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UK: TB news

Gert van der Hoek

In Memoriam - Editor, Senior Moderator
TB warning for 500 hospital patients


Martin Wainwright

Thursday April 26, 2007

Guardian Unlimited


A nurse has been diagnosed with TB.


A hospital has contacted more than 500 surgical patients after doctors diagnosed a part-time nurse's persistent cough as tuberculosis this week.


Eighty people who spent a fortnight or more on the ward at York district hospital where the woman has worked since September have been offered chest X-rays.

A further group who were recently X-rayed will have their results checked for traces of the disease.

Most of those contacted have been advised only to contact GPs if they are concerned or show possible symptoms of TB - a combination of persistent coughing, weight loss, chest pain, unusual sweating and feeling permanently tired.

"There is a risk but only a small one - we're telling people not to worry," said Mike Proctor, chief operations officer at York district hospital where the un-named nurse worked on ward 16.
The ward takes adult surgical cases, a high proportion of them elderly.

"TB is an eminently treatable disease and very difficult disease to catch," said Mr Proctor. "The nurse is being treated and she will make a full recovery."

The hospital said that an initial diagnosis was made last month but letters could not be sent until doctors confirmed TB this week.

Once almost eradicated, the disease has made a comeback in Britain and other European countries because of increasing international travel.

Cases in North Yorkshire remain very rare but the county's rate nearly doubled between 2001 and 2005 from 12 to 21.

Recent cases included two at one school in Easingwold near York within two years, but there have been no notified instances of direct transmission.

Mr Proctor said: "We are concerned because we know the people we have contacted will be concerned. Some of our older patients will have experienced life in the distant past when TB was a major killer. There was a big stigma attached to it.

"Patients will probably worry way in excess of the actual risks. The question we asked ourselves was: Could we have done something to prevent this from happening?' I believe the answer is no. All the actions we're doing are trying to allay as many fears as possible."

The hospital has given advice to all staff and offered X-rays to colleagues who worked with the nurse.

The incident has been reported to the Health Protection Agency, which last month released provisional data for 2006 showing a 2% increase nationally in TB to 8,171 cases from 8,008 in 2005.

Tuberculosis is an infection caused by bacteria belonging to the Mycobacterium tuberculosis complex. Transmission by coughing of infectious droplet usually needs prolonged and close contact.

The letter from Dr Alexander Anderson, a consultant microbiologist at the hospital, says: "Please reassure any friends and relatives who may have visited you while you were on the ward that they are not at risk and do not require any investigations whatsoever."

The evil reputation of TB dates from the early 20th century when there were more than 50,000 cases a year in Britain and isolated sanatoria were part of the landscape.

Preventative treatment in many areas including North Yorkshire is now targeted at high-risk groups, and the old BCG injection administered during teenage years is no longer given universally.

http://www.guardian.co.uk/medicine/story/0,,2066402,00.html
 
Re: UK: nurse diagnosed with TB

Re: UK: nurse diagnosed with TB

Doctors? message after TB alert at hospital

By Lucy Stephens

DOCTORS in York today reinforced a "don't panic" message after a major tuberculosis (TB) alert from the city's hospital.

Yesterday we revealed the shock news that a nurse on ward 16 at York Hospital had come down with the disease - which used to be a major killer in the UK.

As soon as the case was confirmed, the hospital wrote to 500 patients who had been through the ward warning them they could be at risk. The letters were sent on Wednesday night and hundreds of patients were yesterday preparing to receive them.

But GPs contacted by The Press gave further reassurances that people should not panic about the news and praised York Hospital and the sick nurse for their handling of the matter.

Dr Brian McGregor, a GP at Gale Farm Surgery, in Acomb, said one of his patients was expecting to get a letter.

He said: "The nurse has acted appropriately. She's immediately removed herself and she's dealing with it in a sensible and professional manner.

"You can have it for months before you realise you've got it. It's an insidious illness that does gradually cause decline. It's very, very rare. I think we've had three cases in this area over the past four or five years.

