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Tuberculosis (TB)

What is TB?

TB is caused by bacteria, if it is found in the lungs or throat (pulmonary TB) it is infectious, which means it can be passed on to other people.

TB can also affect any other part of the body, including kidneys, brain or bones. This is called non-pulmonary TB and is not infectious.

How is TB spread?

When someone with TB in their lungs or throat exhales such as when they cough or sneeze, they send droplets into the air that contain the TB bacteria. You normally need to have about 6-8 hours close contact with an infected person with infectious TB to breathe in enough bacteria to be at risk

TB cannot be spread through touch, sharing cutlery, bedding or clothes.

Listen to people talking about their TB experience in the video below

 

Translated versions

The film also plays in Arabic [https://www.youtube.com/watch?v=2s8K74-jyQ0], Bengali [https://www.youtube.com/watch?v=bEqrSfP-t7Y], French [https://www.youtube.com/watch?v=Re1q2F7kGs8], Gujarati [https://www.youtube.com/watch?v=bJNaj9mGJ0U], Polish [https://www.youtube.com/watch?v=7YyIFrJBj1s], Portuguese [https://www.youtube.com/watch?v=ewE8mXQgRT8], Somali [https://www.youtube.com/watch?v=QETH_OlZW1I], Swahili [https://www.youtube.com/watch?v=90Dkugj2y8w], Tamil [https://www.youtube.com/watch?v=QAzTWjHVNTY], Tigrinya [https://www.youtube.com/watch?v=89XaAFbaFwU] and Urdu [https://www.youtube.com/watch?v=sVgn540FKw0]. Courtesy of TheTruthAboutTB.com [https://www.thetruthabouttb.org/]

Further NHS written information about TB (in English) [https://www.nhs.uk/conditions/tuberculosis-tb/]

TB symptoms

The most common symptoms of TB are:

  • a cough for three weeks or longer
  • weight loss
  • loss of appetite
  • high temperature or fever
  • drenching night sweats
  • extreme tiredness or lack of energy.

Symptoms of TB will depend on which part of the body is affected. For example, a cough is a common symptom of TB in the lungs. Someone with TB in the lymph nodes may have a swollen neck. Aches and pains in the joints could be TB in the bones. TB meningitis often gives a person severe headache.

Watch the symptoms in the animation video below.

Don’t ignore TB symptoms

If you have a cough that won’t go away or other TB symptoms, go and see your Doctor and ask to be tested for TB. Early diagnosis means there is less chance of long-term damage to your body, makes it easier to treat and reduces the risk of other people catching TB from you.

Am I at risk of TB?

You have a greater risk of catching TB if you:

  • were born in or have links to countries with high rates of TB [https://www.coventry.gov.uk/health-wellbeing/tb-and-hepatitis/7], including those in sub-Saharan Africa, the Indian sub-continent and parts of eastern Europe
  • are or have been homeless or live in poorly ventilated or overcrowded housing
  • have a weakened immune system, for example as a result of another illness or condition
  • are HIV positive
  • are dependent on or regularly use drugs or alcohol
  • have been in prison.

If you are worried you might have TB, please make an appointment to see your doctor.  TB is curable and treatment is free to everyone in the UK. 

If you are not registered with a GP practice, you can register with a GP that suits your needs. See more information on how to register with a GP [https://www.nhs.uk/nhs-services/gps/how-to-register-with-a-gp-surgery/].

BCG and testing for TB

I have had the BCG vaccination. Surely, I don’t need to worry about TB?

You can still develop active TB after you have had the BCG vaccination. This is because the vaccination offers limited protection for up to 15 years.

Testing for TB

If your GP suspects you have TB, they will send you for testing. If you do have TB, it’s best to know as soon as possible. Delaying treatment makes it more likely you may develop long-term health problems and could put people close to you at risk.

Types of TB test

There are a range of tests to show if you have TB, such as a sputum test, and x-rays.

Chest x-ray

A chest x-ray can show damage in your lungs, but you might need further tests to prove you have TB, such as sputum and culture tests or scans.

Testing sputum

A lab will use a microscope to look at any sputum (phlegm) that you cough up. If there are TB bacteria in your sputum, you have tuberculosis of the lungs or throat (pulmonary TB). This test also helps doctors to understand how infectious you may be.

TB treatment

TB treatment takes at least six months.  It is really important to take all your tablets, to kill the TB bacteria completely.  Try to take your TB medication in the morning on an empty stomach about one hour before you eat

Your TB nurse will support you, it is really important to attend all of your appointments. keep in touch, and tell them if you experience any problems with your treatment.

Latent TB

If you have latent TB, the TB bacteria in your body are ‘asleep’. You will not feel ill, and you cannot pass TB on to others. However, the bacteria might ‘wake up’ in the future, making you ill with active TB. The good news is that latent TB can be treated to prevent this happening.

The only way to find out if you have latent TB is to have a test.

Without treatment for latent TB, there is about a 1 in 10 chance that you will develop active TB in your lifetime. You are more likely to develop active TB in the first five years after you breathe in TB bacteria, though you may not know when that happened.

Watch the video about Latent TB

I have been invited for a latent TB test. What should I do?

You have been invited for a latent TB test because you are at increased risk of becoming ill with TB. There is no need to be worried latent TB can be treated before it can cause active TB, and all testing and treatment for TB is free and confidential for everyone.

