Tuberculosis
Oxfordshire Tuberculosis (TB) Nursing Services
Oxfordshire Tuberculosis (TB) nursing services are a team of three TB Nurses including a TB Specialist Nurse. They are based at the Churchill Hospital in Oxford, supporting patients with Tuberculosis in the community over the whole of Oxfordshire. Clinics are held weekly at the Churchill Hospital and as required at the Horton Hospital in Banbury.
The team work closely with the hospital doctors and GPs to assist patients and their families. They also visit TB patients at home.
Here are some of the questions that are often asked about TB:
1) What is tuberculosis (TB)?
2) What are the symptoms of TB?
3) Can TB be cured?
4) Will I need to stay in hospital?
5) How do you catch TB?
6) Is TB always infectious?
7) Can anyone catch TB?
8) Who is most at risk of catching TB?
9) What should I do if I've been in contact with someone who has TB?
10) Can I become a carrier of TB?
11) I've had a BCG, can I still catch TB?
12) I have not had a BCG and my friend has TB. Should I get a BCG now?
13) When and how do you test/screen for TB?
14) I need to have a TB skin test (Mantoux test) - what is this?
15) What does a positive skin test mean?
16)
What does negative test mean?
17) A note about BCG
1) What is tuberculosis?
Tuberculosis is an infection caused by a germ /bacterium called Mycobacterium tuberculosis.
It usually affects the lungs, but can affect any part of the body such as the brain, kidneys, lymph glands and bones.
2) What are the symptoms of TB?
TB develops slowly and usually takes several months for symptoms to appear. Any of the following symptoms can mean you have TB, but these symptoms are also found in many other illnesses:
- Having a cough that lasts for 3 weeks or more
- Coughing up blood. Having fevers or a high temperature
- Drenching sweats at night
- Not wanting to eat and losing weight
- Feeling very tired or unwell
- Having swollen glands, often in the neck
3) Can TB be cured?
We expect to cure most people who have TB; as long as they take their medicines as prescribed.
Treatment is provided free of charge if obtained from your TB clinic.
To avoid the TB germ developing resistance to the antibiotics, it is very important to complete the course of antibiotics. For this reason, patients are monitored during their treatment. Most people are treated as an outpatient. After the first two weeks of antibiotic treatment, someone who has TB of the lung or throat generally stops being infectious.
4) Will I need to stay in hospital?
Occasionally patients will need to stay in hospital for a period; their treatment can then be continued as an outpatient.
5) How do you catch TB?
When someone with TB coughs, sneezes or spits, tiny droplets of water with the TB bacteria in them, are expelled into the air. These droplets are then breathed in by other people. Most of these people will not develop TB but a small number will, especially if they have underlying medical conditions, or are unwell.
6) Is TB always infectious?
No, TB is not always infectious. TB of the lungs and throat can be infectious because the live bacteria are in the sputum. (This is called "sputum-smear positive" or "open" TB). TB in other parts of the body is not infectious.
Even if someone is infectious only those in close and prolonged contact with them will be at risk of catching TB.
Fortunately, people are not usually infectious after two weeks of treatment.
7) Can anyone catch TB?
Anyone can catch TB; you need to have close and prolonged contact with someone who has infectious TB. Some people are, however, more at risk (see question 8).
8) Who is most at risk of catching TB?
Those people who live in the same accommodation as the person with TB. This is because they share the same air-space and usually have close and prolonged contact with them.
Other people may be more at risk because they have less protection against disease are:
- Children and frail elderly people
- People taking medicines such as steroids that affect the body's immune system (often called "immunosuppressed")
- People who have AIDS or are HIV-positive
- People who are in a poor nutritional state
- People who have diabetes
- People living in overcrowded or poor housing
- People who are dependent on drugs or alcohol
- People who have longstanding poor health
9) What should I do if I've been in contact with someone who has TB?
If you live in the same house as someone who has TB, or are a close contact of someone who is infectious with TB, you should receive a letter or phone call from the chest clinic in your area to arrange a TB screening appointment. If you do not receive an appointment and are worried, contact your GP or chest clinic; if appropriate you will be offered an appointment.
If you do need to be screened, you will be given further information about what to expect. There is only a small chance of having caught TB. While you are waiting for your check-up or results, please carry on with all your usual activities, such as work, sporting or social events.
If you are feeling unwell with any of the symptoms of TB (see the section 2: What are the symptoms of TB?) please see your GP and let them know that you have been a contact of TB.
10) I've been in contact with someone with TB at work. Can I pass it on to my family?
No. If you have had contact with active TB, but have not got active disease yourself you cannot pass TB onto your family. However, it is very important that if you are offered screening you should attend. In this way you are protecting your family by being diagnosed early before you could become infectious.
11) I've had a BCG vaccination, can I still catch TB?
Yes, it is still possible to catch TB as the BCG vaccination usually provides only 60% to 80% protection against TB.
12) I have not had a BCG and my friend has TB. Should I get a BCG now?
No. BCG vaccine takes 6-8 weeks to be fully working so would not benefit you if you have already been in contact with TB. It can also interfere with the interpretation of the Mantoux skin test which be used to screen you for TB.
13) When and how do you test/screen for TB?
The TB nurse will discuss with you the timing of your screening.
At your appointment you will have certain tests including one or more of the following:
- A chest x-ray
- A Mantoux test
- A blood test
- Specimens of the sputum (if you have a cough)
14) I need to have a TB skin test (Mantoux test) - what is this?
A tiny amount of liquid Tuberculin is injected just under the top layer of
skin, on the lower arm just below the elbow. The test stings a little, for a few moments.
After you have the test you can wash as normal but do not scratch the area. If it itches you can put a cold compress on the area. Do not cover the area with a plaster or put creams or lotions on it. Do not scratch the area.
You will be asked to return to the clinic 2-3 days after you had the test so that any reaction to the test can be looked at and measured.
The skin test shows whether you have ever been exposed to the TB germs. This can happen if you have breathed in TB germs; the BCG vaccination can cause a reaction.
15) What does a positive skin test mean?
The test may be positive because:
- You have had a BCG in the past or
- You have picked up the TB germ but your body's immune system is preventing you from developing TB disease
- You may have TB
16) What does a negative test mean?
If your test is negative it may mean that you have not picked up any TB germs. It could also mean that you have been tested too early and the test will need to be repeated in 6-8 weeks.
A note about BCG:
The TB Nurses do not provide the BCG immunisation. The
BCG vaccine is usually only given once. In the UK it used to be routinely offered to all secondary school children between the ages of 10 and 14 years, but in 2005 this programme was stopped.
This vaccine is no longer given routinely and is a targeted vaccine for people who are at increased risk of catching TB. For more information on eligibility please click here
In Oxfordshire newborn babies at risk may be offered the BCG before they leave the hospital in the John Radcliffe Hospital and the Horton Hospital in Banbury.
The Community Children's BCG Clinic offers immunisation to children at risk. Please ask to be referred by your Health Visitor or Midwife.