Information on Tuberculosis

Since 1993, tuberculosis (TB) case rates have been declining in both New York State and the United States. While the decrease in TB is encouraging, TB is still a concern. Here are some common questions about TB. If you have more questions after you read this, talk to your health care provider or contact your local health department.

What is Tuberculosis?

TB is caused by a bacteria that usually affects the lungs (pulmonary), but other parts of the body can also be affected. A person can have TB infection but not have TB disease. Approximately 10% of all people with TB infection go on to develop active TB disease. Certain conditions can increase the risk of becoming sick with TB disease.

What is the Difference Between Latent TB Infection (LTBI) and TB Disease?

People with latent TB infection test positive on their TB skin or blood test but they are NOT sick and they can NOT spread TB to anyone else. You cannot get TB from a person with LTBI.

People with active TB disease are sick and usually have symptoms. Only people sick with active TB disease in the lungs or throat can spread TB to others.

How is Tuberculosis Spread?

TB is spread in the air when a person who is sick with active TB disease in the lungs or throat coughs, sneezes, sings, or speaks. The closer and longer you are near someone with active TB disease, the higher your chances of becoming infected. Brief exposure is less risky; it usually takes close contact over a period of days to become infected. TB cannot be spread by touching items like utensils, dishes, or doorknobs that have been handled by someone with TB disease.

Who Gets TB Infection?

Anyone at any age can become infected with tuberculosis. Some people at higher risk include:

  • Close contacts of people with active TB disease;
  • Foreign-born people from countries with high rates of TB;
  • Residents and employees of high-risk congregate settings such as prisons, jails, nursing homes, and shelters; and
  • Health care workers who care for high-risk patients.

What is the Test for TB Infection?

Tests used to detect TB infection are the Mantoux Tuberculin Skin Test or a TB blood test known as an Interferon Gamma Release Assay. A positive test means that the person has been infected with TB – this is known as latent tuberculosis infection (LTBI). More tests are needed to see if the person has active TB disease. People with LTBI have no symptoms and cannot spread TB to others.

If Infected, Who is Most Likely to Develop TB Disease?

  • People who don't have a regular medical provider;
  • Persons who abuse drugs or alcohol;
  • Children under the age of 5 years; and
  • People whose resistance is low due to HIV infection, diabetes, some cancers, chemotherapy, organ transplants, prior TB, poor nutrition, some stomach surgeries, and some medications such as prednisone or certain drugs for Rheumatoid arthritis.

All people at risk for TB should be tested for HIV. The HIV test is available through health care providers and local health departments.

What Are the Symptoms of TB Disease?

Symptoms of TB disease include fever, night sweats, tiredness, decreased appetite, weight loss, chest pain, a persistent, productive cough, and sometimes, coughing up blood. TB disease can occur in other parts of the body and show different symptoms, depending on the site.

What is the Treatment for TB?

Persons with latent TB infection can take treatment, usually for 9 months, to prevent developing active disease. People with active TB disease are given several medications for six months or more.

Directly Observed Therapy (DOT) Programs are recommended for all TB patients with active disease to help them complete their treatment. For more information on this free program, contact your local health department.

What is MDR or XDR TB?

A few patients with TB disease do not respond to the standard medications. This is called multidrug-resistant TB (MDR TB) or, a more extreme form, called extensively drug-resistant TB (XDR TB). This type of TB, most of the time, develops as result of not taking TB medications as directed by health care providers. It can also be caught from others with MDR or XDR TB. Treatment for this type of TB can take several years.

Prevention in Health Care Facilities:

Health care workers in both inpatient and outpatient settings should be aware of the risk of TB in their patients. Health care workers should:

  • Be screened for TB;
  • Be trained to recognize the signs and symptoms of active TB disease;
  • Observe infection control procedures;
  • Follow workplace policies and procedures to ensure that patients with active TB disease are placed in appropriate isolation rooms until TB has been ruled out or the patient has received adequate treatment;
  • Report patients with active TB disease or suspected of having active TB disease to the local health department within 24 hours.

Early identification, prompt isolation, and appropriate evaluation and treatment of TB suspects/cases is key to preventing the spread of tuberculosis.