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Tuberculosis — SCE Infectious Diseases MCQ

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A 42-year-old man is diagnosed with smear-positive pulmonary TB. He lives with his partner and their 3-year-old child. What is the appropriate public health action regarding the child?

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Correct answer: B — Screen the child with Mantoux/IGRA and chest X-ray; consider chemoprophylaxis if IGRA negative but significant exposure

Contact tracing is mandatory for all close contacts of smear-positive pulmonary TB. Children under 5 are particularly vulnerable to rapid progression from infection to disease (including TB meningitis and miliary TB). The child should be assessed clinically, have a chest X-ray, and Mantoux/IGRA testing. If symptomatic or CXR abnormal, investigate for active TB. If asymptomatic with negative initial IGRA, Isoniazid chemoprophylaxis for 3 months followed by repeat IGRA (window prophylaxis) is recommended by NICE.

Reference: NICE NG33 2016 – TB; UKHSA 2023 – TB contact tracing guidance