Control and prevention of tuberculosis in the United Kingdom: Code of Practice 2000

Background-The guidelines on control and prevention of tuberculosis in the United Kingdom have been reviewed and updated. Methods-A subcommittee was appointed by the Joint Tuberculosis Committee (J TC) of the British Thoracic Society to revise the guidelines published in 1 994 by the JTC, including representatives of the Royal College of Nursing, Public Health Medicine Environmental Group, and Medical Society for Study o f Venereal Diseases. In preparing the revised guidelines the authors took a ccount of new published evidence and graded the strength of evidence for th eir recommendations. The guidelines have been approved by the JTC and the S tandards of Care Committee of the British Thoracic Society. Recommendations-Tuberculosis services in each district should have staffing and resources to fulfil both the control and prevention recommendations in this document and to ensure adequate treatment monitoring. Notification of tuberculosis is required for surveillance and to initiate contact tracing (where appropriate). The following areas are discussed and recommendations made where appropriate: (1) public health law in relation to tuberculosis; (2) the organisational requirements for tuberculosis services; (3) measures for control of tuberculosis in hospitals, including segregation of patient s; (4) the requirements for health care worker protection, including HIV in fected health care workers; (5) measures for control of tuberculosis in pri sons; (6) protection for other groups with potential exposure to tuberculos is; (7) awareness of the high rates of tuberculosis in the homeless togethe r with local plans for detection and action; (8) detailed advice on contact tracing; (9) contact tracing required for close contacts of bovine tubercu losis; (10) management of tuberculosis in schools; (11) screening of new im migrants and how this should be performed; (12) outbreak contingency invest igation; and (13) BCG vaccination and the management of positive reactors f ound in the schools programme.