Tuberculosis among immigrants in Britain. Memorandum from the Joint Tuberculosis Committee.

Tuberculosis is much commoner among immigrants to Britain than among the native-born. In 1971, 5% of the population were immigrants yet they accounted for 32% of tuberculosis cases. The notification rate among immigrants is falling in some areas but rising in others, and many immigrants are still arriving in Britain. Most immigrants arrive at London Airport, and as many as possible are x=rayed there with the resources available; Many cases escape detection, however, and it is therefore important that accurate information about all immigrants is sent to the medical officer for environmental health at their destination. New arrivals should then be sought out, tuberculin-tested, and positive reactors x-rayed. All those who are tuberculin-negative should be vaccinated with BCG whatever their age. Positive reactors should undergo annual radiography and be encouraged to report symptoms early. For both new and established immigrants with strongly positive tuberculin reactions chemoprophylaxis is suggested. All children of immigrants should be given BCG at birth and tuberculin-tested when they start school so that omissions can be rectified. Implementation of these recommendations could contribute considerably to the control of tuberculosis in Britain.