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UK TB testing; justified or pointless nonsense?


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In another topic, following a question about obtaining a TB certificate for a UK settlement visa, the following posts appeared (edited for clarity and relevance to this topic):
 
durhamboy
Yes she will need a certificate that she is free from TB.......Personally I cannot really see the point of all this nonsense but there it is.

7by7
TB testing is not pointless nonsense.
 

How common is TB?
Before antibiotics were introduced, TB was a major health problem in the UK. Nowadays, the condition is much less common. However, in the last 20 years TB cases have gradually increased, particularly among ethnic minority communities who are originally from places where TB is more common.
Source

 
Hence the requirement for a TB certificate for immigrants from countries, like Thailand, where TB is more common.

I remember the days of mass chest X-rays in mobile units to test the population for TB. I remember the days of TB sanatoria. I remember the days of people dying of TB in the UK.

Does anyone really want a return to those days merely to save their partner the inconvenience of obtaining a TB certificate?

In addition, if they (your partner) do have it, wouldn't you want to find out sooner rather than later?


bobrussell
TB testing is not pointless and it can be argued that more people coming to the UK (and from more countries) should be tested, not less!

durhamboy
7by7 you are right TB is a dangerous disease - my grandmother died of it at the age of 35. I don't want to hijack this thread but imo the testing is a nonsense for a number of reasons. Please PM me if you want me to explain these reasons. Thanks.

As I feel that others may very well be interested in durhamboy's reasons, if he chooses to post them here, and also want to join in the debate I have started this topic.

So, what is your view on TB testing for settlement, and other long term visa, applicants?
 
Justified or pointless nonsense?
 

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"Thailand is one of the 22 TB high burden countries in the world. According to the WHO Global Tuberculosis Report 2012, Thailand, with a population of 70 million, had about 86,000 TB incident cases and 110,000 TB prevalent cases in past year. Case detection rate for all forms of TB was 76% and treatment success rate was 85% (in 2010)."

 

India has 2-3 million infected people.

 

World Health Organisation suggests the cost of treatment for drug sensitive TB is about US$2000 and drug resistant US$250000. I cannot find figures for how much a patient would cost to treat by the NHS.

 

Anything that reduces the number of cases in the UK must be considered a good thing. Undiagnosed infected people are a real threat. The argument should probably be whether more people visiting the UK should be screened, including visitors!

 

Screening is not 100% effective but if your partner was infected would you not want to know so proper treatment could be started? 

 

(My grandfather died from TB and an aunt was severely disabled by the effects of it!)

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It needs to be added that if TB were ever to become widespread in the UK again, the social stigma that was attached to the disease would return. Many years ago sufferers would deny having TB to acquaintances and the cause of death was often altered on the death certificate. When a stigma is attached to a disease, sufferers avoid taking the necessary action to cure themselves and prevent spreading it to others.

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I don't think that HIV is comparable to TB in this context.

 

It is true that you cannot catch TB merely from sitting next to a sufferer on a bus, you have to be in close proximity for prolonged periods for that; e.g. live with, work with.

 

But TB is still easier to catch than HIV; unless one is in the habit of having unsafe sex with multiple partners, sharing hypodermic needles etc.

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My father spent a year in a sanatorium in his teens and as a result both myself and my siblings were vaccinated when we were only toddlers, I think it is still a good idea to screen from high risk country's.

As a side note due to my family history and the wife being from Thailand we were offered and accepted BCG jabs for both our children before we took them home from the maternity ward.

With the current high prevalence levels in some parts of London this common practice for all parents. 

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I think the TB test is a nonsense for a number of reasons.

Detected TB is treatable by a simple course of antibiotics so the cost to the NHS is minimal compared to treatment of other illnesses which are not tested for.

So the real point about the TB test is not whether the applicant has it but will they pass it on to someone else in the UK.

TB is an airborne disease and is mostly spread in crowded, squalid and cramped conditions. Hence its prevalence in the UK a hundred years or so ago. There are currently about 9,000 cases of TB in the UK per annum. I would suggest that most of those cases were caught in places such as prisons, dormitory accommodation for the homeless and such like.

As part of the visa process the sponsor has to show that they have adequate accommodation for the applicant. Therefore it is highly unlikely to be in the sort of conditions whereby TB will be spread.

