The large number of illegal immigrants in Hackney means tuberculosis rates are even higher than believed, a refugee charity has warned.

The borough already has one of the highest rates of TB in the country. Official figures show that there were 60 cases per 100,000 people in Hackney last year, compared with 15 cases per 100,000 people nationally.

Ibrahim Avcil of the Hackney Refugee Forum referred to the borough’s illegal immigrants as its “invisible people” and claimed that there are thousands of people, many of whom are infected with TB, “who are invisible to the authorities”.

Explaining why Hackney has such a high rate of TB, Mr Avcil said: “The most important thing is that Hackney has a very, very high population of refugees and immigrants.

“Neither the council nor the Primary Care Trust has any policy to help these people with their health concerns,” he said.

Diane Abbott, MP for Hackney North and Stoke Newington, raised the issue in Parliament last week.

“In my lifetime, TB was virtually eradicated,” she told the House of Commons. “In contrast, England now has one of the highest rates of TB in the Western world, and in recent years Hackney has consistently had one of the highest rates in England,” she said.

She added: “Tuberculosis is one of the most serious public health issues facing Hackney,” and that because the disease affects socially excluded groups like immigrants, sex-workers, and the homeless, it is too easy for it to be ignored.

Nathaniel Matthews, a lawyer at the Hackney Community Law Centre, said many of his clients were “living in real slum conditions”, with no water or gas, comparable to those of the nineteenth century. He said that if the rest of the country were similar to Hackney, “then it could be a major national crisis.”

The release of the figures coincides with World TB Day, which took place this week. They show that the number of cases in London rose by two per cent compared with last year. There were 125 new recorded cases in Hackney in 2008.

A medical worker who works with TB patients in the borough has refuted Mr Avcil’s claims: “He’d be surrounded by dead bodies, if it were left untreated for long enough,” she told the Hackney Post.

She also made it clear that the Primary Care Trust is committed to treating those with TB wherever they come from and wherever they are.

“The PCT has recently created a post involving outreach work related specifically to TB. His remit is to get out there, find the squats and treat people. Mostly, these people with TB end up being brought to us through A & E. We’re trying to get to them before that.

“We don’t see it as our role to notify the authorities,” she added.

A spokesman for the Department of Health confirmed this approach as official government policy, saying: “The NHS is not duty bound to inform the police or any other authority if they treat suspected illegal immigrants.

“The risk to the public health of a disease like TB being allowed to spread without treatment outweighs any perceived benefits there might be associated with tracking down or deporting illegal immigrants.”

Case study

Alan, 46, is a former set designer from Hackney Downs. He discovered he had tuberculosis nearly nine months ago after a friend called an ambulance and he was rushed to hospital.

He describes his symptoms as “complete muscle wastage”, “incredible tiredness and coughing up lots of spit”, but has no idea how he contracted the disease.

“It could have been a number of things. No-one that I know had it. But I was an alcoholic and was pretty run down anyway, so that’s probably the reason that I got it. It’s very difficult [to know] because it was such a gradual process.”

He says that his living conditions were poor, with damp in his flat, which experts say is a contributing factor for most cases of TB. “One day a friend phoned for an ambulance because I was so ill. When I was taken to A&E, the doctors weren’t surprised at all. There were quite a few TB patients in there at the same time,” he says.

“The treatment was quite simple. It was just antibiotics that apparently kicked in after two weeks. I’m still taking them until the end of this month - and that will be nine months, and the end of my treatment.

“But the TB service [at Homerton Hospital] didn’t just give me the drugs. They looked at the overall picture. The nurse got in touch with all the right people, including my landlord. They helped me to deal with all of my health issues.”

Names have been changed

TB or not TB?

Tuberculosis is an infectious disease that usually affects the lungs, but can affect any part of the body. It spreads when people with the infection cough, sneeze or talk and propel TB germs into the air - but usually requires prolonged close contact.

About 8,000 new cases are currently reported each year in the UK. Most cases occur in major cities, particularly in London.

One-third of the world’s population is currently infected with TB.

Symptoms include a persistent cough, night sweats or fever, weight loss, tiredness and coughing up blood.

The disease is curable with a combination of specific antibiotics, but treatment must continue for at least six months.

Left untreated, anybody with active TB will infect an average of between 10 and 15 people every year.