ABSTRACT

The profile of infectious diseases has changed dramatically with the advent of air travel, immigration, and immunodeficiency/immunosuppression. Tuberculosis is a prime example that has many manifestations, of which pulmonary tuberculosis is the commonest. The management of TB is not confined to the patient in hospital, but extends into the community. Doctors in England and Wales have a statutory duty to notify a ‘proper officer’ of the local authority of suspected cases of certain infectious diseases. Treatment can be started and supervised as an outpatient. The Mantoux test is now the recommended standard method of tuberculin testing. It involves injecting 0.1 ml of 1 in 10,000 purified protein derivative (tuberculin) intradermally, producing a type IV hypersensitivity reaction. Children who would otherwise have been offered bacillus of Calmette and Guerin (BCG) through the schools’ programme will now be screened for risk factors, tested and only vaccinated if appropriate.