I would therefore suggest that since this test was introduced the number of UK residents saved from a transmission of TB from a Thai person is zero. Obviously difficult to prove this.

TB can be a dangerous and deadly disease if not treated. However there are far more deadly diseases in Thailand that are not tested for. Hepatitis C I think has about 10 times the rate of infection compared to TB in Thailand. It is infectious and can be deadly. So why is that not tested for?

If TB were such a threat to the UK from Thailand then surely tourists should be tested as well. Maybe the UK does not want to risk its tourist industry by imposing tests and greater costs on tourists or maybe the reality is that the risk of TB is actually minimal.

Cynical old me thinks that HMG thinking is "let's put another hoop in the long-term visa process to discourage immigrants."

The practicalities of the test are :-
1. There is only 1 test centre in the whole of Thailand that is accepted for a visa.
2. The test centre is in Bangkok so anyone living in places like Chiang Mai and Hat Yai face arduous journeys and hotel bills.
3. The test is normally simple but not always so. Sometimes the x-rays show shadows that could be TB but maybe not. In these cases extra tests and costs are needed to prove the applicant is negative. I think that can take about a week.
4. Basic cost for a simple negative test is THB3300 (c.£65) plus all the travel and hotel bills. Obviously this is in addition to all the other extortionate visa costs. More straws on the camel's back!

I could actually see a point in having a general medical check up for applicants by a qualified doctors with blood tests etc. I wouldn't necessarily agree with it but, in my opinion, that would make far more sense than testing for one single disease that, at the worst case scenario, is highly unlikely to affect anyone else.
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To the original post:

 

TB testing is not pointless. However, I am not sure to what extent it is being practised, are immigration rules for testing south Asia and eastern European countries being applied? If not it should be applied throughout incoming risk areas, as for risk areas, for those that will argue, follow your risk assessment.

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Anything that reduces the number of cases in the UK must be considered a good thing. Undiagnosed infected people are a real threat. The argument should probably be whether more people visiting the UK should be screened, including visitors!

 

I would not limit the exercise to the UK, but to answer the main points of the post, I entirely agree.

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HIV would be a much bigger problem as it is not curable (at the moment). This would mean a spouse could face permanent exclusion if visa rejection was linked to a positive test.

 

 

The extremes of contagion, one needs actual physical contact, the other needs proximity. If anyone were to suggest, and I am not for a moment inferring that you are, that anything but clear health can be paramount in justifying inclusion, then Heaven help the ones outside of a terrifying health regimen.

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It needs to be added that if TB were ever to become widespread in the UK again, the social stigma that was attached to the disease would return. Many years ago sufferers would deny having TB to acquaintances and the cause of death was often altered on the death certificate. When a stigma is attached to a disease, sufferers avoid taking the necessary action to cure themselves and prevent spreading it to others.

 

I would have to research this a bit more Briggsy, but when I was diagnosed with TB, it sent terror through my family in Ireland as they remembered the bad days of the 50's when it could be prevalent, but no stigma was attached to me. But as you say, if stigma is attached, it can only exacerbate the problem.
 

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It is true that you cannot catch TB merely from sitting next to a sufferer on a bus, you have to be in close proximity for prolonged periods for that; e.g. live with, work with.

 

It is true that you cannot catch TB merely from sitting next to a sufferer on a bus,
you have to be in close proximity for prolonged periods for that; e.g. live with, work with.

 


 

I have quoted two lines from the poster, just to say, yes you can catch TB from a person on the bus and no you don't have to have prolonged association with an infected workmate.

 

The best and logical assessment from the TB clinic I attended was that I had walked through a sneeze or a cough of an infected person, in a city in the UK, I was too long out of Thailand for it to be a contributing factor. ( and no other known associate had the the decease )

 

Just remember it is difficult to catch, contributions can be low immunity, being ill (possibly one and the same thing) or longer term association, it is an awful decease, don't let it escalate.

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Mossfinn,
 
I based my comment on Causes of Tuberculosis, but did misread it. It says " It would be highly unlikely to become infected by sitting next to an infected person on a bus or train." not that you cannot catch it by so doing.

Your experience obviously shows that it is possible to catch it from such an encounter.
 
The TB certificate requirement is part of the immigration rules and thus applied identically in all countries where a certificate is required.

