TranslateTB Guidance
Annual advice on Human Tuberculosis (TB)
Human Tuberculosis (TB) is caused by infection with bacteria of the Mycobacterium Tuberculosis complex and may affect almost any part of the body. The most common form is pulmonary TB, which accounts for almost 55% of cases in the UK. The symptoms of TB are varied and depend on the site of infection. Almost all case of TB in the UK are acquired through the respiratory route, by breathing in infected respiratory droplets from a person with infectious respiratory TB, and often after prolonged close contact such as living in the same household. The initial infection may:
- Be eliminated
- Remain latent – where the individual has no symptoms but the TB bacteria remain in the body, or
- Progress to active TB over the following weeks or months.
General symptoms may include:
- Cough lasting more than 3 weeks
- Coughing up blood
- Chest symptoms including chest pain, shortness of breath
- Unexplained weight loss
- Intermittent or persistent fever or night sweats
You are advised to seek medical advice from your GP and inform Occupational Health if you experience any of the above symptoms.
Individuals at occupational risk
People in the following occupational groups, with direct TB patient contact or contact with infectious materials, should be vaccinated with BCG:
- Healthcare worker (HCW) or laboratory and mortuary workers who have either direct contact with TB patients or with potentially infectious clinical materials or derived solutions.
BCG is recommended for unvaccinated, tuberculin-negative individuals in these occupations. BCG efficacy data in adults over the age of 35 years is scarce, nevertheless because these groups have high exposure risk; it is advised that the benefits outweigh risks for vaccinating individuals over the age of 35 with BCG. In addition, there are a number of occupational groups who are working with persons at higher risk of acquiring TB, including those staff working with prisoners, homeless persons, persons with drug and alcohol misuse and those who work with refugees and asylum seekers. BCG vaccination may also be considered for these groups.
It should be noted that the risk of exposure of HCW’s other than those listed in the category above is unlikely to exceed the background risk of TB to the general population and therefore vaccination is not routinely required.
Routine Health Surveillance
For those individuals who are identified through local workplace risk assessment as being of occupational risk exposure to TB there is a need to conduct routine health surveillance in order to determine if any symptoms have developed. Health surveillance is not a substitute for effective control measures and should be done because the local risk assessment determines that a risk of exposure exists. Annual respiratory questionnaires will be sent out to those ‘at risk’ employees.
Source information:
DOH – Immunisation against Infectious Disease (The Green Book) Aug 2018 Ch 32
TB Elimination CDC – www.cdc.gov/tb
Prepared by the Cheshire and Mersey OH Manager forum Dec 18
