Broadgate GP

Who should and shouldn’t have the Mantoux test and/or the Tuberculosis BCG vaccination

At the beginning of the 20th century, the incidence of Tuberculosis (also known in history as Consumption, Phthisis, Scrofula, Pott’s disease, and the White Plague) which is a highly contagious disease, was of epidemic proportions. Thanks to the development of the Tuberculosis vaccination and the introduction of the Mantoux test, Tuberculosis here in the UK is relatively rare.

Tuberculosis back in decline

The incidence of Tuberculosis here in the UK had given cause for concern in recent years, when in 2011, the rate peaked to 15 people in every 100,000 being contaminated. This was partly due to immigration rates, and thanks to improved worldwide immunisation programs and the continuance of the UK immunisation program, in 2015 the rate fell to 12 infections in every 100,000.

The Mantoux test

The Mantoux test was introduced in the UK in 2005when it replaced the Heaf test. The Mantoux test consists of injecting 5 units of PPD Tuberculin in between skin layers, normally in the upper arm. If the recipient has latent TB, the reaction can be measured within 48 to 72 hours and a Tuberculosis vaccination should be avoided.

The BSG vaccine

The BSG (Bacillus Calmette-Guérin) vaccine is only administered to babies when a particular baby is thought to have a high risk of coming into contact with a person infected with Tuberculosis. It can also be given to young people and adults below 35 years of age. It is not administered to adults over 35 because there is no proof that it has any benefit.

The BSG vaccine for those travelling abroad

If you are aged between 16 and 35 and you are travelling abroad to areas that have a high risk of Tuberculosis you should have the BCG vaccination. It should also be administered to people under the age of 16 if they will be living or working for longer than 3 months with local people in areas where the risk of contagion is high.

Countries to be considered high risk include:

  • Africa-especially sub Saharan Africa (all countries south of the Sahara desert) and Western Africa, including Nigeria and South Africa
  • Asia (Southeast)-countries including Bangladesh, India, Indonesia and Pakistan
  • China
  • Pacific region (Western) – including Cambodia and Vietnam
  • Russia
  • South America

People who should not have the BSG vaccination

There are some people who should avoid having the BSG vaccination. If you are in one of these groups and you expect to be in a risk situation, you should consult your GP. These groups include:

  • Those who have already had a BCG vaccination
  • Anyone with a Tuberculosis history
  • Anyone with a positive Mantoux test
  • Anyone with an allergy to any of the vaccine’s ingredients
  • Newborn babies living in a household where Tuberculosis is present
  • Anyone who has had another vaccination within the 3 weeks before their BCG vaccination is administered
  • Anyone with a compromised immune system
  • Anyone with white blood cell. marrow or lymph node cancer
  • Pregnant women