There are some reasons why you may be more likely to have latent TB such as:

  • If you have settled in the UK in the last five years, came from a country where TB is more common [https://www.coventry.gov.uk/health-wellbeing/tb-and-hepatitis/7] and are aged 16-35 years. You may receive an invitation to have a latent TB test through the Coventry and Warwickshire TB service.
  • If you meet the criteria for New Entrant Screening, you can contact the TB service directly on 024 76964169 if you have not received an invitation for screening. This test is different to the x-ray that you may have had as part of your visa application process, which only looked for active TB. Having a test or testing positive for latent TB does not affect your right to be in this country.
  • You may be asked to take a test for TB if you have spent a lot of time with someone who has TB – it could be a family member, friend or colleague.

What does a test for latent TB involve?

You may be offered either one of two different tests for latent TB, a TB skin test (known as a TST or Mantoux test) or a blood test (known as an IGRA test).

Skin test: For children who have come into contact with someone with infectious TB, a tiny amount of TB extract is injected under the skin on your forearm. If your body has come into contact with TB, the skin becomes raised and red. You will need to return to the test centre between 48-72 hours later for the doctor or nurse to measure and interpret the results.

Blood test: For adults a small amount of blood is taken from your arm and sent to a laboratory. You will be told when to expect the results.

The person taking the test may also ask some questions to help identify your risk of TB:

  • if you were born in, or have strong links to particular countries
  • whether you know anyone who has had TB
  • if you have any long-term illnesses, such as HIV
  • if you currently have any unexplained symptoms.

Latent TB treatment

A course of antibiotic medicine for three months will treat latent TB.  The TB specialist nurse will talk you through the treatment and answer any questions you may have. It is important that you take your medicine regularly and complete the full course, to make sure all TB bacteria are removed from your body.

Try to take your TB medicine at least one hour before you eat food or two hours afterwards. You can eat anything you like, but you should avoid drinking alcohol.

Make sure you keep all your clinic appointments and tell your doctor or nurse any side effects you may have, or if you are having trouble to remember to take our medication – they will be able to help.

Prevention is better than cure. About 1 in 10 people with latent TB will develop active TB. And there is no way to know if you will be one of them. It is possible to become ill with active TB many years after you breathe in TB bacteria. Treatment is the only way to remove the TB bacteria from your body.

When I finish my treatment, will I be free of TB forever?

If you complete your treatment as prescribed, your risk of developing active TB is much lower. However, it is possible you could breathe in the TB bacteria again in future. The chances of this are low for most people, but is useful to know the most common symptoms of active TB so you can see your GP if you have any of them:

  • a cough which lasts for three weeks or longer
  • fever (a high temperature)
  • night sweats
  • weight loss
  • no appetite
  • tiredness.

Full list of countries for TB screening

  • Afghanistan
  • Angola
  • Bangladesh
  • Bhutan
  • Botswana
  • Cambodia
  • Cameroon
  • Central African Republic
  • Congo (Republic of the)
  • DR Congo
  • Djibouti
  • Equatorial Guinea
  • Eswatini
  • Gabon
  • Gambia
  • Greenland
  • Guinea
  • Guinea-Bissau
  • Haiti
  • India
  • Indonesia
  • Kenya
  • DPR Korea
  • Kiribati
  • Lesotho
  • Liberia
  • Madagascar
  • Marshall Islands
  • Mongolia
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Nigeria
  • Pakistan
  • Papua New Guinea
  • Philippines
  • Sierra Leone
  • Somalia
  • South Africa
  • South Sudan
  • Tanzania
  • Thailand
  • Timor-Leste
  • Tuvalu
  • Uganda
  • Vietnam
  • Zambia
  • Zimbabwe

Source: World Health Organisation (WHO), 2020.

TB resources

To download more leaflets in a range of languages, please visit the TB alert page. [https://www.thetruthabouttb.org/professionals/awareness/]

Hepatitis B and C

Hepatitis is a type of damage to the liver. This can be caused by viruses (amongst other things). The two viruses responsible for most infections are called Hepatitis B and Hepatitis C viruses.

These viruses are spread through blood (most commonly medical procedures with unclean instruments, childbirth, piercings etc) or through having sex with someone with the virus.

In some people, they cause liver damage and eventually liver failure, liver cancer and death.

This process is often very slow and for many years people have no symptoms. They feel completely normal and well

Around the world, it is estimated that 257 million people are infected with hepatitis B but only one in 10 of them have been diagnosed.

Do I have hepatitis?

The only way to tell if you have an early infection is with a blood test. This can be done by your GP.

Testing is offered to anyone who has lived in or had medical treatment in a country with high rates of the hepatitis viruses:

This includes all countries in Africa, Asia, the Caribbean, Central and South America, Eastern and Southern Europe, the Middle East and the Pacific islands

How to get a hepatitis test

To arrange a test, discuss it with your GP.

If you do not have a GP, you should register with a GP [https://www.nhs.uk/nhs-services/gps/how-to-register-with-a-gp-surgery/]. This is available to all people living in the UK, regardless of their immigration status.

or

If you are eligible for TB screening (see above), the TB service can test for hepatitis at the same time as your TB test

Testing and treatment

Testing and treatment are free, whatever your immigration status is.

If you have a hepatitis infection confirmed on a test, the GP will refer you to the Hepatitis Team at University Hospital Coventry and Warwickshire. They will explain the treatment options.

Usually, Hepatitis C [https://www.nhs.uk/conditions/hepatitis-c/] can be cured with a course of anti-viral medications.

Hepatitis B [https://www.nhs.uk/conditions/hepatitis-b/] cannot be cured but medications can slow and often prevent damage to the liver.

There are other infectious diseases that have screening programmes for people who have spent time in certain countries, for example, HIV. View a comprehensive list of national screening and health recommendations for UK migrants broken down by country [https://www.gov.uk/government/collections/migrant-health-guide-countries-a-to-z].

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