Sussex Travel Clinic

Hove Clinic

01273 749100

Worthing Clinic

01903 254774

 

What  is Tuberculosis ?

Tuberculosis (TB)  is a bacteria that can invade any part of the body but most commonly the lungs are affected.

There are 2 types of TB infection

1- Active TB – this can take months or years to develop.

2- Latent TB-  has no symptoms and is not infectious to others .

However  10- 15 % of people with latent TB can go on to  develop active TB in their lifetime.

Incidence of TB

Africa has the highest TB infection rate with more than 300 people per 100:000. The UK has a very low number of TB cases 13:100:000 (1)

How is TB spread?

TB is  caught by inhaling the droplets that are spread by coughing sneezing and spitting. The risk of infection is highest in situations of close prolonged contact with infected persons.

Symptoms of TB

The symptoms of TB include any of the following :

  • Productive cough
  • Weight loss
  • Night sweats
  • Loss of appetite
  • High temperature

Treatment of TB

Although TB is a very serious condition it can be treated successfully with antibiotics.

Prevention of TB

There is a vaccine available to prevent TB called BCG but it is only effective in the under 16 – 35 year age group.There are no studies that prove effectiveness beyond age 35 years of age.

The UK BCG vaccination programme was discontinued in 2005 as a result of the continuing decline of TB infection in the UK indigenous  population. The UK programme is now focused on  targeting those babies and children most at risk of exposure to Tb( 4 )

Travellers- Do I need a BCG vaccine for travel?

Most travellers are considered to be at low risk of catching TB.

Risk of exposure increases in those travellers living  and working in close contact with the local populations in high risk TB countries for prolonged periods of time ( > 3 months) and those working with TB  infected persons. Travellers that have other health conditions that affect their immune system they could be more at risk of catching TB.

 Which travellers should have the BCG vaccine?

  • Travellers age 16 years or under who are going to living in countries with a high incidence of TB ( 40 per 100.000 cases) for 3 months or more.
  • Healthcare  workers aged up to 35 years of age who are likely to come into contact with infected cases in high incidence countries (5)

TB Frequently Asked Questions

1. My child missed their BCG vaccination at school,  why has it been stopped?

Rates of TB in the UK population have fallen to very low levels over the past 15 years. The BCG vaccination programme was changed to reflect this and is now only given to people in at-risk groups.

(http://www.nhs.uk/Conditions/vaccinations/Pages/bcg-tb-vaccine-questions-answers.aspx#teenagers)

2. I am travelling abroad and want the bcg vaccine but have been told I don’t meet the criteria?

The vaccine is recommended for those under 16 years who are going to live or work with local people for more than three months in a country where the annual incidence of TB is 40/100,000 or greater.

(https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/148511/Green-Book-Chapter-32-dh_128356.pdf)

3Can you catch TB on an aeroplane?

TB is a difficult disease to catch because it requires prolonged exposure to an infected person. For example, you are very unlikely to catch it by sitting or standing next to someone who is infected. The CDC and WHO have concluded that the risk of TB transmission on an aircraft does not appear to be greater than in other confined spaces.

(https://www.nathnac.org/pro/factsheets/TB.htm)

 4I had BCG vaccine as a child how long does it last? Do I need a booster?

 Protection has been shown to last for 10 to 15 years (WHO, 1999). Although the protection afforded by BCG vaccine may wane with time, there is no evidence that repeat vaccination offers significant additional protection and repeat BCG vaccination is not recommended.

(https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/148511/Green-Book-Chapter-32-dh_128356.pdf)

5. I am under age 35 and planning to work on an orphanage in Kenya for 3 months and am worried I may catch tb but have been told I can’t have the vaccine- Why?

BCG is not usually recommended for people aged over 16 years, unless the risk of exposure is great e.g. healthcare or laboratory workers at occupational risk. There is insufficient data on the protection afforded by BCG vaccine when it is given to adults – aged 16 years or over and virtually no data for persons aged 35 years or over.

 http://www.nhs.uk/Conditions/Tuberculosis/Pages/Symptoms.aspx

 6. I had BCG vaccine ages ago can I have a test to prove I am still immune?

There is no test to demonstrate immunity to Tuberculosis . Evidence of a previous BCG vaccination includes: documentary evidence; a clear, reliable history of vaccination; or evidence of a characteristic scar.

7. What happens if I do catch TB after travelling to a risk country?

You would be referred to a specialist for treatment. Treatment for tuberculosis (TB) depends on which type you have, although a long course of antibiotics is most often used.

8. How will I know if I have caught TB ? What are the symptoms ?

The symptoms of tuberculosis (TB) depend on where the infection occurs. TB usually develops slowly. Symptoms may include: persistent cough /breathlessness/lack of appetite and weight loss/ a high temperature / night sweats/extreme tiredness or fatigue. If you experience symptoms you should see your GP as soon as possible.

To book an appointment for a BCG vaccine please call 01273 749100 or 01903 254774 or book online

References

  1. Travax – http://www.travax.nhs.uk/diseases/vaccine-preventable/tuberculosis.aspx
  2. NHS Choices- http://www.nhs.uk/conditions/Tuberculosis/Pages/Introduction.aspx
  3. NathNac- http://www.nathnac.org/travel/factsheets/tuberculosis.htm
  4. Department of Health Green Book – tuberculosis chapter page 393 – https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/148511/Green-Book-Chapter-32-dh_128356.pdf
  5. Department of Health Green Book – tuberculosis chapter page  398 – https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/148511/Green-Book-Chapter-32-dh_128356.pdf

Written by Helen Thorpe RGN

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