Countries where you need a TB test to enter the UK

Edited by 7by7
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Mossfinn,
 
I based my comment on Causes of Tuberculosis, but did misread it. It says " It would be highly unlikely to become infected by sitting next to an infected person on a bus or train." not that you cannot catch it by so doing.

Your experience obviously shows that it is possible to catch it from such an encounter.
 
The TB certificate requirement is part of the immigration rules and thus applied identically in all countries where a certificate is required.

Countries where you need a TB test to enter the UK

 

Yes, trust me you can catch it with a chance encounter, but I must stress, it is a difficult decease to catch, nevertheless it still needs to be controlled.

 

I am pleased to see an extensive list of countries, more extensive than I thought.
 

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Durhamboy,

 

The point of TB testing is not to save NHS money treating an immigrant sufferer, it is to help stop the spread of TB in the UK.

 

As Mossfinn's experience shows, TB can be, and is, caught merely by breathing in microscopic droplets expelled by someone nearby sneezing.

 

You say that there are currently about 9000 cases a year in the UK; I would suggest that this is about 9000 to many! As you say, it is impossible to say how many, if indeed any, UK residents have ever caught TB from an immigrant. But testing as part of the application process is a sensible precaution.

 

Remember, it is not just Thai people who have to provide a certificate; it's people from all countries where TB is high risk; see the list linked to above.

 

To say that TB was prevalent in the UK "a hundred or so years ago" is rather misleading. Yes, it was prevalent then, but also prevalent within living memory. 

 

When I was at school, everyone had a BCG vaccination at around the age of 13/14. About 15 years ago, due to the large drop in TB cases in the UK, this routine vaccination ceased and now only those in high risk groups are vaccinated.

 

I used to work in the office of a large factory employing several 100 people. Once a year a mass X-ray unit visited so that those who wished could be X-rayed to check for TB.

 

I may be getting on a bit; but I've not reached 100 yet!

 

To compare TB with hepatitis C is like comparing TB to HIV. Like HIV, you cannot catch hepatitis C from someone unless you exchange bodily fluids with them; unprotected sex, sharing hypodermic needles etc..

 

There is an argument for testing tourists from high risk countries (not just Thailand!). But the practicalities of doing so are enormous. Also, as most visitors spend just a short time in the UK, at most 6 months, then the risk of their passing it onto someone whilst here is significantly lower than someone who comes to the UK for a longer period.

 

Remember, it is not just settlement applicants who require a certificate; it is all those applying to enter the UK for a period in excess of 6 months, regardless of the type of visa.

 

Having just the one test centre is inconvenient; but the government want to be as sure as they can that not only are the tests accurate, but that corruption is not involved. If any doctor or hospital could provide the certificate then there is a risk of corruption. In many of those countries on the list an envelope slipped under the table could easily produce the required certificate; and we all know this is, unfortunately, certainly possible in Thailand!

 

You'll see from the list that there are no approved test centres in some of the countries and that applicants there have to go to a neighbouring country fro their test. At least Thais don't have to do that.

 

I cannot understand your objection to additional tests if the X-ray shows a problem. If when your wife applied her X-ray showed a possibility that she may be infected, surely you would want to be sure so that, if necessary, she could get the required treatment as soon as possible?

 

Finally, TB testing is not new; it is testing as part of the visa application which is.

 

When my wife and step daughter applied for their settlement visas in 2000, a TB certificate was not required.

 

But, on arrival at Heathrow they were sent to the medical centre to be tested. We had to wait in a queue for nearly three hours!

 

Had a TB certificate been a prerequisite for a visa then, obtaining one in Bangkok would have been a lot more convenient, and a hell of a lot less frustrating, than that!

 

 

 

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Before starting this next post please remember that my original comments that kicked this whole thing off was the nonsense of TB testing for Thai settlement visa applications. I make no comment on the merits of testing other long-term visa applicants such as students.

In my first post above I said "I would therefore suggest that since this test was introduced the number of UK residents saved from a transmission of TB from a Thai person is zero. Obviously difficult to prove this."