"I wouldn't be overly worried. A lot of elderly patients have been immunised as children. For those who weren't immunised, if you've got reasonable fitness levels then it's okay.

"I think the hospital has acted appropriately."

Dr David Fair, from Jorvik Medical Practice, said: "It all seems reasonable to me - the hospital has taken immediate action to try to prevent the spread of the disease.

"It's a reminder that doctors and nurses are prey to getting the same sorts of infections as everybody else. It's an occupational hazard that we put ourselves at risk of.

"TB used to have a worse stigma - it used to be nearly always fatal. Nowadays, it's treated with antibiotics and it's completely curable."

In December last year, we revealed how teenagers in this area would no longer be offered a BCG jab to protect them against TB when they asked for it - under new Government rules.

Parents were told their child could only be vaccinated if its parent or grandparent was born in countries with a higher risk of TB, including Afghanistan, China, El Salvador, Iraq, Morocco or Portugal, and had not already been given it.

Dr Robin Ball, district immunisation co-ordinator, said it was better not to have the BCG jab if the risk of TB was low, as it was not a very effective vaccine and there were advantages to not being given it.

Case study

Lynne Martin, niche publications editor for Newsquest York, was a patient in York Hospital's ward 16 for nine days this January and is therefore expecting to get one of the warning letters from the organisation.

Lynne, 57, said she was not particularly worried about the possible risk of TB infection on her ward as she had been immunised against the disease when she was young.

She said: "I feel there could be worse things. I had a TB jab when I was younger so I'm not unduly concerned about it. I feel it's unfortunate for anybody like me who didn't have the jab at school. If there was somebody in there who didn't have the jab because the automatic programme ended, they're probably more at risk than I am."

http://www.thisisyork.co.uk/display.var.1359517.0.doctors_message_after_tb_alert_at_hospital.php
 
Scotland, Aberdeen

Tuberculosis testing at hospital

NHS Grampian said it would be rare for the infection to be passed on.

More than 30 patients and staff at an Aberdeen hospital are being screened for tuberculosis after a member of staff was diagnosed with the disease.

Nineteen patients and 14 staff are being given chest X-rays and blood tests at Royal Cornhill hospital.

The staff member was diagnosed with suspected tuberculosis last month.

Tuberculosis is a bacterial chest infection which can affect other organs. NHS Grampian said it was not particularly infectious.

An NHS Grampian spokesperson said: "It would be rare for this infection to have been passed to other patients or members of staff.

"However, a risk assessment has been carried out by NHS Grampian to identify anyone who, as a routine precautionary measure, should be offered screening for TB.

"Those for whom this is advisable have been notified individually and screening has been arranged."

http://news.bbc.co.uk/2/hi/uk_news/scotland/north_east/6646213.stm
 
Re: UK: TB news

Screening as pupils contract TB

Early diagnosis is key to treating TB

Pupils and teachers at a junior school are being screened for TB after four pupils tested positive for the disease.

A letter was sent to parents of pupils at Southfields Junior School, in Luton, Beds, offering the tests after a pupil displayed symptoms of tuberculosis.

Three of his classmates were confirmed to also be in the early stages of the disease, which the Health Protection Agency said is not contracted easily.

Luton has three times as many incidents of TB than the national average.

The bacteria, which commonly affects the lungs, is on the increase nationally, the Health Protection Agency has said.

The affected pupils are being treated with antibiotics and the school has offered the screening as a precaution.

http://news.bbc.co.uk/2/hi/uk_news/england/beds/bucks/herts/6647995.stm
 
Re: UK: TB news

Last Modified: 14 May 2007

Source: PA News

A single dose of vitamin D may be enough to ward off developing tuberculosis (TB) for six weeks or more, researchers say.


In March, the Health Protection Agency (HPA) issued figures showing that cases of TB are on the rise.

Between 2005 and 2006, TB rose by 2% to over 8,000 new cases in England, Wales and Northern Ireland. London had the highest proportion of cases (42%), owing to its higher migrant population and number of at-risk groups, including the homeless and those with a history of drug abuse.

