TB notification rates (including extra-pulmonary disease) in children in England and Wales fell during the 1980s. After a transient peak in 1993 they have shown little fluctuation and stood at 4.6 per 100,000 population (448 notifications) in 2001 in 0-14 year olds. Rates in London showed a similar trend until 1994 for all children's age groups. Since then, the rates have risen sharply peaking in 1998 with 13.8 notifications per 100,000 0-14 year olds. In 2001 the London rate was 11.0 per 100,000 (150 notifications), more than double the national rate.