FIVE hundred York Hospital patients were getting letters today telling them they could be at risk of having Tuberculosis (TB).

The hospital is contacting 500 patients who have been through one of its wards, after a nurse there was discovered to have the disease.

The health care worker is said to have been suffering from a persistent cough since last September, which was diagnosed as TB last month.

Yesterday, shortly after the case was definitively confirmed, the hospital contacted all the patients and their GPs who had been on ward 16 - where the member of staff worked part-time - between September and March.

The letters were expected to arrive on patients' doormats this morning.

About 80, who were on the ward for more than two weeks and deemed more seriously at risk, are being offered chest x-rays to screen for the disease. Those who have had recent chest x-rays will have them reviewed to check for TB.

The rest, some 420, are being given advice on what symptoms to look out for.

Mike Proctor, the hospital's nursing director, said TB was very difficult to catch as it required contact at close quarters, unlike, for example, the Norwalk virus which spread very easily.

He said: "We are concerned because we know people will be concerned. Some of our older patients will have experienced life in the distant past when TB was a major killer, and they will have concerns. There was a big stigma attached to it."

But he said: "They will probably worry way in excess of the actual risks. The question we asked ourselves was: Could we have done something to prevent this from happening?' "I believe the answer is no. It's just one of those things. All the actions we're doing are trying to allay as many fears as possible."

Dr Alexander Anderson, a consultant microbiologist and infection control lead at York Hospital, who wrote the letters to patients, said: "It's a big deal, but it happens.

"It's unusual for North Yorkshire as we have a low incidence of TB. In similar incidents at other hospitals, they've never found any secondary cases at all."

Staff who have worked on the ward are being treated in the same way as the category of less serious patients and are being given advice on symptoms.

Ward 16 is an adult general surgical ward, which sees a high proportion of elderly patients.

Infection control leaders said all staff were routinely assessed for their immunity to TB when they were employed, and it was not known how the nurse had got the disease.

Hospital staff stressed she only worked part-time, so the chances of infecting patients or staff were very slight.

The hospital has arranged for NHS Direct to give out specific advice about the incident for anyone who phones up with queries. The service will start tomorrow and will be available by phoning 08454647.


Key message is there's no need to panic'

"DON'T panic." That was the message today from a diseases expert from North Yorkshire's Health Protection Unit on today's shock news.

Dr Ebere Okereke, a consultant in communicable diseases control, said: "The key message is that there's no cause for panic.

"This is not an unusual situation, because TB does exist in the community and from time to time health care workers, like anyone else in the community, can get it.

"All the evidence suggests the risk of a health care worker transmitting the disease to a patient is extremely small. TB is difficult to catch and you need to have close and prolonged contact with people."

Dr Okereke said increasing movement of people around the world meant that there had been a rise in cases over recent years.

Although this had been reflected in North Yorkshire, there were still very few cases in the county.

She said: "There has been an increase, but rates have not gone up significantly. It's been 20 cases a year in North Yorkshire. This is a very low prevalence area for TB. There has been a national increase, but we haven't seen the increase that we've seen in other parts of the UK."

As reported in The Press last year, teenagers in this area are no longer offered the BCG jab on request. That is because the Government is now targeting specific at risk groups, saying it is a far more effective way of tackling the disease.

Dr Okereke said: "TB never went away. The number of cases went down. It's an old disease that went underground for a while and came back because we got a bit relaxed about it.

"We understood the disease and it kept declining. In the 1930s, there were 50,000 cases a year in the UK. With the improvement in housing and hygiene, and the introduction of treatment for it, people didn't die from TB any more. We got confident we understood the disease, we knew about it, we were doing it very well. We weren't as aggressively pursuing TB as when it was such a big thing.

"With the change in the world movement, a problem in one country is a problem in another. It follows that, with the movement of people, we are exposed to risks from different parts of the world.

"The strategy is making sure we improve our systems for detecting and treating it. The most efficient thing is finding people who have got TB and treating them."


Cases on the rise in county

CASES of Tuberculosis may be low in North Yorkshire, but they have still been on the rise.

A public health report written by experts from North Yorkshire and York Primary Care Trust (PCT) released this spring revealed that numbers of people in the county coming down with the disease nearly doubled in five years.

In 2001, there were 1.6 cases per 100,000 people - but that figure had risen to 2.6 in 2005.

That equated to 12 cases in 2001, which rose to 21 incidences four years later.

Cases had dropped steadily between 2001 and 2003, but shot up in 2004.

Nationally, cases of Tuberculosis are rising fastest among communities with links to countries with high rates of the disease, such as sub-Saharan Africa and the Indian subcontinent.

Two pupils at Easingwold School have come down with Tuberculosis in recent years.

One was in 2004, with the second just over a year later.