Most cases of TB in London arise from people in whom the bacteria has laid latent for some time, experts say. This means they have been infected with TB at some point but do not currently have an active TB infection.

The study, published in the American Journal of Respiratory and Critical Care Medicine, found that a single 2.5mg dose of vitamin D may be enough to boost the immune system to fight TB and similar bacteria for at least six weeks.

Researchers from Queen Mary's School of Medicine and Dentistry and the Wellcome Trust Centre for Research in Clinical Tropical Medicine at Imperial College London studied around 200 patients who had been exposed to TB.

Around two-thirds had latent TB while the rest had been exposed to TB but had not become infected. The patients, from London, were in high-risk groups and included migrants and the elderly. The researchers found that more than 90% of the patients were suffering from a vitamin D deficiency but that a supplement helped the body fight infection by mycobacteria, the family of bacteria that includes TB.

The supplement was found to stop reactivation of latent TB in those sufferers.

Dr Adrian Martineau from Imperial College London, who co-ordinated the study, said: "We found that a single large dose of vitamin D was sufficient to enhance a person's immunity to the bacteria. This is very significant given the high levels of vitamin D deficiency in people at the highest risk of TB infection, and shows that a simple, cheap supplement could make a significant impact on the health of people most at risk from the disease."

Sunlight is the main source of vitamin D, although a diet of oily fish can also provide some of what is required. However, Dr Martineau said the amount of sunlight in Britain is not enough to provide what most people need, and the elderly do not have the ability to absorb it as well as other people.

http://www.channel4.com/news/articles/society/health/vitamin+d+dose+could+ward+off+tb/510462
 
Re: UK: TB news

Three infant school pupils have TB


Last Modified: 14 May 2007

Source: PA News


Three children at an infants' school have been diagnosed with tuberculosis after one of their teachers contracted the disease.

The pupils, all in the nursery class at Gorseinon Infants' School in Swansea, were screened for TB last Wednesday after the teacher and her three children were diagnosed.

The National Public Health Service for Wales (NPHS) said the three pupils were now receiving treatment.

Dr Sara Hayes, consultant in communicable disease control with the NPHS, said: "The children found with TB have no symptoms and appear to be well. All the cases are expected to make a full recovery."

A total of 150 pupils at the infants school and Gorseinon Junior School have so far been screened for TB, six of whom were offered chest x-rays after returning positive tests.

Screening for pupils in Years One, Four and Six is to take place on June 12, six weeks after they were in contact with the teacher's children, when the test is most accurate. Only those who had been in close contact with the teacher and her children are being tested.

Dr Hayes said: "I appreciate that this is a worrying time for the school, staff and parents.

"They have been very supportive of the actions we have taken and this has helped us make progress."

Parents have been sent a TB fact sheet and nurses were at the school for three days to explain the situation.

http://www.channel4.com/news/articles/society/health/three+infant+school+pupils+have+tb/511002
 
Re: UK: TB news

Five patients test positive for TB

Last Modified: 23 May 2007

Five hospital patients have been diagnosed with tuberculosis, health bosses said.

The patients at the Royal Cornhill Hospital in Aberdeen were among 33 people tested for the respiratory illness.

NHS Grampian ordered the screening after a worker was found to be suffering from the infection.

A spokeswoman said the five patients had tested positive for the inactive form of TB.

She said it was not contagious and they not require treatment.

She added that it was "highly unlikely" that the patients had caught the illness from the worker, who is being treated for the condition.

"A proportion of people who had contact with the TB bacteria in their early years developed inactive TB," she added.

"They have continued to carry the bacteria in their body throughout their life without developing any symptoms or being unwell."

http://www.channel4.com/news/articles/society/health/five+patients+test+positive+for+tb/528062
 
Re: UK: TB news

Many with TB in Britain homeless, poor

Published: May 24, 2007 at 9:13 AM

LONDON, May 24 (UPI) -- Greater social support is needed to meet the needs of the growing number of disadvantaged British residents suffering from tuberculosis, a study says.

