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Many people who have TB infection never develop TB disease. But some people who have TB infection are more likely to develop TB disease than others. These people are at high risk for TB disease. They include:
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Tuberculosis (TB), is a disease caused by bacteria caused by Mycobacterium tuberculosis. It is spread from person to person through the air. TB usually affects the lungs. TB can also affect other parts of the body, such as the brain, kidneys, or the spine.
TB bacteria become active if the immune system can’t stop them from growing. The active bacteria begin to multiply in the body and cause TB disease. Some people develop TB disease soon after becoming infected before their immune system can fight the TB bacteria. Other people may get sick later when their immune system becomes weak for some reason.
Babies and young children often have weak immune systems. People infected with HIV, the virus that causes AIDS, have very weak immune systems. Other people can have weak immune systems, too, especially people with any of these conditions:
Symptoms of TB depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs. TB in the lungs may cause:
Other symptoms of TB disease are:
TB is spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe in these bacteria and become infected.
The nurse will arrange for a chest x-ray and lab work. Persons with normal chest x-rays and no signs or symptoms of Tuberculosis will be scheduled for a Chest Clinic appointment at the Health Department. These persons are infected with tuberculosis but don’t have active disease. They have a latent infection and are not contagious. Chest clinics are held on the first and third Thursday of the month from 4 pm to 6 pm, by appointment only.
You will receive a physical assessment and be asked to provide a detailed history. View the assessment sheet (PDF). You will be tested for HIV which will impact your treatment plan. Translation services are available at this clinic. You will be placed on medication which will be provided without charge.
You will be given follow up appointments and will have lab work done prior to each appointment. There is no charge for the lab work.
Tuberculosis is a treatable disease and most people do very well when they receive proper treatment. TB is an infectious disease, so you may be isolated until you are no longer infectious-usually several weeks. Most people find out they have tuberculosis while in the hospital where they will be placed in a negative pressure room, in isolation. Sputum specimens will be collected. A nurse from the health department will visit you in the hospital, or in your home, to talk with you about Tuberculosis and your plan of care.
You will be asked to reveal the names of persons who you may have infected so that they can be tested and treated, as needed. You will take four different antibiotics to treat your tuberculosis. A nurse will come to your home 5 days a week to watch you take your medicines ( Directly Observed Therapy) and to assess how you are tolerating your medications.
Directly observed therapy (DOT) is a way that patients are administered their medication. Patients on DOT will meet with a health care worker every day or several times a week. They will meet at a mutually agreeable place. This can be tuberculosis (TB) clinic, at home or work, or any other convenient location.
DOT helps in several ways. The health care worker can help persons remember to take their medicine and complete their treatment. This means they will get well as soon as possible. With DOT, they may need to take medicine only 2 or 3 times each week instead of every day. The health care worker will make sure that the medicine is working as it should.
This person will also watch for side effects and answer questions you have about TB.
Even if a person is not getting DOT, they must be checked at different times to make sure everything is going well. They should see their doctor or nurse regularly while they are medicine. This will continue until they are cured.
When tuberculosis (TB) patients do not take their medicine as prescribed, the TB bacteria may become resistant to a certain drug. This means that the drug can no longer kill the bacteria. Drug resistance is more common in people who:
Sometimes the bacteria become resistant to more than one drug. This is called multidrug-resistant TB, or MDR TB. This is a very serious problem. People with MDR TB disease must be treated with special drugs. These drugs are not as good as the usual drugs for TB and they may cause more side effects.
Also, some people with MDR TB disease must see a TB expert who can closely observe their treatment to make sure it is working.
People who have spent time with someone sick with MDR TB disease can become infected with TB bacteria that are resistant to several drugs. If they have a positive skin test reaction, they may be given preventive therapy. This is very important for people who are at high risk of developing MDR TB diseases, such as children and HIV-infected people.
TB infection is detected by the administration of a tuberculin skin test on the arm. A single needle is used to put some testing material, called tuberculin, under the skin. In two or three days, a nurse or a doctor will check to see if there is a reaction to the test. The test is "positive" if a bump about the size of a pencil eraser or bigger appears on the arm. This bump means a person probably has a TB infection.
A chest X-ray is done to see if someone with a positive skin test (TB infection) also has TB disease.
People who are infected with TB do not feel sick, do not have any symptoms, have a normal chest X-ray, and cannot spread TB. However, they may develop TB disease at some time in the future. People with TB infection but are not yet sick can take medicine so that they will never develop TB disease.
A TB skin test is one way to detect TB infection. People can get skin tested at the health department or at their doctor’s office. Not everybody is at the same risk for TB infection and, therefore, does not to be tested. However, persons should get tuberculin skin tested if they:
If a person has a positive reaction to the skin test, a doctor or nurse may do other tests to see if TB disease is present. These tests usually include a chest x-ray and a test of the phlegm people cough up. Because the TB bacteria may be found somewhere besides the lungs, a doctor or nurse may check the blood or urine, or do other tests. Persons with TB disease need to take medicine to cure the disease.
If a person has recently spent time with someone with infectious TB, the skin test reaction may not be positive yet. The person may need a second skin test 8 to 10 weeks after the last time they spent time with the infectious person. This is because it can take several weeks after infection for one’s immune system to be able to react to the TB skin test. If the reaction to the second test is negative, the person probably does not have a TB infection.
Many people who have TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active and cause TB disease.
BCG is a vaccine for tuberculosis (TB). This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG vaccine does not always protect people from TB. Persons who were vaccinated with BCG may have a positive reaction to a TB skin test. This reaction may be due to the BCG vaccine itself or to a real TB infection.
But one’s positive reaction probably means that they have TB infection if:
A person can have a tuberculosis (TB) infection for years without any signs of disease. But if that person’s immune system gets weak, the infection can quickly turn into TB disease. Also, if a person who has a weak immune system spends time with someone with infectious TB, he or she may become infected with TB bacteria and quickly develop TB disease.
Because HIV infection weakens the immune system, people with TB infection and HIV infection are at very high risk of developing TB disease. All HIV-infected people should be given a TB skin test to find out if they have TB infection. If they have TB infection, they need preventive therapy as soon as possible to prevent them from developing TB disease. If they have TB disease, they must take medicine to cure the disease. TB disease can be prevented or cured in people with HIV infection.