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Has My Daughter Developed TB?

The BCG (Bacillus Calmette-Guerin) vaccine is made from a treated (attenuated) live strain of bacterium derived from Mycobacterium bovis, a bacterium which typically causes tuberculosis (TB) in cattle but can infect humans.

The vaccine was introduced by Calmet and Guerin in France in 1921. It was originally given by mouth but was not successful. It was not until 1927 when Wallgren introduced injectable BCG vaccinations in Sweden that it became a striking success in the fight against TB.

In the UK the BCG vaccine is routinely offered to all children between 12 and 14 years of age - just as your daughter has been offered. Some children will already be immune to TB, either following earlier infection with TB (such infection can be with a milder strain of TB and pass unnoticed), or following previous vaccination, for example as a baby if living in a high risk area or under a different country's immunisation schedule.

A few children may have active TB infection. When a person has had TB infection or received the BCG vaccine he develops hypersensitivity to Mycobacterium tuberculosis, the bacterium which usually causes TB in humans.

Part of the immunisation procedure involve testing all children before giving them the BCG vaccine to see if they are already sensitised. This is the test which your daughter has just had. A protein called Tuberculin is extracted from the Mycobacterium tuberculosis and is highly purified.

A drop of the tuberculin is placed on the inner surface of your daughter's forearm. A sterile set of six tiny needles in a circle of 6mm is then pushed or fired from a spring loaded 'gun' into her skin over the tuberculin so as to penetrate her skin by 1 - 2mm depth.

This method is called the Heaf teat and is the one commonly used in this country as it is not painful and is quick and easy to perform in a standardised way. An alternative similar test sometimes used is called the Mantoux test.

Your daughter's arm is examined five to seven days later and the results are graded according to the strength of response. If there is no response the result is negative. If five or six individual puncture marks are seen or felt, the reaction is called Grade 1. Positive reactions are graded two to four and are a sign that she has already been sensitised to TB.

The redness on your daughter's arms is not usually caused by the Heaf test and does not give a definite guide as to whether she is immune to TB. It could be part of a hypersensitivity reaction to tuberculin in which case she would also have a positive Heaf test.

The redness could be caused by an allergy to one of the components of the tuberculin used in the Heaf test. This is quite rare. Alternatively the red reaction on her arms may have been caused by something entirely different such as a viral infection, an allergy for example to clothing or body lotions or an underlying condition such as eczema.

Your daughter's GP may be able to tell the cause of her rash, however it is likely that your daughter will also need to be examined by a doctor with a specialist interest in vaccinations or TB - this may be a paediatrician or a chest specialist. The immunization team who gave her the Heaf test will probably refer her automatically, alternatively her GP can refer her. The specialist can also decide whether or not she needs the BCG vaccine.

If your daughter's Heaf test is negative or Grade 1 she is not immune to TB and requires the BCG vaccination. This is given as an injection into the skin itself (an intra dermal injection). Within two to six weeks a small swelling appears at the injection site.

This turns into a raised lump or ulcer about 10mm across which heals in six to 12 weeks. She can put a dry dressing over the skin if it produces a discharge but she should allow air to get to the skin. Once the skin heals she will be left with a characteristic small round scar which is evidence of BCG vaccination for the rest of her life.

The specialist may find that she has a condition causing generalised skin infection or inflammation which means that she cannot receive the vaccine until her skin is clear as it relies on being injected into the skin. If she suffers with eczema the vaccine needs to be injected into a site on her body free from eczema.

If your daughter's Heaf test is positive she will not be given the BCG vaccination. She will be checked to see if she has any scars from previous BCG vaccination (although you do not mention she had earlier BCG vaccine). She will be referred to the local chest specialist who may do a chest X-ray and further tests to make sure she does not have active Tuberculosis. If these tests are clear it means that she is already immune to TB and will not need the vaccine.

Your daughter may ask about side effects of the BCG vaccine. Like any vaccine it can produce discomfort at the injection site in her arm and mild fever or malaise. Serious reactions with BCG are uncommon.

If there is a reaction at all it is usually a prolonged ulcer or abscess at the injection site. This can be a result of the injection having been given too deep, ie below the skin, instead of into the skin, which is why people giving the injection have to be skilled at performing it correctly.

Severe allergy (anaphylaxis) to BCG is very rare. It happens within minutes of receiving the vaccine and needs immediate treatment, usually with adrenalin which is always kept on site by the medical team giving the vaccine.

