Control and prevention of tuberculosis: a code of practice.

The Joint Tuberculosis Committee has compiled a report that is designed to answer the questions most commonly asked about the control and prevention of tuberculosis. Advice is given on assessing the degree of infectivity and on the segregation of patients. The measures necessary to protect National Health Service workers depend on the risk of exposure, and health authorities should follow the advice given by the Department of Health and Social Security. Chest x ray examinations may be recommended for those entering the teaching profession and may be necessary for staff and children when tuberculosis is discovered in a school child. The diagnostic, protective, and therapeutic measures required for contacts depend on the degree of infectivity in the index case, the closeness of contact, and the ethnic group of the index case. The incidence of tuberculosis is much higher among some immigrant populations than among the native population and screening programmes are needed (a) to detect cases of active tuberculosis, (b) to identify infected individuals without active disease, and (c) to identify those in need of vaccination. Finally, the current recommendation that BCG vaccinations should be offered routinely in schools to children aged 10-14 has been highly effective in preventing tuberculosis and should be maintained.