United Kingdom TB Screening

The purpose of the UK immigration screening medical is to detect the suspected presence of active pulmonary TB in those who are applying to stay in the UK for more than 6 months from countries with a high incidence of Tuberculosis.

The process involves:

Adults

Screening of adults will include all of the following:

• A symptom screen.
• Any history of recent contact with a case of active pulmonary TB (shared the same   enclosed air space or household or other enclosed environment for a prolonged period for days or weeks).
• A physical examination.
• Chest X-ray.

Where the CXR is suggestive of either active or old pulmonary TB, further laboratory testing for pulmonary TB will be required. This will have to be conducted within 7 days of having the CXR.

Pregnant women

Screening of pregnant women will include all of the following:

• A symptom screen.
• Any history of contact in the previous year with a case of active pulmonary TB (shared the same   enclosed air space or household or other enclosed environment for a prolonged period for days or weeks).
• A physical examination.
• A CXR in the second or third trimester if the applicant consents.

During pregnancy there is a small risk of radiation to the unborn baby, particularly in the first trimester. It is not recommended to take CXRs during the first trimester. A pregnant woman has 3 options:

• Postpone the CXR (and TB clearance) until after delivery.
• Opt for TB clearance based on negative cultures from 3 appropriately taken sputum samples.
• Continue with the CXR with double shielding in the second and third trimester.

Where the CXR is suggestive of either active or old pulmonary TB, further laboratory testing for pulmonary TB will be required. This will have to be conducted within 7 days of having the CXR.

If you had a normal CXR taken at a UK approved screening clinic for UK TB screening purposes within the last 3 months, then this previous CXR may be used for TB clearance purposes, providing that you do not have signs or symptoms of TB and have not been in close contact to any TB case in the meantime. No CXR taken in an un-approved clinic will be accepted, nor any other screening test.

Children under 11 years old

Screening of children will include all of the following:

• A symptom screen (cough, haemoptysis, weight loss, night sweats, fever, history of previous TB).
• Any history of contact within the previous year with a case of active pulmonary TB (shared the same enclosed air space or household or other enclosed environment for a prolonged period for days or weeks).
• A physical examination.

Where a child has symptoms or signs of active pulmonary TB, or a history of previous TB, or a history of recent contact with a case of active pulmonary TB, the child may be required to have EITHER a CXR OR 3 sputum samples for laboratory examination.