Tuberculosis in migrant processing centre

[surreysarah]

I was rather alarmed to read this bit about tuberculosis at a migrant processing centre in Essex:

We were also shown the NHS medical facility within the site, with doctors and nurses available to residents.
A number of arrivals, we were told, had active tuberculosis and that up to 20 per cent have been diagnosed with latent TB.
That distinction matters. Latent TB is not infectious in the way active pulmonary TB can be. But for one in five residents to be carrying latent TB is certainly something the public is entitled to know about.
In addition, some people arrive suffering from scabies, something the medical staff take extremely seriously because of how readily it can spread in communal accommodation.

https://www.dailymail.com/news/article-16076797/asylum-centre-holiday-camp-Wethersfield-former-RAF-base.html

Should we worry that TB and scabies could spread into the wider community, or is it easily treated/containable?

We don't give foreign aid to France (Well actually we give them a silly amount of money to stop migrants coming here .. which they could actually spend on hotels etc for the migrants there)

You dont have to get it on the NHS any travel vaccination centre will do it.

What would "they" bring that any person coming into the UK from abroad might not? Is this the latest chapter in the How to Demonise Asylum Seekers handbook? It has echoes of this (trigger warning for the anti-semitic poster. You will only see the whole thing if you click on it):

https://perspectives.ushmm.org/item/propaganda-poster-jews-are-lice-they-cause-typhus

I used to work in health protection and it's always been around, particularly in prisons. Its just not reported on much in mainstream media. We think of these diseases as something from the past but they're still around - including syphilis for instance.

Nice try though.

This isn’t exactly shocking. There are also notable rates in prisons.

That said, TB generally takes prolonged exposure to spread. It’s not like someone coughs over a fence from a detention centre or coughs on you in the tube and you wind up with TB.

I spent 20 years working in infectious diseases research and no doubt had lots of casual contact with people with comorbid TB infections as most of the people I worked with were living with HIV. I had poorly children coughing (and bleeding) all over me with often limited PPE in resource poor settings.

I’ve not had TB and never really worried too much about it. It’s, of course, worrying from a health justice standpoint. It’s not really worrying from an infection control standpoint.

I have just realised OP hasn't come back to the thread 🙄

Ds was vaccinated as I have family from South Asia who often come and stay

not sure I bothered telling anyone they could be at risk

Well considering most of the countries that these people come from are on the FCDO advises against all travel list that’s not strictly true is it. Nice to see you mention the handbook, terrible that we need to issue them but that’s another thread.

When I was going to start biologics and every time they change the prescription, I have to have an immunity test and chest x-ray to check for latent TB because many people have it in this country as well as others.

As it is, I don't have latent because I gained immunity from coming into contact with active TB aged 5. Also why I never needed a BCG when they were still given routinely.

I can't get worked up about anybody who is no different from a whole swathe of the UK born population in that respect.

I knew someone who caught TB from working in a surgery in a leafy suburb. It became chronic, despite the best efforts of the NHS and was severely debilitating. They were semi invalid.

Bizarrely, doctors and engineers get into leafy suburbs, and people in leafy suburbs sometimes visit less leafy vicinities. Weird, I know.

That's awful. Didn't know that.

TB killed close relatives.I would like to see the BCG reintroduced as a routine vaccination

Nevertheless, TB spreads in crowded and confined conditions.

Some foreign aid has made a difference. It's not all well spent and some is a complete waste but some has helped.
More widely if you look at how many countries have risen from low income to middle income status, how fast life expectancy has gone up and infant mortal gone down world wide it's genuinely amazing. There are lots of "good" things that have happened..it's not all (or even in the main) down to aid of course but the idea that in the last few decades "nothing has changed" is false. The problem is war tends to disrupt a lot of the processes which is why rates of TB etc will go up in conflict affected areas because there are disruptions to normal medical/vaccination supply lines, people are moving around more, and you aren't going to be taking your toddler for their vaccine when you are literally running for your life. So anyone coming from a conflict area is likely to have a higher risk of TB than other groups.

The worst recent pandemics we have had were not spread by refugees however**. Ironically once they have left the active war zone they do tend to be closely managed by different systems (UN and charities in refugee camps, asylum processing facilities etc) so chronic illnesses like TB tend to be picked up and contagion stopped. You are more likely to catch TB from someone coming back from holiday because they aren't being screened and treated as rigourously. If you wanted to stop the next pandemic it would male more sense to ban tourism or force tourists to take a full screening when entering the UK. But that would be madness.

**HIV spread to America and the West via "patient zero" an American who was paying for swx in Africa; COVID came from either a wet market or lab leak on China but was carried by regular tourists; Ebola fortunately for nipped in the bud but all the people who might have carried it into the West were Westerners not refugees.

I agree, but that's not really because of the threat from asylum seekers. It's because the game has changed now antibiotics resistance is on the up and, apart from anything else, the leas people able to catch TB the less people needing the few antibiotics that work and the slower resistance develops in them. In general it's quite hubris to have stopped. I vaccina my son but would rather we had a public programme so there was more herd immunity. However, tying that need to asylums seekers is a mistake.

My brother died of it in 2002 after catching it and not getting checked out on time. London is now the TB capital of the world.How London became the tuberculosis capital of Europe | Cities | The Guardian https://share.google/oFNUdnZGfDGizmC2G
And this is now not down to homelessness as stated back then but illegal immigration.

I don't understand why the BCG was stopped being routinely administered. Yes the numbers were low.....because it was being routinely administered! Numbers of polio etc are low, but that's still routinely given.

I'm a nurse and every time I get a routine OH screen prior to starting a new post I have to show my BCG scar (I'm old enough to have had it at school) as evidence I'm immunised.

There is a super TB which is immune to antibiotics.

When my family went to be checked out after my brother's death we were told there no vaccines available.

I’m so sorry to hear that people have lost loved ones

My mum got TB in spite of being vaccinated, she was very ill with it and it was a worrying time but she recovered. I was horrified when they stopped vaccinating routinely but what can you do? I don’t know who makes these decisions but the huge amount of it will be some kind of cost…. We can easily afford it…we just spend money on really weird things. Often things that are of no benefit to British people.

editing to add - I feel really old now because I remember talking to parent friends about my shock that the vaccine was no longer available and that was a really long time ago! Or it feels like it anyway.

Yes some areas have always given it out to new Born's and now those from certian areas

TB capital of the world. That's where we're at. Even The Guardian has published that.

Maybe anti vaxxers are in the mix too but apparently, they're not vaxxing for Tb. Why?