"TB has risen considerably in major European cities in the last 10 years and London is no exception," lead researcher Dr. Gill Craig, of The City University's Institute of Health Sciences, said in a statement.

"Increased migration, poverty, HIV, poor quality and overcrowded housing, homelessness, the failure of TB control in institutionalized populations and lifestyle factors related to drug misuse have all played a role."

The researchers studied 250 patients attending one London hospital between January 2003 and January 2005. Key findings in the study published in the Journal of Advanced Nursing included:

-- 42 percent of TB patients were from Africa, 27 percent from Asia, 24 percent from the United Kingdom and 6 percent from the rest of Europe.

-- About one-third were homeless, with 11 percent living in a hostel or on the streets and a further 21 percent staying with friends or relatives.

-- 39 percent received welfare benefits and 13 percent had no income.

-- More than one-third anticipated problems taking their medicine and 30 percent had no one to remind them.

http://www.upi.com/Consumer_Health_...4/many_with_tb_in_britain_homeless_poor/2710/
 
Re: UK: TB news

Five cases of TB at family centre

All those affected attended a family centre in the Ely area of Cardiff
Parents in a suburb of Cardiff have been contacted by health experts after a childminder and four children were diagnosed with tuberculosis.

Another six people are being treated with preventative medicine but have shown no signs of TB.

The National Public Health Service for Wales said the woman was diagnosed in mid April and is "responding well" to treatment.

All those affected attended a family centre in the Ely area of the city.

The National Public Health Service for Wales (NPHS) said it had worked with Cardiff and Vale NHS Trust to investigate everyone who has been in contact with the woman.

'Precautionary measure'


Gwen Lowe, consultant in communicable disease control with the NPHS, said: "As a result of the screening we have carried out, we have detected a number of cases of TB.

"Careful assessment has identified that we should screen young children, childminders and adults attending a specific two-hour weekly drop-in session at the Ely Family Centre.

"Although it is unlikely that TB could have been transmitted in such a short time, we are offering screening tests as a precautionary measure.

"We are contacting staff and the parents or guardians of the children concerned."

'Low risk'

The NPHS said the woman was diagnosed in mid April and is "responding well" to treatment.

A total of 11 adults and 30 children have been invited to be tested for TB on 6 June.

Dr Lowe added: "Other staff and visitors to the centre are at extremely low risk and do not need screening.

"Normal casual contact such as passing someone in a corridor or sharing a lift does not put someone at risk of developing TB."

Tuberculosis is an infectious disease caused by bacteria and is usually found in the lungs, although other parts of the body can be affected.

It is treated by a combination of antibiotics.

http://news.bbc.co.uk/2/hi/uk_news/wales/south_east/6693435.stm
 
Re: UK: TB news

Call for TB screening of immigrants


Denis Campbell, health correspondent

Sunday May 27, 2007

The Observer


Cases of tuberculosis in the UK are rising despite government efforts to curb a disease synonymous with mass death in Victorian times.

Doctors' leaders are calling for improved efforts to screen immigrants from the Indian and African continents for signs of TB, and more widespread use of the vaccine, BCG, in infants.

Two new outbreaks, in Luton and Cardiff, have prompted concern that public health officials are failing to get to grips with the disease. In Luton 71 pupils at Southfield junior school have been affected, while four children who attended a drop-in centre in the Ely area of the Welsh capital have also been diagnosed.

Vivienne Nathanson, the British Medical Association head of science and ethics, said the re-emergence of TB was so serious that ministers should consider the mandatory immunisation of all school children with the BCG jab, and that GPs should offer screening to new patients who come from parts of the world where the disease is common, including Eastern Europe.

Dr Mayur Lakhani, chairman of the Royal College of General Practitioners, said: 'My sense is that the health community has taken its eye off the ball a bit in relation to TB. We shouldn't think that this is a disease of the past.'

Lakhani said primary care trusts, which deliver healthcare in local areas, must do more to ensure that people coming to live in the UK from high-risk countries were screened when they arrived at an airport or port or when they registered with a GP. Students coming to Britain should also be tested.

