Tuberculosis (TB)

Tuberculosis (TB) is an infection caused by bacteria. It mainly affects the lungs, but it can affect any part of the body, including lymph nodes (glands), bones and the brain causing meningitis.

TB is spread when a person with TB in their lungs or throat coughs or sneezes.

When people talk about TB, they usually mean ‘active TB disease’. This means that the bacteria are multiplying in your body, making you ill and you could pass TB on to other people.

You may also hear the term “latent TB” which means the bacteria are inactive - sometimes it is called sleeping TB. People with latent TB are not unwell and can not pass it on to other people. Many people who have latent TB infection never develop TB disease. In these people the TB bacteria remain inactive for a lifetime without causing disease. But in other people the bacteria become active, multiply and can cause disease.    

Anyone can get TB, but people are at higher risk if they have other conditions that may make them more vulnerable to infections. For example, if you have diabetes,  or HIV or had treatments for conditions such as cancer, rheumatoid arthritis, or an organ transplant. 

The most common symptoms of TB are.

• A persistent cough for three weeks or longer
• Coughing up blood 
• Loss of appetite/Unexplained weight loss
• A high temperature/ drenching night sweats 
• Extreme tiredness/lack of energy
• Swollen glands, especially in the neck

If you are worried that you have any of these symptoms, then it is important that you tell your GP and ask about TB. 

It is important to try and diagnose TB as quickly as possible. 

If you have a cough, then your General Practitioner (GP) will organise a chest X ray for you. They will ask you to collect some samples of your phlegm/sputum that can be tested.

If your doctor thinks you might have TB in another part of our body, then you may have some samples taken from that area. For example, if you have a large lymph node (gland), you may have a test done to remove some tissue/fluid to look for the TB bacteria. 

Latent TB is diagnosed by a skin test or a blood test - please see 'Can I be screened for TB?' for more information.

Yes! TB is a curable disease, and treatment is free for everyone. 

Treatment for active TB involves taking a mix of antibiotics for at least six months. 

It is very important that you complete the full course of treatment or the TB will not be treated properly. This means the TB may return in a form that cannot be treated by the normal medications and can be harder to treat. 

You will be looked after by a specialist TB team which includes doctors and nurses. They will see you regularly and give you advice and support during your treatment. 

TB is only infectious when it affects the lungs and the throat.

If you are told you have TB in another part of the body, then you are not infectious and can not spread TB to other people.

If TB is affecting the lungs, then you are considered to be infectious.

How infectious you are will depend on:

• If you are coughing
• How much of your lung is affected by TB.
• How much bacteria is in the lung

Your GP or TB team will let you know if they think there is a risk you might be infectious.

One of the most important things you can do to avoid spreading the bacteria is to cover your mouth with a tissue or handkerchief when you cough and throw away in a bin.

You may be asked to stay at home and have no new visitors whilst having any investigations.

After two weeks of effective treatment, and on the advice of the TB nurse or doctor you should be able to return to your normal activities.

If you are infectious, it is very important that you tell us who you have had close contact with.

These people will be offered screening to check if they have TB too. They will not be told your details unless you give the TB team permission to do so.

There are different reasons that you may be offered screening for active or latent TB.

These include.

• If you have been in contact with someone who has TB in the lungs. Sometimes you may not know that you had contact with TB, especially if the contact occurred happened at work or college. If you do receive an invite to be screened, it is important  to go to the appointment. It is important to attend your appointment.
• If you have a certain condition, like rheumatoid arthritis or Crohn’s where you need to have biologic treatments. 
• As part of an occupational health screening. 
• If you have recently arrived from a country where there is a high rate of TB, your GP may invite you for a TB test.

GPs

General practitioners (GPs) are doctors and treat all common medical conditions. They also refer patients to hospitals and to other medical services for urgent and specialist treatment.

Everyone is entitled to register and consult with a General Practitioner (GP), free of charge.

You do not need to show proof of address or identification. Help to register with your GP can be found here. 

See a GP if:

• you've had a cough for more than 3 weeks
• you're feeling tired or exhausted and you're not sure why
• you have a high temperature or night sweats that do not go away
• you often do not feel hungry
• you keep losing weight without changing your diet or exercise routine
• you've spent a lot of time with someone who has tuberculosis (TB) and has symptoms (for example, you live with someone who has it)

Your GP may order some tests (see 'How is TB diagnosed?) and you might be referred to the specialist TB team at a hospital (see below).

Barts Health TB Services

What we provide.

There are three TB teams based at 

• Shrewsbury Road Health Centre, East Ham (0207 363 9180)
• Mile End Hospital (0208 121 4184)
• Whipps Cross Hospital (0208 538 5522, Ext 5748)

Opening Times:  Monday – Friday 09:00 -17.00 (Excluding BH’s) 

The teams run outpatient services for people who they think may have TB or who have active TB. This includes those with complex needs such as HIV TB, paediatric TB and Multi Drug Resistant TB.

There are clinics run by doctors and nurses. Clinics throughout the week and the teams provide specialist support to patients in hospital. 

The teams will work with the health protection team to organise and provide screening if there is a case of infectious TB, for example in a work place, college or school.

The nursing team will do home visits for patients needing additional support.

In Newham, the BCG vaccine is provided by Vaccination UK. 

You will be asked if you would like your baby to have BCG within 28 days of the birth of your baby of your baby being born.

If you do not get a letter within 28 days of your child’s birth, it is important that you contact Vaccination UK to book an appointment.

You can call Vaccination UK on 0208 214 1395 or email newham.bcg@nhs.net

The BCG doesn’t stop you from getting TB, but it is the most effective way to stop babies and young children getting severe TB disease, such as meningitis.   

The BCG vaccine is not normally given as part of the NHS vaccination schedule.

The vaccine is only recommended for people at higher risk of getting TB, such as some babies and children, some travellers and people at risk through their work. 

Your midwife, health visitor, local health centre or hospital will usually let you know if the BCG vaccine is recommended for your baby.

For other children and adults, speak to your GP surgery if you think you or your child may need the BCG vaccine.