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Summer tuberculosis
  1. M C KELSEY,
  2. C A MITCHELL
  1. Department of Microbiology
  2. Whittington Hospital
  3. Highgate Hill
  4. London N19 5NF, UK
  5. Department of Primary Care & Population Science
  6. Royal Free & University College Medical School
  7. Archway Campus
  8. Highgate Hill
  9. London N19 5NF, UK
  10. Division of Microbiology
  11. Infectious Diseases & PHLS
  12. University Hospital
  13. Queen Mary’s Centre
  14. Nottingham NG7 2UH, UK
    1. M GRIFFIN
    1. Department of Microbiology
    2. Whittington Hospital
    3. Highgate Hill
    4. London N19 5NF, UK
    5. Department of Primary Care & Population Science
    6. Royal Free & University College Medical School
    7. Archway Campus
    8. Highgate Hill
    9. London N19 5NF, UK
    10. Division of Microbiology
    11. Infectious Diseases & PHLS
    12. University Hospital
    13. Queen Mary’s Centre
    14. Nottingham NG7 2UH, UK
      1. A M EMMERSON
      1. Department of Microbiology
      2. Whittington Hospital
      3. Highgate Hill
      4. London N19 5NF, UK
      5. Department of Primary Care & Population Science
      6. Royal Free & University College Medical School
      7. Archway Campus
      8. Highgate Hill
      9. London N19 5NF, UK
      10. Division of Microbiology
      11. Infectious Diseases & PHLS
      12. University Hospital
      13. Queen Mary’s Centre
      14. Nottingham NG7 2UH, UK

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        We wish to confirm previous reports of the seasonality of tuberculosis.1 2 The Second National Prevalence Study (SNPS) documented the prevalence of hospital and community acquired infections in 37 111 hospitalised patients in 157 centres in the UK and Ireland between 1993 and 1994.3 Hospital acquired lower respiratory tract infections were reported in 2.4% of the population (882 cases). Community acquired lower respiratory tract infections were reported in 6.1% of patients (2282 cases), of which 55 cases were tuberculosis. The prevalence rate of community acquired tuberculosis in the winter quarters (January to March, October to December) was 1.0/1000 patients and doubled in the summer months (April to June, July to September) to 1.9/1000 patients (OR 1.72, 95% CI for OR 1.0 to 2.97, p⩽0.05). The mechanism for such an increase in prevalence is unclear, although it is hypothesised that the seasonal fluctuation in vitamin D serum levels may contribute to impaired host defence mechanisms to Mycobacterium tuberculosis.1 4 We are unaware of any publication relating to the date of onset of symptoms as opposed to the date of diagnosis or notification. Are people more tolerant of coughs in the winter?

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