What Is Tuberculosis?
TB is short for tuberculosis. TB is a serious
disease that can cause a person to become very sick if not
treated with medicine. TB usually affects the lungs,
but it sometimes affects other parts of the body.
Are You Looking For a TB Skin
Testing Clinic in Thurston County?
The Thurston County
Public Health and Social Services no longer provide
Tuberculosis (TB) Skin Testing services.
For
clinics in our community that provides TB Skin Testing services,
see the list of clinics to the right of this page, or
Click Here...
Quick Search:
- A bad cough that lasts 3 weeks or longer
- Pain in the chest
- Coughing up blood or phlegm from deep inside the
lungs
- Weakness or feeling very tired
- Losing weight without trying
- Having no appetite
- Chills and fever
- Sweating at night or when you are sleeping
- TB is spread through the air from one person to
another. The TB germ are passed through the air
when someone who is sick with TB disease coughs, laughs,
sings, or sneezes.
If you breathe air that has TB germs, you may get TB
infection. This means you have only dormant
(sleeping) TB germs in your body. These dormant
germs are not making you sick, and you cannot pass these
germs to anyone else.
- If these dormant TB germs in your body wake up
and multiply, you will get sick with TB disease.
- TB can cause death if not treated with medicine.
To identify those who may have been exposed to M.
tuberculosis, health care providers typically inject a
substance called tuberculin under the skin of the
forearm. If a red welt forms around the injection site
within 72 hours, the person may have been infected. This
doesn't necessarily mean he or she has active disease.
People who may test positive on the tuberculin test
include:
- Most people with previous exposure to M.
tuberculosis.
- Some people exposed to bacteria related to M.
tuberculosis.
- Some people born outside the United States who were
vaccinated with the TB vaccine (see TB vaccine below)
used in other countries.
If people have an obvious reaction to the
skin test, other tests can help to show if
they have active TB. In making a diagnosis,
doctors rely on symptoms and other physical
signs, the person's history of exposure to
TB, and X-rays that may show evidence of M.
tuberculosis infection.
The health care provider also will take
sputum and other samples to see if the TB
bacteria will grow in the lab. If bacteria
are growing, this positive culture confirms
the diagnosis of TB. Because M. tuberculosis
grows very slowly, it can take 4 weeks to
confirm the diagnosis. An additional 2 to 3
weeks usually are needed to determine which
antibiotics to use to treat the disease.
With appropriate antibiotic treatment, TB can be cured in
most people.
Successful treatment of TB depends on close cooperation
between patient and healthcare provider. Treatment usually
combines several different antibiotic drugs that are given
for at least 6 months, sometimes for as long as 12 months.
Some people with TB do not get better with treatment because
their disease is caused by a TB strain that is resistant to
one or more of the standard TB drugs. If that happens, their
healthcare providers will prescribe different drugs and
increase the length of treatment.
The Importance of Finishing the TB Medicine
People who do not take all the required medicines can become
sick again and spread TB to others. Additionally, when
people do not take all the prescribed medicines or skip
times when they are supposed to take them, the TB bacteria
evolve to outwit the TB antibiotics. Soon those medicines no
longer work against the disease. If this happens, the person
now has drug-resistant TB.
Some people have disease that is resistant to two or more
drugs. This is called multidrug-resistant TB or MDR TB. This
form of TB is much more difficult to cure.
Treatment for MDR TB
Treatment for MDR TB often requires the use of special TB
drugs, all of which can produce serious side effects. People
with MDR TB may have to take several antibiotics, at least
three to which the bacteria still respond, every day for up
to 2 years. Even with this treatment, however, between four
and six out of ten patients with MDR TB will die, which is
the same rate seen with TB patients who are not treated.
TB is largely a preventable disease, and adequate
ventilation is the most important measure to prevent its
transmission in the community.
In the United States, healthcare providers try to identify
people infected with Mycobacterium tuberculosis (Mtb) as
early as possible, before they have developed active TB.
They will give infected people a medicine called isoniazid
(INH) to prevent active disease. This medicine is given
every day for 6 to 12 months. INH can cause hepatitis
(inflammation of the liver) in a small percentage of people,
especially those older than 35 years.
Hospitals and clinics take precautions to prevent the spread
of TB, which include using ultraviolet light to sterilize
the air, special filters, and special respirators and masks.
In hospitals, people with TB are isolated in special rooms
with controlled ventilation and airflow until they can no
longer spread TB bacteria.
TB Vaccine
In those parts of the world where the disease is common, the
World Health Organization recommends that infants receive a
vaccine called BCG (Bacille Calmette Guerin) made from a
live weakened bacterium related to Mtb. BCG vaccine prevents
Mtb from spreading within the body, thus preventing TB from
developing.
BCG has its drawbacks, however. It does not protect adults
very well against TB. In addition, BCG may interfere with
the TB skin test, showing a positive skin test reaction in
people who have received the vaccine. In countries where BCG
vaccine is used, the ability of the skin test to identify
people infected with Mtb is limited. Because of these
limitations, U.S. health experts do not recommend BCG for
general use in this country.
The World Health Organization (WHO) estimates 11.4
million people worldwide are infected with both
Mycobacterium tuberculosis (Mtb) and HIV. The primary cause
of death in those infected with body microbes is from TB,
not AIDS. In the United States, health experts estimate
about two out of ten people who have TB are also infected
with HIV.
One of the first signs that a person is infected with HIV
may be that he or she suddenly develops TB. This form of TB
often occurs in areas outside the lungs, particularly when
the person is in the later stages of AIDS.
It is much more likely for people infected with Mtb and HIV
to develop active TB than it is for someone that is only
infected with Mtb. Fortunately, TB disease can be prevented
and cured, even in people with HIV infection.
People infected with both MDR TB and HIV appear to have a
more rapid and deadly disease course than do those with MDR
TB only. If no medicines are available, as many as eight out
of ten people with both infections may die, often within
months of diagnosis.
Diagnosing TB in people with HIV infection is often
difficult. They frequently have disease symptoms similar to
those of TB and may not react to the standard TB skin test
because their immune systems do not work properly. X-rays,
sputum tests, and physical exams may also fail to show
evidence of Mtb infection in people infected with HIV
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