A leading TB consultant has warned an "inexorable rise" in tuberculosis will continue unless more specialist nurses are put in place.
London is now a TB "hotspot" with nearly half of all UK cases occurring in the capital - around 3,000 each year - double the total of 15 years ago.
TB cases have jumped by nearly 20% in England and Wales over the last two years, but London in particular is under threat from the bacterial disease, which is more commonly found in developing countries.
Immigration, overcrowding and the spread of HIV infection have all contributed to the resurgence of TB in the UK.
TB is a contagious airborne bacterial disease of the respiratory system which causes severe lung symptoms, but can often be present without causing any symptoms until the patient becomes run down or the immune system is damaged.
The disease can usually be treated by a six-month course of drugs, but in many developing nations it can prove to be fatal due to a lack of medical care, a failure to complete treatment, and a combination of other diseases.
An audit of high incidence TB areas in 43 districts across England and Wales carried out last year by the British Thoracic Society (BTS) found that nearly 90% of them had insufficient staff to cope with such a high prevalence rate.
Dr Vas Novelli, head consultant on infectious diseases at Great Ormond Street hospital, London, which is running a new monthly TB clinic in response to the steep rise in cases, called on the government to pump more cash into improving TB services.
Two of the main problems, he said, are that certain strains of TB are becoming resistant to many drugs, and that the number of specialists falls far short of current recommendations.
"Whilst screening for TB in high-risk groups has always been a priority, TB is not always picked up immediately, and we are now facing multi-drug resistant strains of TB in the capital".
Dr Novelli said: "The current numbers of TB clinical nurse specialists also fall dramatically short of (BTS) Joint Tuberculosis Committee recommendations that there should be one nurse for every 40 TB patients.
"Unless the numbers of TB nurses are increased we will continue to see an inexorable rise in TB cases in London."
Areas worst-hit by TB such as Newham and Tower Hamlets should be a top priority for recruiting more specialist nurses in order to better screen and keep track of TB patients and ensure they are taking their medication, he said.
A Department of Health spokeswoman said it was "well aware" that a small number of areas of the country were seeing TB cases rising.
"Primary care trusts are responsible for delivering TB services appropriate for their population and a huge amount of action is already under way across the country", she said.
The spokeswoman added: "The chief medical officer identified the need for more intense action and that is why we have been preparing a TB action plan for England, which will be published in the autumn."
Main findings:
· The BTS reported a rise in TB cases in England and Wales from 5,798 in 1992 to 6,891 in 2002. No other EU country has suffered an increase in TB over the past 10 years.
· London accounted for 43% of all cases reported - West Midlands (15.6%), East Midlands (12.2%), and Yorkshire and Humberside (10.6%), according to figures from the Health Development Agency.
