When you are told that you may have Tuberculosis (TB), this can be surprising and worrying. This leaflet helps explain what to expect at the Tuberculosis clinic and the tests you may need to have.
What is Tuberculosis?
TB is caused by a bacterium (type of germ). TB usually affects the lungs although it can affect any part of the body. The symptoms can therefore vary depending on the site of the infection.
Not all TB is infectious. Only TB of the lungs or throat is infectious and can be spread from person to person. The germ is spread through the air by tiny droplets expelled into the air when the infected person breaths, coughs or sneezes. For this reason, we like to see people with symptoms promptly to reduce the chance of spread and to start treatment as soon as possible.
In the UK in 2021 there were 4,125 cases of active TB.
TB is curable with a course of medication that usually lasts for 6 months.
You may have been referred because you have symptoms of active TB. Symptoms can include one or more of the following:
Fever and night sweats
Prolonged and unexplained cough (more than 3 weeks)
Unexplained weight loss
Blood in your phlegm
Fatigue and lethargy
Assessment and Tests at the TB clinic
In the clinic you will see a TB Nurse Specialist who will ask you questions about your medical history. We will ask you where you were born and the countries you have lived in. (TB is more common in some countries, and you may have had a greater exposure to the germ). It is also important for us know if anyone in your family or friends circle has had TB in the past.
Tests can include a chest X-ray, a TB specific blood test, and a Tuberculin skin test (a small injection in the forearm). If you are coughing and producing phlegm, we will ask you to collect and provide samples of this on 3 consecutive mornings as this is the best way for us to look for the germ.
Referral for other reasons
You may have been referred to the TB clinic for TB screening not because you are unwell or have symptoms but because we need to know if you have ever been infected with the TB germ.
It is possible to be exposed to TB unknowingly and this may have allowed the germ to enter your body. It does not make you ill at the time because the immune system deals with this infection by containing it and sending it to sleep. We call this latent TB.
Latent TB cannot be passed from person to person. The infection may remain in this state throughout your lifetime, but certain circumstances can encourage it to wake up or reactivate. This will make you unwell with active TB.
Sometimes people are screened for TB as part of a medical so your GP may refer you to the TB clinic for treatment of latent TB. This takes the form of medication for 3 months.
You may be referred to the TB clinic because you have potentially been exposed to the TB germ. This might be because a family member, friend, or colleague has TB and you have been identified as a contact.
The TB clinic appointment will follow the same format as described above in ‘Assessments and Tests at the TB clinic’, but may only involve a Tuberculin skin test or TB blood test, not a Chest X ray. The timing of these tests depends on the date of your exposure to TB so they may not be immediate.
It is important to understand that you should not turn down the opportunity to have TB screening because you have previously received a BCG immunisation and / or you are feeling well.
TB screening pre biologic therapy
Your specialist may have requested a TB screening ahead of you receiving biologic drugs for another condition (connected with gastroenterology, rheumatology, dermatology, neurology).
This is because biologic drugs have a suppressant effect on the immune system and therefore if latent TB is present, the introduction of a biologic medication might trigger the infection to reactivate and cause active TB.
If latent TB is discovered as part of your screen, you will be offered treatment for latent TB prior to biologic therapy. This screen will include Tuberculin skin test (in most cases), TB blood test, with or without a chest X-ray.
Support from the TB service
We want you to feel comfortable and informed at every step of your journey within the TB service. We welcome telephone enquiries and offer an open access service to our patients on treatment and undergoing investigation with us.
The TB Nurse Specialists work as part of a multidisciplinary team and manage the service with TB Respiratory Consultants.
Contact details for the TB clinic are at the bottom of this leaflet.
Please speak to a member of staff before or during your visit to the hospital if you require translation support to access Patient Information. Please ring the phone number on your appointment letter, if you have one.
Request More Information
Please contact the Patient Experience Team on 020 893 3850 if you need this information in a different format.
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