Resurgence of paediatric tuberculosis in London.

There is estimated to be over a million new cases of paediatric tuberculosis (TB) globally every year. Children usually acquire TB infection from smear positive adult family contacts, a high proportion going on to develop disease. Childhood disease reflects recent infection, and therefore paediatric TB represents continuing transmission in the population. In England and Wales, TB notifications declined from 7406 cases in 1982 to 5085 in 1987, rising to 6087 cases in 1998. In London notifications increased from 1445 in 1987 to 2444 in 1998, representing 16% and 40% of the national total respectively in those years. We had noted an increase in referrals of paediatric TB at St George’s Hospital. The aim of this study was to identify and describe any evidence for an increasing incidence of paediatric TB in London.