Having done some further research the proving of this may be easier than I first thought.

http://data.worldbank.org/indicator/SH.TBS.INCD

The above table shows that Thailand has an incidence (in 2012) of 119 people infected in every 100,000 of population. Thailand's population is approx. 70 million. Therefore there is 1 case of TB for every 840 people in Thailand. (Calculation is 70,000,000 divided by 100,000 = 700 x 119 = 83300 divided back into the population = 840).

Ok let's look at the number of visas issued. I had some trouble getting these figures (the UKVI visa wait time report which is normally a good source is unavailable today!) so I'm using figures supplied by 7by7 for November 2013 in a previous post. In that month there were 118 settlement visa decisions made. Annualising this comes to 1,416 applicants.

Therefore the absolute maximum number of positive TB tests that the testing of IOM (the only test centre in Thailand) would have revealed is just 2. Actually 1.68 (1416 divided by 840). Even this figure is generous in the extreme because the number of applicants for settlement visas would include a significant number of children who are not tested.

So had these 2 cases not been tested and they had gone to the UK I think the risk of them infecting anyone is absolutely minimal. They wouldn't be living in a place like a Sally Army Doss House where the spread of TB really is dangerous. No, they will be living in adequate accommodation with a household income of a minimum of £18,600 p.a. Not the likely conditions for spreading TB.

Even when living in slum conditions the actual transmission rate is not high. As said, my grandmother died of TB but my grandfather and 3 children never got it even though they lived in, what we would call today, slum conditions.

Now if you guys really believe that TB is such a danger to the UK then you must consider the following :-

1. In November 2013 3,861 visit visas were issued. Annualised that is 46,332. Therefore, statistically, 55 would have had TB (46,332 divided by 840). Ok they may only stay a few months but it is a heck of a lot more than the 2 potential cases among the settlement applicants. So shouldn't they all be tested if you want to protect the UK?

2. Romania has an incidence level of TB nearly as high as Thailand - per the above table 94 cases per 100,000. The whole of Romania has the right to roll up at Dover and be allowed in indefinitely without any test. Is that right?

3. The test certificate that settlement applicants get from IOM is valid for 6 months and obtained BEFORE they apply for the visa. So the very next day (and in the following 6 months) they could catch TB and bring it to the UK. If the system were to implemented properly then the visa should be issued subject to them getting TB clearance a few days before they travel and the certificate shown to UKBA staff on arrival in the UK.

4. Did any of you when you started your relationship with your Thai beloved get them to have a TB test? Frankly I very much doubt it even though a few of you are saying here what a good thing it is know.

The truth about TB in the UK is that living conditions have changed radically in the last hundred years. In 1913 there were 36,500 deaths in the UK from TB compared to just 261 in 2012. Yes that is 261 too many as with all premature deaths. But do you think that any of those deaths were caused by settlement visa applicants from Thailand. Of course not!

Frankly the whole rationale for TB testing of settlement applicants from Thailand has more holes than a packet of polo mints!

I therefore stand by my original comments.

So 7by7 I believe that you recently told me that your sister-in-law is coming over from Thailand for a visit. Given your views on TB is it not your civic duty to get her to take a TB test before she comes? Over to you.
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1) You seem to think that Thailand is being singled out; it isn't. As you must have missed it before, here is the list of countries where one is required.
 
All countries which, according to WHO have a high incidence of TB.
 
Why should settlement applicants from those countries be exempt when students, workers, anyone else coming to the UK for more than 6 months isn't?

 

2) Despite the fears of Daily Mail readers, I doubt that the entire population of Romania is waiting for the chance to swarm into the UK. However, you do make a valid point.

 

Unfortunately, EEA Freedom of Movement regulations, which British citizens benefit from too, would preclude testing of EEA nationals.

3)I fail to see the logic in obtaining the certificate after the visa is issued. especially as no matter when the test is carried out, one theoretically catch it on walking out of the office.
 
But let's say it was done after the visa is issued.

 

Your wife applies, you pay the fee, wait anxiously for the result, get the result and the visa is issued.

 

Only to find when she goes for her TB test that she is infected and so can't use the visa.

 

How would you feel?
 
Better to find out before applying, surely? That way the person can be treated and then, once cured, apply for their visa.
 
As I said to you before, TB testing did exist before this certificate was required. But it was done at the port of entry to the UK.
 
Surely it's better to find out that one has TB before applying for the visa rather than on arrival in the UK only to be refused entry due to failing the test at the port of entry!

