Identification of tuberculosis cases by port health screening in Essex 1997-2003.

Between 1997 and 2003 an annual average of 1867 new entrants seen at the port of arrival were notified to the communicable disease teams who now form the Essex Health Protection Unit. We examined the number of individuals who made contact with health services by linking port health and tuberculosis databases with combinations of surname, forename and date of birth the number of new entrants developing tuberculosis. We also searched paper records for all incidents of active tuberculosis in health and residential care workers. Eighteen individuals were in both port health and tuberculosis data sets; only one was identified by new entrant screening. In the same period there were 35 cases of active tuberculosis in health care workers, only one of whom had been screened on arrival in the United Kingdom, resulting in follow-up of 371 contacts. The new entrant screening programme in Essex should be stopped and resources diverted to improve followup of new entrants, especially those who are health care workers.