Patient information · Infectious disease
Tuberculosis
curable, and still present in East London
TB is a bacterial infection, usually of the lungs, that remains more common in London than anywhere else in the UK — and Tower Hamlets has among the highest rates in the country. It is entirely curable with the right treatment, but it is frequently diagnosed late because the symptoms build slowly.
Seek urgent assessment if you have
- coughing up blood
- a cough lasting more than three weeks, particularly with weight loss
- drenching night sweats that soak the bedding
- unexplained weight loss and persistent fever
- severe headache, neck stiffness or confusion alongside these
- any of these with a weakened immune system or HIV
TB affecting the brain or spine is a medical emergency. If you suspect TB, telephone before attending any healthcare setting so that arrangements can be made — active lung TB spreads through the air. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
The symptoms
- a persistent cough for more than three weeks, often with phlegm and sometimes blood
- fever and night sweats, characteristically drenching
- unintentional weight loss and loss of appetite
- extreme tiredness
- chest pain, or breathlessness that is worsening
- TB outside the lungs can cause swollen lymph nodes in the neck, back pain, abdominal pain or joint swelling
Latent TB is not the same as TB disease
Most people who inhale the bacteria contain it: it lies dormant, causes no symptoms, and cannot be passed to anyone. This is latent TB. Around one in ten people with latent TB will develop active disease at some point, usually when their immune system is under strain — and that risk is far higher with HIV, diabetes, certain arthritis medications, chemotherapy or after transplant. Latent TB is detected by a blood test and can be treated to prevent it ever activating. That is the whole point of screening.
Who should be screened
- people who have lived for six months or more in a country with high TB rates — which includes much of South Asia, sub-Saharan Africa, and parts of Eastern Europe
- close contacts of someone with active TB
- anyone about to start immunosuppressive treatment, particularly biologics for arthritis, psoriasis or inflammatory bowel disease
- people with HIV, or on dialysis, or after transplant
- healthcare workers, and some visa and employment applicants
- people experiencing homelessness, and those in contact with the criminal justice system
Testing
- An IGRA blood test detects latent infection and is unaffected by previous BCG vaccination, unlike the older skin test.
- A chest X-ray looks for active disease in the lungs.
- Sputum samples — usually three, including an early morning one — confirm active TB and identify drug resistance.
- Further imaging or biopsy where TB outside the lungs is suspected.
Treatment
- A combination of antibiotics, typically four drugs for two months then two for four more. Latent TB needs a shorter course.
- You must complete the full course. Stopping early is the principal cause of drug-resistant TB, which is far harder and longer to treat.
- Rifampicin turns urine, tears and sweat orange — expected, and it stains contact lenses.
- It also reduces the effectiveness of hormonal contraception; alternative contraception is essential.
- Report jaundice, persistent vomiting, visual changes or numbness in the hands and feet promptly.
- TB treatment and care is free on the NHS regardless of immigration status, and is not reported to immigration authorities.
Why come to us. Many people needing TB screening are put off by cost, language or worry about immigration status. We offer IGRA blood testing for latent TB in-house, with chest X-ray arranged rapidly through our CQC-registered imaging partners, and results explained by a clinician — useful for visa applications, employment, and before starting biologic treatment. Many of our clinicians speak Bengali, Turkish, Somali, Urdu and Arabic. If active TB is suspected we refer you into NHS specialist TB services the same day, where treatment is free to everyone.
Latent TB blood testing, in-house
Results explained, in your language where we can. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.