 

4. Are you saying that you would have ended the relationship with your now wife had you tested her and discovered she had TB or some other serious disease?

 

I hope not; I wouldn't have.

 

With most diseases, the earlier it is discovered, the easier it is to treat and the more effective that treatment is.

 

Which is better; discover your wife has TB at an early stage, or not finding out until she's coughing up blood?

 

Obviously the former; which is why the UK had the mass X-ray programme when TB was prevalent here.

 

5. As already said, and proven by Mossfin's misfortune, whilst you are more likely to catch TB in the living conditions you describe, you can still catch it from a stranger on the street, train, bus etc.

 

6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.

 

As for my 'civic duty' and my sister in laws visit; as I know for sure that she has been vaccinated against TB, then no.

 

But if the rules required visit visa applicants to obtain a certificate, she would.

 

7. I believe that the public health concerns outweigh the inconvenience to visa applicants; you obviously think the opposite.

Edited by 7by7
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6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.


Most Thai visitors to the UK are having unprotected sex with a UK citizen.
(not to mention some lesser STDs)
It would make more sense to test them for Hep C and HIV, than TB.
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Shouldn't anyone returning to UK from Thailand have to have a TB test?  UK citizens included?  Either you test everyone or no-one.  A UK national, having spent time here has just as much chance as a Thai of having TB.

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6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.


Most Thai visitors to the UK are having unprotected sex with a UK citizen.
(not to mention some lesser STDs)
It would make more sense to test them for Hep C and HIV, than TB.

 

 

Really?

 

As far as I'm aware, my step son didn't when he visited, neither did my sister in law nor our friend's elderly father and another friends two sons.

 

But that's only five; maybe you have more personal experience in this area than I.

 

Of course, many Thai visitors are in a relationship with, often married to, their UK sponsor. Their sex life is no concern of ours.

 

But most are simple tourists who are unconnected to any UK resident.

Edited by 7by7
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Shouldn't anyone returning to UK from Thailand have to have a TB test?  UK citizens included?  Either you test everyone or no-one.  A UK national, having spent time here has just as much chance as a Thai of having TB.

 

Valid point; but fraught with even more legal difficulties than testing EEA nationals.

 

British citizens have the unconditional right to enter the UK when and as often as they choose for as long as they choose.

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6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.


Most Thai visitors to the UK are having unprotected sex with a UK citizen.
(not to mention some lesser STDs)
It would make more sense to test them for Hep C and HIV, than TB.

 

 

"Most Thai visitors to the UK are having unprotected sex with a UK citizen."

 

Please substantiate...

 

Anyway most visitors to the UK are for visits of less than six months, TB is a terrible disease that  that we do not want to take hold again.

 

TB rates in the UK have stabilised at a high level in recent years, and the UK now has one of the highest incidence rates of any Western European country. Within the UK, TB is very unequally distributed, with certain sub-groups, such as new migrants, ethnic minority groups, and those with social risk factors disproportionally affected. Action is required to ensure that best practice in prevention, control and treatment is delivered to all communities across the country.

From:  www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317139689583

PDF:[attachment=276793:TB in the UK report 2013 version2.pdf]

 

This is why it is important that long term visitors should be screened for TB

 

As for screening for HIV and other STD's maybe but then there are other infectious diseases too.

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6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.

Most Thai visitors to the UK are having unprotected sex with a UK citizen.
(not to mention some lesser STDs)
It would make more sense to test them for Hep C and HIV, than TB.

Really are they?
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6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.

Most Thai visitors to the UK are having unprotected sex with a UK citizen.
(not to mention some lesser STDs)
It would make more sense to test them for Hep C and HIV, than TB.

Really are they?
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Shouldn't anyone returning to UK from Thailand have to have a TB test?  UK citizens included?  Either you test everyone or no-one.  A UK national, having spent time here has just as much chance as a Thai of having TB.

 

Valid point; but fraught with even more legal difficulties than testing EEA nationals.

 

British citizens have the unconditional right to enter the UK when and as often as they choose for as long as they choose.

 

 

If a Thai wife has TB, then her UK husband probably has it, so why bother ruling her out from coming to UK, when the most likely person she will infect is her husband who already has it?  Just more red tape & additional expense....