Cases of TB rose by 11 per cent between 2004 and 2005.

http://observer.guardian.co.uk/uk_news/story/0,,2089144,00.html
 
Re: UK: TB news

Alert as student is diagnosed with TB

Jun 11 2007

By Rob Kennedy, The Evening Chronicle


Hundreds of students have been caught up in a tuberculosis alert at a Tyneside college.

A pupil at TyneMet College in North Tyneside has contracted the potentially deadly disease.

Around 300 staff and pupils have been warned and anyone worried they may have caught the contagious infection are being urged to seek medical advice
.

The 17-year-old student is believed to have caught pulmonary TB after a visit to South America. Now there are fears he could have passed the infection on to fellow students and teachers at the college.

All 300 students and staff have been warned of the risk according to an internal e-mail sent last week. The student is no longer infectious and is believed to be recovering well.

Anyone who has had contact with the victim has been told to visit their doctor for tests urgently as TB has no symptoms at first.

It is understood the teenager was infectious throughout April and he was at college for the duration of the month.

Health chiefs are now carrying out an investigation into the scare.

North Tyneside Primary Care Trust decided not to release information to the general public about the outbreak until the Chronicle was informed of it and contacted it. The Chronicle understands a decision was taken not to release the information in case it caused panic.

But pupils and parents at the college have questioned why more was not done to publicise the scare. A parent of one pupil, who didn't want to be named, said: "If they had just been more upfront about it maybe there would be less paranoia and fear."

The 17-year-old was based at the college's Tynemouth campus not the Wallsend campus.

Health experts from the Health Protection Agency and North Tyneside Primary Care Trust are carrying out an investigation

Dr Meng Khaw of the Health Protection Agency added: "TB does not spread easily and tends to be passed on only after pro longed close contact with an infectious person over several days."

(snip)

http://icnewcastle.icnetwork.co.uk/...objectid=19279077&siteid=50081-name_page.html
 
Re: UK: TB news

TB case confirmed at high school

Tests are being offered to 210 children and staff at a Flintshire secondary school after a member of staff was diagnosed with tuberculosis (TB).

Screening will be available on Tuesday to nine at Holywell High School classes who may have been in close contact with the staff member.

Flintshire Council said the staff member had been off sick since 24 May.

In a separate case, officials said there was "no further spread" of TB at Gorseinion Infants School in Swansea.

The Holywell case was confirmed in a joint statement by Flintshire Council and the National Public Health Service for Wales (NPHS).

The statement said tests would be offered on Tuesday to classes in years seven, eight and nine.

The staff member was admitted to Glan Clwyd Hospital in Bodelwyddan, but has been discharged and is said to be "recovering well".

Officials said the person's "close household contacts" had been tested and there had been no spread of the infection.

'Precautionary measure'

Chris Whiteside, consultant in communicable disease control with the National Public Health Service of Wales, said: "The likelihood of TB spreading within the school is very low indeed.

"TB is only spread by people in very close contact with each other. We have no evidence of there being any spread and older children, such as those at the high school, are less vulnerable.

"However, as a precautionary measure and in line with guidance, we will be screening those who may be at risk"

He added: "The screening involves a skin test which can be read two to three days later. It checks if any children may have caught TB. It should be done at least six weeks after the last contact. Otherwise it may not be accurate.

"A team of staff from the school, the council, the NHS trust, local health board and the NPHS are working together to organise the screening."

The NPHS also said there was no evidence of further spread of TB at Gorseinon Infants School in Swansea, following the latest round of tests.

Screening was offered after a dinner supervisor tested positive after becoming ill in March. Three of the staff member's own children, and three other nursery pupils, were also diagnosed.

Sara Hayes, of the NPHS, said all 92 children who had their tests read on 8 June had been ruled out of infection.

She added: "It is very reassuring that all the children tested have been cleared of carrying the infection.

"It would have been very unusual to have found TB."

