Tuberculosis (TB)

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What is tuberculosis?

Tuberculosis (TB) is a disease caused by TB bacteria that are spread from person to person through the air. TB usually affects the lungs, but can affect lymph nodes, bones, joints, and other parts of the body.

What are the symptoms?

General symptoms of TB disease include fever, night sweats, weight loss and tiredness. Symptoms of TB disease in the lungs also include coughing, coughing up blood, and chest pain. Symptoms of TB disease in other parts of the body depend on what area is affected. Some people with TB disease have no symptoms.

Who gets tuberculosis?

Tuberculosis can infect anyone. People infected with the HIV virus, AIDS patients, persons with weakened immune symptoms, young children and the elderly are at increased risk of developing active TB disease. Other medical risks include: diabetes mellitus, prolonged corticosteroid therapy or other immunosuppressive therapy, cancer, silicosis and being 10 percent or more below ideal body weight.

How is it spread?

TB is spread from person to person through the air. When a person with active TB disease of the lungs or throat coughs or sneezes the TB bacteria may get into the air and be breathed in by others. Prolonged exposure is normally necessary for infection to occur. If infection does occur the exposed person will most likely have a latent TB infection (LTBI), in rare cases the exposed person may quickly develop active disease after being infected.

What is the difference between latent TB infection and active TB disease?

Latent TB infection may result after being exposed to a person who has infectious TB disease in the lungs or throat. A person with LTBI does not feel sick or have symptoms of TB. They cannot spread TB to others. Latent TB infection may last a lifetime without developing into active TB disease. However, without preventive treatment, LTBI may develop into active TB at a later date.

Active TB disease is normally characterized by the appearance of TB symptoms. A person with active TB disease of the lungs or throat may be capable of infecting others. Medications are given to the person to treat TB disease.

What should I do if I have been around a person with active or latent tuberculosis?

A person with LTBI is not contagious and cannot infect others. You do not need to be tested for TB if you have spent time with someone with LTBI. However, people with active TB disease in the lungs or throat may be infectious. People with infectious TB are most likely to infect people they spend time with everyday, such as family members or coworkers. If you have been around someone with active TB disease in the lungs or throat, you should contact your local health department (http://www.doh.wa.gov/cfh/TB/abouttb/testing.htm) for more information on when, how, and where to get tested for TB.

What is the treatment for LTBI and active TB disease?

If you have LTBI but not TB disease, your physician may want you to take medication to prevent you from developing TB disease. People with LTBI should be evaluated to determine the need for preventive therapy based on their individual risk of developing TB disease and other medical conditions. The exact preventive therapy treatment plan must be determined by a physician but normally involves taking medication for several months.

If you have active TB disease you must complete a course of curative therapy. Treatment consists of taking several drugs exactly as prescribed by a physician. Treatment is normally done in two phases; an initial phase, usually lasting about two-months, and a continuation phase lasting four-months or longer. Along with taking medications the physician may also perform follow-up laboratory tests to monitor treatment effectiveness. It is important for people being treated for active TB to take all of their medication as prescribed to prevent themselves from getting sick again or developing TB that is resistant to medication. Often time’s, healthcare workers watch patients take their medications. This is called directly observed therapy (DOT). DOT helps the patient complete treatment and helps reduce complications associated with treatment.

How common is it in Washington?

In 2010, Washington State reported 236 cases of tuberculosis for a case rate of 3.5 per 100,000 persons. Only 7 of the 39 counties had 5 or more cases of TB. King County accounted for 114 cases (48%) of the 236 cases (incidence rate of 6.0 per 100,000).

A Glance at Tuberculosis in Washington - World TB Day: March 24, 2011 (105KB PDF)

What is multiple drug resistant tuberculosis?

When patients fail to take TB medications as prescribed, the bacteria can become resistant to treatment. People exposed to a case of drug-resistant TB, especially if they have a weakened immune system, are at high risk for multiple drug resistant tuberculosis. How common is multiple drug resistant tuberculosis? Although this is a serious threat that is causing problems in other parts of the nation and the world, it is not a major problem in Washington.

What is the treatment for multiple drug resistant tuberculosis?

Advice from a TB specialist is necessary when treating drug resistant TB. It is unknown whether preventive therapy can prevent the development of active TB disease in people who are infected with drug-resistant TB strains.

What can be done to prevent the spread of tuberculosis?

The most important way to stop the spread of tuberculosis is to cover the mouth and nose when coughing, and to take all TB medicine exactly as prescribed by a physician. Educating TB patients, providing adequate treatment for people with drug-resistant TB and providing directly observed administration of anti tuberculosis medications is valuable in preventing the further spread of the disease as well.

Where can I get more information?

Email the Tuberculosis program at tbservices@doh.wa.gov, or call us at 360-236-3443.

Testing

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