|Mode of transmission||Inhalation of airborne droplets produced by people with pulmonary or laryngeal tuberculosis (TB). |
People with latent TB infection and non-pulmonary TB disease are not infectious.
|Incubation period||Between 2 and 10 weeks from infection to primary lesion or significant tuberculin skin test (Mantoux) reaction.|
|Period of communicability||May be years with untreated pulmonary TB. |
Refer to the Guidelines for Tuberculosis Control in New Zealand 20101 (or current edition).
|Burden of disease||Disseminated and meningeal TB are more common in very young children. |
The immunosuppressed, particularly HIV-infected individuals, are more at risk of disease and complications.
The New Zealand burden is seen in foreign-born residents and those in low socioeconomic groups.
|Vaccine||BCG vaccine an only be administered by an authorised vaccinator with BCG endorsement. |
Live attenuated vaccine, which must be reconstituted.
At the time of writing, BCG supply to New Zealand was interrupted by a global shortage.
|Recommendations||Neonatal BCG vaccine should be offered to infants at increased risk of TB, deﬁned as those who: |
|Contraindications||Immunosuppression for any reason, or suspected of being immunocompromised. |
HIV-positive or potentially HIV-positive individuals.
Infants of mothers taking anti-tumour necrosis factor (anti-TNF) therapies (eg, infliximab) during pregnancy.
Positive tuberculin skin test or interferon gamma release assay (IGRA).
Generalised infected skin conditions.
|Expected responses||90–95% of people develop a local reaction, which may scar within 3 months. |
A minor degree of adenitis is normal, not a complication.
Suppurative adenitis may take months to resolve; usually no treatment is required.