients and inactive or previously treated tuberculosis in 86 patients. The highest incidence of active tuberculosis was found in those arriving from Somalia, who had a incidence of 1047 per 100 000 screened. Bearing in mind that those most at risk of subsequent infection—other asylum seekers and those in the new entrant community—are already vulnerable, these findings further emphasise the importance of primary screening in newly arrived political asylum seekers. (Thorax 2002;57:152–6)