Doctors at University Hospitals of Leicester NHS Trust think that a rapid access service for patients suspected of having tuberculosis (TB) might have helped reduce infection rates in Leicester, Leicestershire and Rutland.

The rapid access service was set up in 2005 as a joint project between local primary care trusts (PCTs) and local hospitals.

In 2005, there were 309 TB cases in Leicester, Leicestershire and Rutland – but since then, respiratory doctors and specialists in infectious diseases have seen an average of 250 cases per year.

The service works by targeting patients who appear to have early symptoms of TB. As soon as a patient is found to have signs of potentially active TB on a chest X-ray, they are fast-tracked to be seen and investigated as soon as possible. This alert system is now established across 10 radiology departments within the region.

Consultant respiratory physician Dr Gerrit Woltmann said:

‘Early detection is key because the quicker we can confirm it is TB, then the less chance there is of a patient passing it on to friends or family.

‘Treatment outcome is also likely to be better if treatment is started earlier – it is important for GPs to refer possible cases quickly and the rapid access system raises awareness of possible TB.’

Antibiotic treatment for TB takes six months or more – patients are monitored in their own home by a team of TB nurses who are managed by TB clinical nurse manager Helen Thuraisingam.

Ms Thuraisingam – who looks after a team of eight community TB nurses and three support workers – said:

‘They have been completely reorganised and developed over the last eight years. We have worked very hard at creating a partnership with the team of respiratory physicians and that has been the difference between making it work.’

Dr Woltmann added that preventative treatment was now used increasingly where signs of early infection were found on TB-specific blood tests – for example, after in cases of recent contact with the disease.

‘In the future, we would like to screen people who move to Leicester from countries where TB is common for signs of latent or active TB and we are looking at how we can do that,’ he said.

‘This could potentially have a huge impact on active case rates, as four out of five cases of TB in Leicester arises in people born in countries with high rates of the disease.’

TB is a potentially infectious disease which affects more than 8 million people worldwide each year – and more than 8,000 cases are diagnosed in the UK each year. It is estimated that one-third of the world population is infected with the latent form of the disease.

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