Guidance

TB in farm animals algorithms: text versions

Updated 16 September 2026

Algorithm for TB in cattle

The Animal and Plant Health Agency (APHA) notifies the relevant UK Health Security Agency (UKHSA) health protection teams (HPTs) of tuberculosis (TB) in cattle, either by email or direct call.

The HPT then sends a standard ‘Inform and advise’ letter to the farmer whose premises are affected by the TB incident. The letter states that the farmer should contact the HPT if a child under 5, or anyone who is immunocompromised or in a risk group defined by NICE, has been exposed.

If the farmer contacts the HPT, proceed with the risk assessment.

Path 1: The HPT confirms that no child under 5, or individual who is immunocompromised or in a risk group defined by NICE, has been exposed.

No TB screening required.

Path 2: HPT confirms that a child under 5, or an individual who is immunocompromised or in a risk group defined by NICE has been exposed.

Beef herd:

Is there evidence of highly infectious disease in any animal, such as lung lesions, intense or unusual transmission?

If NO, TB screening is not required.

If YES, TB screening is required, and the following actions are taken:

• refer individuals to local NHS TB service for screening
• copy letter to GP
• TB service will provide screening result to UKHSA

Dairy herd:

Is there evidence of udder lesions in any animal, or evidence of milk-borne spread in the herd? And if so, was unpasteurised milk (or milk products) consumed?

Or:

Is there evidence of highly infectious disease in any animal, such as lung lesions, intense or unusual transmission?

If NO, TB screening is not required.

If YES, TB screening is required and the following actions should be taken:

• refer individuals to local NHS TB service for screening
• copy letter to GP
• TB service will provide screening result to UKHSA

Algorithm for TB in camelids, other non-bovine farm animals and pets

APHA or the National Mycobacterial Reference Service notifies the relevant UKHSA HPT of TB disease in an animal.

The HPT then obtains animal history from APHA including:

• how long was the animal sick?
• nature of TB in affected animal - cutaneous TB, pulmonary TB or other?

The HPT then assesses the need for follow-up of exposed persons at premises or household (if pet) and considers who else might need risk assessment (others with close contact with the animal while it was sick, for example the vet, frequent visitors?)

Questions for risk assessment of exposed persons should include:

• was there close, prolonged and frequent contact with the affected animal?
• was there contact with wounds or abscesses, or was the animal coughing or spitting?
• has any child under 5 years been in close contact?
• is anyone in close contact immunocompromised or in a risk group as defined above under ‘Risk factors’?

Path 1: YES to any of the risk assessment questions

• consider referral for TB screening
• send ‘Inform and advise’ letter to at risk persons letting them know they are being referred
• refer to local NHS TB service for screening
• screening results provided by TB service to UKHSA
• results of risk assessment and screening to be passed to UKHSA National TB Unit at Tbunit@ukhsa.gov.uk

Path 2: NO to all the risk assessment questions

• assess as negligible risk
• UKHSA to provide a standard ‘Inform and advise’ letter
• results of risk assessment and screening to be passed to UKHSA National TB Unit at Tbunit@ukhsa.gov.uk