TB – it’s back

Treating TB

The most important step is to find, isolate and treat all disease carriers until they are no longer an 'infective risk' to others.

Most children with TB can be cared for at home using a combination of drugs that are powerful anti-microbial agents - the major ones being Isoniazid, Rifampicin and Pyrazinomide.

A single tablet is available that contains all these chemicals. The course of treatment can last several weeks or even months, but it's vitally important to complete the course of medications in order to cure the TB.

Pregnant women with TB are treated urgently, to prevent the disease progressing and posing a risk to both mother and baby.

Vaccination at secondary school level

As I mentioned, senior school children used to be vaccinated. This involved injecting a live, but weakened tuberculosis bacteria (BCG), which caused the body to set up a protective mechanism, greatly reducing the risk of lung TB - and effectively preventing varieties of blood-borne TB.

A shortage of vaccine means that the BCG isn't given as a matter of routine but, if young people are travelling to Africa, Asia or Eastern Europe for a prolonged trip, they should make sure they're vaccinated.

Recent outbreaks

It's the homeless and people with other problems, like HIV infection, drug abuse and alcoholism, who are particularly at risk at the moment.

All of these conditions tend to weaken the body's general defence mechanisms. We also know that an increasing number of immigrants arriving in this country have been exposed, or may be carrying active tuberculosis from their own country.

Treatment regimes are strictly managed and observed in the UK and we probably have the lowest incidence of drug resistant TB in the world. Only around one per cent of all TB cases in the UK are caused by a multi-drug resistant strain, and only a very small proportion of these are extensively drug resistant.

Preventing TB depends on maintaining good living standards, eating well, having plenty of sunlight and taking exercise.

It also depends on vaccination but, the national schools vaccination program has now been replaced with targeted immunisation of children with an increased risk of TB - infants living in areas with a high incidence of TB, and any child whose parent or grandparent was born in a country with a high incidence.

Tuberculosis is certainly not a disease of the past. We've been lulled into a sense of false security, doctors included, and now that we take foreign travel for granted, we also need to be aware of the risks a disease like TB poses.

An undetected infectious TB victim can infect another 10 people annually - each of whom could transmit the disease.

In future, children in the most vulnerable age groups will be screened or monitored more closely, and the outlook for those children diagnosed recently is excellent.

They will receive effective treatment, long-term monitoring and declared cured by the end of the regime.