We recommend readers seek personal medical attention in appropriate circumstances.

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My Spouse Has Bad Credit. Will We Get A Mortgage?

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There are plenty of good reasons to buy a home these days. If you're still working remotely, you may have a more flexible job schedule, which will make it easier to scope out homes and deal with your mortgage application. Given that mortgage rates have climbed and home prices remain high, buying a home today is often a challenge.

But what if you're applying for a mortgage jointly with a spouse, and their credit score could use some work? Will you qualify for a mortgage if your credit score is strong, but your spouse's isn't?

When your spouse's credit score needs work

You might assume that if your credit score is great, but your spouse's isn't, mortgage lenders will just average your two scores and go with that number. But that's not really how it works.

Your strong credit could help compensate for a spouse's poor credit to some degree. But ultimately, lenders will fixate on the lower of the two scores if you're applying for a mortgage jointly.

Lenders often pull credit scores for both applicants from each of the three major bureaus. Then they use the "lower middle score."

Suppose your three credit scores are 787, 790, and 802. Your middle score is 790. Your spouse's credit scores are 608, 620, and 627.

Many lenders would base your mortgage eligibility on the lower middle score -- your partner's 620.

A 790 is an excellent credit score. But a 620 is usually the minimum credit score required for a mortgage, so in this scenario, you might get approved for a home loan without the most competitive interest rate on it.

On the other hand, if your score is a 790 but your spouse has a 540, that low score could potentially ruin your chances of getting approved for a mortgage, despite your great credit.

Should you apply for a mortgage solo if your spouse has bad credit?

When there's a huge gap between your (strong) credit score and your spouse's, one solution could be to apply for a mortgage on your own rather than apply jointly with your spouse. This will only work, though, if you earn enough money to cover your housing costs on your own.

In addition to credit scores, lenders will look at your income to see if it's high enough to qualify for the loan you're seeking. If your income isn't high enough to snag that mortgage, and you need your spouse's income factored into the equation, then you'll have to apply for that loan jointly. That's when your spouse's poor credit could be an issue.

Unfortunately, you can't have it both ways. You can't count your spouse's income on your application, but not their credit score.

How to help your spouse's credit improve

If you have a spouse whose credit needs work, it could pay to bring that number up and then apply for a home loan. First, have your spouse get a copy of their credit report to see what it looks like. If there are errors on that report that work against your spouse, correcting them could boost their score quickly.

Next, see why your spouse's score is so low. Is it because of a late payment history? Too much credit card debt? If there are delinquencies on your spouse's credit record, it could help to get current on those payments, and then pay on time from that point onward. Similarly, paying off a large chunk of existing debt could help your spouse's score improve.

In many cases, applying for a mortgage along with a spouse puts you at an advantage -- namely, you'll have two sets of income to present to lenders. But the flipside is that you'll both need good credit to snag an affordable mortgage rate. If your spouse's credit score is poor, it could prove problematic. Figure out a backup plan, whether it's applying for a mortgage on your own or taking steps to bring your spouse's score up quickly before submitting your application.

Still have questions?

Here are some other questions we've answered:

If you want to uncover more about the best mortgage lenders for low rates and fees, our experts have created a shortlist of the top mortgage companies. Some of our experts have even used these lenders themselves to cut their costs.

FAQs

Do lenders look at both spouses' credit scores when you apply for a mortgage?

If you're applying for a joint mortgage, lenders will consider both of your credit scores. Many will pull scores for both spouses from each of the three credit bureaus and use the middle score for the spouse with the lower scores. If only one spouse applies for the mortgage, only their credit scores will be considered.

Does your spouse's credit affect your credit score?

No. Your credit score is based on your individual credit history, not your spouse's. However, if you jointly apply for a mortgage or another type of loan, both of your credit scores will be considered.

How can you improve your credit score quickly?

Paying off a large amount of credit card debt helps you increase your score quickly because you lower your credit utilization ratio, or the overall amount of credit you're using. Paying off a loan has less impact because it doesn't affect credit utilization. Making on-time payments for credit cards and loans will help your score, but the impact is gradual. If you don't have open credit and can't get approved for a credit card, applying for a secured credit card can also help.

Does My Spouse Have Any Claim To My Gifted Or Inherited Assets In Our Divorce?

The answer to this question is: it depends.

