Tuberculosis

TB, or tuberculosis, is a disease caused by bacteria called Mycobacterium tuberculosis. The bacteria can attack any part of your body, but they usually attack the lungs. TB disease was once the leading cause of death in the United States.

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.

People with TB disease can be treated and cured if they seek medical help. Even better, people who have TB infection but are not yet sick can take medicine so that they will never develop TB disease.

TB in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious. People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and co-workers.

It is possible and very common to be infected with TB and not have TB disease. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called TB infection. People with TB infection

• have no symptoms

• don't feel sick

• can't spread TB to others

• usually have a positive skin test reaction

• can develop TB disease later in life if they do not receive preventive therapy

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.

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.

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

• a bad cough that lasts longer than 2 weeks

• pain in the chest

• coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of TB disease are

• weakness or fatigue

• weight loss

• no appetite

• chills

• fever

• sweating at night

A TB skin test is the only way to find out if you have TB infection. You can get a skin test at the health department or at your doctor's office. You should get tested for TB if

• you have spent time with a person with infectious TB

• you have HIV infection or another condition that puts you at high risk for TB disease

• you think you might have TB disease

• you are from a country where TB disease is very common (most countries in Latin America and the Caribbean, Africa, and Asia, except for Japan)

• you inject drugs

• you live somewhere in the U.S. where TB disease is common (most homeless shelters, migrant farm camps, prisons and jails, and some nursing homes)

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

• people with HIV infection

• people in close contact with a person who has infectious TB

• people who became infected with TB bacteria in the last 2 years

• babies and young children

• people who inject drugs

• people who are sick with other diseases that weaken the immune system

• elderly people

If you have TB infection (a positive skin test reaction) and you are in one of these high-risk groups, you need to take medicine to keep from developing TB disease. This kind of treatment is called preventive therapy. Also, if you are younger than 35 and you have TB infection, you may benefit from preventive therapy even if you are not in a high-risk group.

There is good news for people with TB disease! TB disease can almost always be cured with medicine. But the medicine must be taken as the doctor or nurse tells you.

If you have TB disease, you will need to take several different drugs. This is because there are many bacteria to be killed. Taking several drugs will do a better job of killing all of the bacteria and preventing them from becoming resistant to the drugs.

If you have TB of the lungs or throat, you are probably infectious. You need to stay home from work or school so that you don't spread TB bacteria to other people. After taking your medicine for a few weeks, you will feel better and you may no longer be infectious to others. Your doctor or nurse will tell you when you can return to work or school.

Having TB should not stop you from leading a normal life. When you are no longer infectious or feeling sick, you can do the same things you did before you had TB. The medicine that you are taking should not affect your strength, sexual function, or ability to work. If you take your medicine as your doctor or nurse tells you, the medicine will kill all the TB bacteria. This will keep you from becoming sick again.

The most important way to keep from spreading TB is to take all your medicine, exactly as told by your doctor or nurse. You should also keep all of your clinic appointments! Your doctor or nurse needs to see how you are doing. You may need another chest x-ray or a test of the sputum you may cough up. These tests will show whether the medicine is working. They will also show whether you can still give TB bacteria to others. Be sure to tell the doctor about anything you think is wrong.

If you are infectious while you are at home, there are certain things you can do to protect yourself and others near you. Your doctor may tell you to follow these guidelines to protect yourself and others:

• The most important thing is to take your medicine.

• Always cover your mouth with a tissue when you cough, sneeze, or laugh. Put the tissue in a closed paper sack and throw it away.

• Do not go to work or school. Separate yourself from others and avoid close contact with anyone. Sleep in a bedroom away from other family members.

Remember, TB is spread through the air. People cannot get infected with TB bacteria through handshakes, sitting on toilet seats, or sharing dishes and utensils with someone who has TB.

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