Screening children from overseas for infections: is it justified?

OBJECTIVES To investigate current practice of screening children from abroad for infections after coming to the United Kingdom, and to make recommendations for future practice. DESIGN A review of literature and a questionnaire sent to all health authorities and boards in the United Kingdom. SETTING All health authorities and boards in the United Kingdom. SUBJECTS 167 Health authorities or boards that completed questionnaires (response rate 80%), 59 of which used a screening programme. MAIN OUTCOME MEASURE Response to questionnaire on policies for screening children for infections on their return from overseas. RESULTS 12 Of the 59 authorities screened all children and one screened only those from the West Indian subcontinent. 13 Authorities excluded children from school while awaiting results; 58 screened for tuberculosis and four for diphtheria. CONCLUSIONS There is a wide variation in screening policies around the country with no national consensus. Screening for diphtheria, typhoid, and salmonellosis is hard to justify and is probably not effective. Screening for tuberculosis, however, is supported by many authorities, is widely practised, and probably is effective. There is a strong case for rationalisation of screening.