In general, all assets in either party's name or in which either party has a beneficial interest at the time of the divorce are subject to division in the overall division of the marital estate. However, not all assets or beneficial interests are created equal.  Some assets may be subject to division between the spouses as part of the divorce, and some assets may stay with one spouse based upon the nature of that asset and how it was received and held. While there is no specific carve out in Massachusetts for gifted or inherited assets, a spouse can seek to exclude those assets by providing evidence supporting exclusion.

The Appeals Court's recent decision in Dylan Jones v. Juliana Jones, issued on September 6, 2023, provides further guidance on whether gifted assets received by a party during a marriage are appropriately excluded from the marital estate for purposes of equitable distribution. In that matter, after a long-term marriage of over 19 years, the wife's interest in an irrevocable trust established by her mother, a piece of real estate gifted to the wife by her mother, and a certificate of deposit gifted to her by her mother were all included in the marital estate for purposes of equitable distribution.

In the Jones matter, the wife's mother made a variety of financial gifts to the wife during the parties' marriage, including settling a trust for the wife's benefit, granting the wife a 99% interest in a limited liability company that held title to the marital home and a 1/3 interest in real property located in Michigan, and gifted substantial funds that were deposited into a certificate of deposit. Based upon the wife's mother's financial contributions, the parties were able to live a lifestyle they could not otherwise afford financially and only contributed minimally to retirement and educational accounts for the children… likely due to the wife's anticipated inheritance and significant gifts received during the marriage.

With respect to the trust, the Court in Jones found that the wife's interest was a "fixed and enforceable" property right properly includable in the marital estate, notwithstanding the fact that she had not received any distributions and her right to receive distributions was solely in the discretion of the trustee. The trust contained a provision for the wife to receive all of the monies free from the trust at her mother's death unless the trustee determined that she should not receive those monies due to circumstances existing at the time. The fact that the wife was the sole beneficiary of the trust and that she had the power to appoint the trust corpus to the beneficiaries of her will if she were to die before receiving the mandatory distribution weighed heavily in the Court's determination that the trust was part of the divisible marital estate. While interests in discretionary trusts are generally treated as too remote for inclusion in the marital estate (because the beneficiary must rely upon the trustee's exercise of discretion), because of the mandatory distribution clause of this trust (providing that the trustee shall pay to wife the corpus of the trust upon the wife's mother's death), the trustee did not actually have the power to divest the wife of her interest in the trust (such as by giving the monies to another beneficiary).  Further, the wife's right to receive the mandatory distribution was enforceable, making the wife's interest in the trust more than a mere expectancy that may otherwise keep the trust out of the marital estate.

With respect to the Michigan real estate, the Court found that Massachusetts law, not Michigan law, applied when determining how to divide this real estate. Whereas Michigan law provides that the gifted interest in the real estate is separate from the marital estate and not subject to distribution, Massachusetts law provides that the court may assign property owned by either spouse whenever or however acquired, including real property outside of Massachusetts. While the wife's interest in the Michigan real estate was gifted to her by her mother and kept separate from other marital assets, the Jones Court found that it was reasonable to conclude that the existence of the asset was woven into the fabric of the marriage and enabled a higher standard of living for the parties during the marriage.

The same was true with respect to the certificate of deposit. The Court found that the availability of gifts from the wife's mother allowed the parties to enjoy an otherwise unaffordable lifestyle and forgo saving for anticipated future expenditures such as college savings or retirement. The Court found that even if the parties did not have occasion during the marriage to draw upon the CD, it was reasonable to conclude that its existence was "woven into the fabric of the marriage," enabling a higher standard of living for both parties, deeming the asset "marital" for purposes of equitable division.

The moral of the story: whether a beneficial interest in a trust may be included in the marital estate requires a close examination of the particular trust instrument to determine whether the interest is a "fixed and enforceable" property right. For other gifted or inherited property (real, financial, or otherwise), whether the property is includable in the marital estate requires a close examination of whether its existence was "woven into the fabric of the marriage." Even if the asset was not used and kept separate from the marital estate, if it enabled a higher standard of living for the parties due to the existence of that asset, it may be deemed a divisible marital asset.  The Jones decision, coming after a long line of cases defining and curtailing a spouse's right to gifted or inherited assets of the other spouse, makes clear that gifted and inherited assets can be considered marital assets for purposes of equitable division of the marital estate. It is important to consult with a knowledgeable divorce attorney to determine whether a spouse has any entitlement to assets received during the marriage through gift or inheritance to the other spouse.

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