TY - JOUR T1 - Trends in tuberculosis in the UK JF - Thorax JO - Thorax DO - 10.1136/thoraxjnl-2018-211537 SP - thoraxjnl-2018-211537 AU - Philippe Glaziou AU - Katherine Floyd AU - Mario Raviglione Y1 - 2018/04/19 UR - http://thorax.bmj.com/content/early/2018/04/19/thoraxjnl-2018-211537.abstract N2 - The industrial revolution, starting in the 18th-century England and coupled with poverty, urbanisation and squalor, created an optimal environment for the propagation of TB.1 One in four deaths were due to TB by the early 19th century.2 Since then, the remarkable decline in the burden of TB at an average annual rate of 3.3% between 1913 and 1940, documented in one of the longest ever recorded time series of data on the burden of TB (figure 1), a notifiable disease in the UK since 1912, was only interrupted by the two world wars. During those years, the temporary peaks in both incidence and mortality were linked to impoverishment of the population and poorer nutrition. In the years following the Second World War, as in other Western European countries, the fall in TB burden significantly accelerated to an average annual decline of 10% between 1955 and 1960 following the advent of modern chemotherapy. This allowed a reduction in transmission and drastically improved the prognosis of the disease, with a case fatality ratio (approximated as the ratio of mortality over incidence) of about 50% in the prechemotherapy era dropping to less than 10% within a decade of the introduction of chemotherapy. A decline in the effective contact rate3 and low TB rates have also been achieved in other settings that have in common a combination of near-universal access to … ER -