Tuberculosis (TB)

Tuberculosis is a potentially serious infection that mainly affects the lungs. The incubation period is usually around two to three months but can take longer. A person with symptomatic TB will be contagious for two to three weeks into their treatment.

Number of cases of tuberculosis in England

Cases reported to the WHO per country per year

Incubation period

2-12 weeks (can be longer)

Symptoms

Lack of appetite, Weight loss, Cough, Fever, Night sweats

Possible complications

Breathing difficulties, Spinal pain, Meningitis, Joint damage, Kidney and liver problems, Heart disorders, Death

About Tuberculosis (TB)

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. It mainly affects the lungs, typically causing a cough, fever and weight loss, but it can affect other parts of the body, such as the kidneys, joints and bones.

TB can lead to more serious health problems including spinal pain, meningitis, joint damage and arthritis, liver and kidney problems, and heart disorders.

It can also be fatal.

In the past, TB was known as “consumption” because of the way it slowly consumed sufferers.

Tuberculosis symptoms

TB develops very slowly, so it isn’t always immediately obvious that someone with the illness is unwell. In fact, it can take months or even years for symptoms to develop after the initial infection. It’s also possible to have TB without developing any symptoms – this is called latent tuberculosis.

The general symptoms of TB include lack of appetite and weight loss, a high temperature, night sweats, and extreme tiredness or fatigue. This can make TB hard to spot because many other illnesses cause these symptoms too.

Most TB infections also affect the lungs and can cause a persistent cough that lasts at least three weeks and usually brings up phlegm that may be bloody. The infected person may also find themselves becoming increasingly short of breath.

TB can develop outside of the lungs, although this is rarer and can cause a wide range of symptoms. Issues to look out for include swollen glands, abdominal pain, joint pain and loss of movement, confusion, persistent headaches and/or fits (seizures).

Possible complications

Without treatment, TB can be fatal. Other possible complications from the illness include spinal pain, joint damage, meningitis, liver or kidney problems, or heart disorders.

Tuberculosis FAQs

TB is caused by bacteria and is usually spread via inhalation of droplets from an infected person’s coughs or sneezes.

In 2020, there were 4,458 reported cases of TB in the UK and 72.8% of these cases were in people born outside of the UK. In the same year, 149 children were diagnosed with TB in England; 67.8% of these were born in Britain. The vast majority of people who catch TB can be successfully treated with a six- to nine-month course of antibiotics.

TB is most common in inner cities, areas of poverty and homelessness, and in families originating from areas with high rates of TB, such as the Indian subcontinent.

Nearly half of all the cases of TB in the UK occur in London. There are also a few TB hotspots outside London, such as Leicester and Slough.

Tuberculosis is less infectious than diseases like measles or chickenpox – only a third of people who are in prolonged close contact with a person with TB become infected. Research updated in May 2022 concludes that one in 10 people infected with TB will develop the illness within their lifetime and that the risk of this is highest during the first year post-infection. The remaining nine out of 10 are able to keep the disease under control and remain reasonably healthy.

Although cases of TB fell in 2020 (the latest current available data), it should be noted that social distancing measures for COVID-19 may have reduced transmission rates.

FIND OUT EVERYTHING YOU NEED TO KNOW ABOUT TUBERCULOSIS VACCINATION HERE

Several tests can be used to diagnose TB, depending on what type of the illness is suspected. The following approaches are likely:

  • Pulmonary TB (in the lungs): X-rays, phlegm samples
  • Extrapulmonary TB (outside of the lungs): CT/MRI/Ultrasound scans, endoscopy, laparoscopy, urine/blood tests, biopsy, lumbar puncture
  • Latent TB (i.e. possible infection but no symptoms): Mantoux skin test, Interferon Gamma Release Assay (IGRA) blood test

You might have heard of the Mantoux skin test (sometimes called the tuberculin skin test (TST)) – this is necessary before BCG immunisation against tuberculosis for:

  • All adults and children over six years of age
  • Babies and children under six years of age who have lived or stayed for more than three months in a country with a high incidence of TB
  • Anyone who has had close contact with someone with TB
  • Anyone with TB in the family within the last five years

The Mantoux test involves injecting a tiny quantity of extracts of the TB bacterium (bug) into the forearm. The skin is examined two to three days later.

If there is a skin reaction (usually a small, hard lump at the injection site of a certain measurement), it means the person having the test could have latent or active TB and should not have the vaccine until further investigations have been done.

The Mantoux skin test can show us whether someone has already been vaccinated against TB too.

TB typically requires antibiotic treatment for around six months. However, some strains are resistant to some antibiotics and may require a longer course of antibiotic treatment for nine to 24 months. Treatment for latent TB will depend on a person’s age and various other factors but a six-month course of antibiotics may be advised.

Individual advice about protecting your child against TB

Need advice about the right combination vaccine to protect your child against TB? The BabyJabs team is here to listen and answer your questions to help you decide.