Minutes:
Asmat Nisa, Consultant in Public Health and Assistant Director, Public Health Directorate, NHS Berkshire East, outlined a presentation on Tuberculosis (TB) detailing the cause of the disease, the infection rate and ways in which it could be cured. The Panel was advised that TB could be cured through treatment and could be effectively controlled and prevented through the BCG immunisation. Ms Nisa advised that a multi-agency strategy group had been set up and within its strategic plan refresh the PCT had committed to prioritise TB under its ‘Staying Healthy’ programme. It was noted that the TB service had been enhanced through investment, the recruitment of additional staff, the provision of weekly BCG clinics and community outreach. Testing had been extended to cover new entrants and data collection had been improved using a local database.
The Panel noted the progress to date in preventing TB which included visiting hard to reach groups and the formalisation of the BCG pathway for neonates born in the area. It was also noted that provision had been made to screen contacts of all cases of TB to detect transmission of infection earlier and other measures including the creation of a new TB infection control policy for the Acute Trust. It was highlighted that the TB service was currently located at King Edward Hospital, Windsor but there were plans to have outreach clinics in Slough.
Members raised a number of questions / comments in the ensuing discussion. In response to a question regarding the success rate of treatment, the Panel was advised that patients were generally compliant with the medication given and that anyone over the age of thirty-five would not be required to have the BCG vaccination and the antibiotics would cure the infection. Ms Nisa explained the symptoms of TB and the ways in which close contacts with TB patients were managed. It was highlighted that there was no upward trend in the number of TB cases reported and that in Berkshire there were between fifty to seventy-five cases each year of which eighty percent were normally in Slough.
A Member asked how many patients were hospitalised each year due to TB and how many deaths occurred. He also asked for information about the use of KAT and spitting and was there any evidence that this caused the spread of TB. Ms Nisa advised that she did not have this information to hand but this would be forwarded to the Panel. In response to a further question she also advised that she would provide further detail on the strains of TB which were found in Slough.
Ms Nisa confirmed that the prevalence of houses in multi occupation were a causative link in the incidences of TB and there was also clearly a link with the number of migrants coming to Slough from countries where TB was endemic. The Trust was working with Slough BC to address this issue.
Ms Nisa discussed representation on the TB Strategy Group which included members from the Polish and other communities. In response to a further question it was confirmed that BCG immunisation in schools had stopped in 2004 but this was still given to newborn babies if they were at a high risk of TB. Also clinics were provided for children born elsewhere who had not previously received the BCG immunisation but the immunisation could only be given with the approval of parents.
Resolved- That the Panel thank Ms Nisa for her comprehensive presentation.