Description of the TB service
The TB Service is led by Specialist Nurses for Tuberculosis and a part-time support worker. Their role involves working in collaboration with the Respiratory consultant at WWL in the control and prevention of Tuberculosis and other mycobacterial infections in the Wigan Borough.
The main responsibilities of the team are:
- To manage the treatment of all cases of Tuberculosis
- To visit all newly diagnosed TB patients – to identify contacts and arrange and initiate screening
- To monitor and support patients on anti-TB drugs, check compliance, monitor for side effects, give advice on treatment and act as a link between patient, family, physician and General Practitioner
- To offer health screening to new entrants, advise GP registration and identify those who are showing symptoms of TB infection or who require BCG vaccination
- Refer to chest clinic as appropriate
- To provide a BCG vaccination service to those identified to be at higher risk
- To offer support and specialist advice to patients, carers and health professionals
- To monitor and support patients who are receiving treatment for mycobacterial infections other than TB
- To ensure notification, surveillance and reporting of cases to the Health Protection Agency (HPA)
Who can access the service?
The TB Service will accept referrals from acute services, healthcare professionals, other professionals, or other services including self referrals from patients.
Recommendations for Immunisation
Immunisation against Tuberculosis is by BCG Vaccination which can only be offered to those individuals who meet the following criteria and have no history of BCG Vaccination.
- Previously unvaccinated infants and children under six years of age who were born in a country outside the UK with a TB incidence of 40/100,00 or greater or with a parent or grandparent born in a country where the annual incidence of TB is 40/100,000 or greater or has a family history of TB in the last six years.
- Previously unvaccinated individuals aged from six years to under sixteen years who have been documented to be tuberculin negative within the last three months and where born in a country outside the UK with a TB incidence of 40/100,000 or greater or with a parent or grandparent born in a country where the annual incidence of TB is 40/100,000 or greater or has a family history of TB in the last six years.
- Contacts of individuals with active TB who are under thirty six years of age, previously unvaccinated and tuberculin negative.
- New entrants, under sixteen years of age who are previously unvaccinated, tuberculin negative and have arrived from a country with an annual TB incidence of 40/100,000 or greater. BCG is also recommended for previously unvaccinated tuberculin negative new entrants from sixteen years of age to under thirty six years from a sub-saharan African country or a country with a TB incidence of 500/100,000.
- Travel – BCG is recommended for previously unvaccinated tuberculin negative individuals under the age of thirty five years who are going to live or work with local people for more than one month in a country where the annual incidence of TB is 40/100,000 or greater. This will be provided by the TB service for individuals up to the age of sixteen. Individuals over the age of sixteen should be referred to Occupational Health.
- Occupational risk. Those at occupational risk of TB may be eligible for BCG. These groups should be referred to Occupational Health.
- People seeking vaccination for themselves or their children should be assessed for specific risk factors for tuberculosis. Those without risk factors should not be offered BCG vaccination but should be advised of the current policy and given written information.
Where is the service offered?
Outpatient clinics are held at the Thomas Linacre Centre in Wigan and the Leigh Walk in centre by appointment. Home visits are also undertaken by arrangement.
How can people access the service?
Referrals are accepted from all sources but can only be acted on if the eligibility criteria is met. Referrals are accepted from any source either by telephone, fax, letter, or by completing the online referral form.
For further information please contact:
Telephone: 01942 483582
Further information and leaflets can be found on the following websites and reading material:
- NICE Guidance NG33 Tuberculosis
- TB Alert
- Department of Health (2004) Stopping Tuberculosis in England: an Action Plan from the Chief Medical Officer. London: Department of Health, 2004.
- Department of Health (2007) Tuberculosis Prevention and Treatment: A Toolkit for Planning, Commissioning and Delivering High-quality Services in England, Wales and Northern Ireland. Department of Health, 2007.
- Pratt R.J, Grange J.M, Williams V.G (2005) . Tuberculosis. A Foundation for Nursing and Healthcare Practice. Hodder Arnold, London.