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1) You seem to think that Thailand is being singled out; it isn't. As you must have missed it before, here is the list of countries where one is required.
 
All countries which, according to WHO have a high incidence of TB.
 
Why should settlement applicants from those countries be exempt when students, workers, anyone else coming to the UK for more than 6 months isn't?
 
2) Despite the fears of Daily Mail readers, I doubt that the entire population of Romania is waiting for the chance to swarm into the UK. However, you do make a valid point.
 
Unfortunately, EEA Freedom of Movement regulations, which British citizens benefit from too, would preclude testing of EEA nationals.
3)I fail to see the logic in obtaining the certificate after the visa is issued. especially as no matter when the test is carried out, one theoretically catch it on walking out of the office.
 
But let's say it was done after the visa is issued.
 
Your wife applies, you pay the fee, wait anxiously for the result, get the result and the visa is issued.
 
Only to find when she goes for her TB test that she is infected and so can't use the visa.
 
How would you feel?
 
Better to find out before applying, surely? That way the person can be treated and then, once cured, apply for their visa.
 
As I said to you before, TB testing did exist before this certificate was required. But it was done at the port of entry to the UK.
 
Surely it's better to find out that one has TB before applying for the visa rather than on arrival in the UK only to be refused entry due to failing the test at the port of entry!
 
4. Are you saying that you would have ended the relationship with your now wife had you tested her and discovered she had TB or some other serious disease?
 
I hope not; I wouldn't have.
 
With most diseases, the earlier it is discovered, the easier it is to treat and the more effective that treatment is.
 
Which is better; discover your wife has TB at an early stage, or not finding out until she's coughing up blood?
 
Obviously the former; which is why the UK had the mass X-ray programme when TB was prevalent here.
 
5. As already said, and proven by Mossfin's misfortune, whilst you are more likely to catch TB in the living conditions you describe, you can still catch it from a stranger on the street, train, bus etc.
 
6. As I said before, the practicalities of testing every visit visa applicant are enormous, perhaps insurmountable. As I also said, due to the short time most visitors spend in the UK the risk of their passing the disease on is a lot lower than that of a long term entrant.
 
As for my 'civic duty' and my sister in laws visit; as I know for sure that she has been vaccinated against TB, then no.
 
But if the rules required visit visa applicants to obtain a certificate, she would.
 
7. I believe that the public health concerns outweigh the inconvenience to visa applicants; you obviously think the opposite.


1. You asked me to justify my remark with regard to Thailand. I have done this. Maybe there should be tests for people from other countries but, as you know, my comments were purely about the absurdity of testing Thai settlement visa applicants.

2. The fact is that many thousands have come from Romania without any testing. A lot tend to be economic migrants and they have a tendency to live in the sort of poor housing that makes the transmission of TB greater.

3. I was looking at it from the viewpoint that would make the TB test make more sense not what was good for me and my wife. Personally if we are going to have such a test I prefer the old way at a UK airport.

4. No. Where did you get the impression that I would have ended the relationship?

5. Yes you CAN catch it from a stranger on the street and possibly that did happen to Mossfin. One has to balance the chances of something happening with the resources available to prevent it.

6. Agreed that testing short term visitors is impractical but if you read my previous post statistically a lot more of them are infected and, as tourists, maybe moving around the country a lot more and possibly staying in cheaper more crowded accommodation. I accept that your sister-in-law has been vaccinated but would you have made her have a test if she hadn't been vaccinated?

7. Yes we must agree to disagree. So does that means that you do not accept my analysis in my previous post that no one has been infected in the UK from a Thai settlement visa applicant? If so, please explain what you do not agree with. Thanks.
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If a Thai wife has TB, then her UK husband probably has it, so why bother ruling her out from coming to UK, when the most likely person she will infect is her husband who already has it?  Just more red tape & additional expense....

 

 

Wrong...

 

If British husband of Thai wife was raised and attended school in the UK and is older than 22 years old he would have almost certainly had the BCG vaccine to protect him from catching TB, although this is only effective in 80% of the recipients, so the chances of contracting the disease is less than 20%.

 

Unfortunately the routine vaccination of school children stopped in 2005, furthermore we have many immigrants in the UK who never had the vaccine and it is these communities that TB is more common.

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