Additional tests are due to be carried out at the junior school on Tuesday.


http://news.bbc.co.uk/2/hi/uk_news/wales/6742215.stm
 
Re: UK: TB news

Fourth pupil is diagnosed with TB

Another pupil at a Swansea school where there is an outbreak of tuberculosis has been confirmed with the disease.

Four children at Gorseinon infants and junior schools are now diagnosed as having TB. Three others are being treated for exposure to the infection.

A woman staff member and her three children - all pupils at the schools - were diagnosed in May.

Public health experts say there is no evidence the disease is spreading from child-to-child in the schools.

The latest case first came to light from a positive reaction to testing carried out on 12 June and was confirmed by examination of an x-ray.

Dr Sara Hayes, consultant in communicable disease control for the National Public Health Service for Wales (NPHS), said: "Every child who has been infected with TB is linked to the one adult - a member of staff who must have been highly infectious.

Antibiotics


"The new child we have confirmed this week matches this pattern - with links to the member of staff working in the nursery."

The outbreak started in May when the woman staff member was diagnosed with TB and her three children were also found to be infected.

Screening was offered to children in the nursery where the adult worked and in the classes her children are in.

Seven nursery pupils have tested positive for exposure to TB, of whom four are being treated for the disease.

A few children at the schools still have to be screened but Dr Hayes said all those diagnosed with TB have no symptoms of the illness itself.

They are all being treated with antibitotics and are not considered infectious to others and have returned to school. The infected member of staff is also recovering well.

http://news.bbc.co.uk/2/hi/uk_news/wales/south_west/6231676.stm
 
Re: UK: TB news

TB outbreaks in schools simply a ?coincidence?

Jun 25 2007

by Madeleine Brindley, Western Mail


EXPERTS have described cases of tuberculosis in two Welsh schools that were discovered only a couple of weeks apart as a ?coincidence?.

Pupils at Holywell High School, in Flintshire, will be tested for the disease next month after a member of staff fell ill with TB.

The decision to test children at the 840-pupil school comes only weeks after more than 170 children at Gorseinon Infant and Junior schools, in Swansea, were offered screening for the disease.

A member of staff and her three children all developed the disease. A further seven children ? including one at nursery school ? had positive skin tests.

And six children in the Ely area of Cardiff were given preventative medicine after a childminder and four children in her care were found to have TB, also last month.


But Dr Lika Nehaul, a consultant in communicable disease control at the National Public Health Service for Wales (NPHS), said the cases are not evidence of a rise in TB in Wales.


He said, ?An initial look at the number of cases of TB in Wales in the first quarter of this year shows they are the same as last year. Cases of TB in the UK have been going up but most of those increases have occurred in London and other large urban areas in England.


?We have had cases in schools in Wales but I wouldn?t want to say that this suggests a bigger problem.


?These cases appear to be coincidental, and if we do find cases in a school or childcare setting the guidance is quite clear about what we should do.?


Although there is some evidence that some children have tested positive for TB after being in contact with an infected adult, Dr Nehaul said TB will not spread between different groups of people in the community.


And Dr Sara Hayes, another consultant in communicable disease control for the NPHS, said of the Gorseinon cases, ?We have nearly completed screening at the Gorseinon schools and have found no evidence of spread from child to child.


?We have also not found any evidence of spread within the infants and junior schools. Every child who has been infected with TB is linked to the one adult ? a member of staff who must have been highly infectious.?


The emergence of cases of TB in Welsh schools will reopen the debate about whether all children should be given the BCG jab to help protect against the disease.


The nationwide vaccination programme was shelved in 2005 when it was decided that only babies living in areas where there is a high level of TB will be given the jab ? there are no such areas in Wales.


The only other babies to be offered the vaccine, which was once a mainstay of the childhood immunisation programme, are those with a parent or grandparent who was born in a country with high levels of TB.


Three-quarters of cases of TB in the UK are diagnosed in people who have been born abroad, although in Wales the disease is largely found in the indigenous population.


Dr Nehaul said, ?We need to keep the situation in perspective, although I understand that parents may be concerned.

http://icwales.icnetwork.co.uk/0100...objectid=19350042&siteid=50082-name_page.html
 
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