What Everyone Should Know (PDF)
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Learn About Tuberculosis
TB is a disease that can damage a person's lungs or other parts of the body and can cause serious illness. People of all ages, all nationalities, and all incomes can get tuberculosis (TB). In almost all instances, with modern medicine tuberculosis can be cured.
How is TB spread?
Tuberculosis (TB) is a serious disease caused by bacteria. It is spread from person to person through the air, and usually affects the lungs. When a person who is sick with TB coughs, sneezes, or speaks, they put TB germs in the air. Other people may breathe in the TB germs, and some may become sick.
Brief contact with people who are sick with TB (such as on trains or buses) is unlikely to give a person TB. TB is not spread by shaking hands, sharing food or having sex.
People usually get TB germs in their bodies only when they spend a long time around someone who is sick with TB — for example, if they live or work with someone with TB every day.
Most people do not know they have TB until they become sick. That is why it is a good idea for people at high risk for TB to get tested. With proper care and treatment, TB can be prevented and cured.
How the Body Fights TB
People usually get TB germs in their bodies only when they spend a long time around someone who is sick with TB. Even then, the body can usually fight off the germs.
Most people who breathe in TB germs do not get sick. When a person’s immune system is strong, it builds a wall around the germs so they cannot spread and hurt the body. These walls are called tubercles — that is how tuberculosis gets its name. Once the germs are trapped inside the tubercles, they slow down and stop activity, as if they went to sleep. This is called TB infection or latent (sleeping) TB.
As long as the immune system stays strong, people with TB infection do not feel sick, and they cannot spread their TB germs to others. However, if the immune system becomes weak, people with TB infection can become sick. The TB germs wake up and begin to spread. That is why many people with TB infection take medicine to kill the TB germs.
If you have TB infection, your health care provider will tell you if you need to take medicine.
Active TB Disease
When a person cannot fight TB germs, they become sick. The TB germs multiply and do a lot of damage to the body. This is called active TB disease. People with active TB usually have symptoms:
Coughing for more than 3 weeks
Heavy sweating at night
Feeling tired all the time
Loss of appetite
People with active TB must take medicine to kill the germs and prevent damage to the lungs and other parts of the body, including the brain, spine and kidneys. Until they take medicine, people with active TB in their lungs are contagious. They can spread the disease to others when they speak, cough or sneeze.
To get well and protect others from getting the TB germs, people with active TB must take medicine. If they do not, they will not get well. They may even die.
TB medicine has to be taken for several months to work. People with active TB feel better once they start taking medicine — symptoms usually go away quickly. The TB germs may come back, though, if a person does not take their medicine long enough. If this happens, the TB germs may be stronger and much harder to kill.
If you have active TB, your health care provider will tell you what medicines you need to take, and how long to take them. You have to take TB medicine until you are cured — usually 4-9 months. Only your health care provider can tell you when it is safe to stop taking medicine.
What If I Have Spent a Lot of Time Around Someone With Active TB?
Ask your doctor or other health care provider for a TB test. Sometimes people do not know they have been exposed to active TB until the Health Department tells them. If this happens to you, do not worry. The Health Department will explain how to get tested. You can go to your own provider, or visit a Chest Center for free.
Learn About Testing
Some people are at higher risk for getting TB. These people should get tested.
People who have spent a long time around people with active TB
- Family members, friends and co-workers of people with active TB
- People who have recently immigrated to the US from countries with a lot of TB
- People who have recently spent more than 1 month in a country with a lot of TB
- People who have worked or stayed in hospitals, prisons, homeless shelters or nursing homes
People with certain medical conditions
- People with weak immune systems, especially those with HIV infection, or very young children
- People with diabetes, chronic kidney failure, some cancers or other medical conditions
- People who are injection drug users
- People who have received an organ transplant
- People who take certain medicines that suppress the immune system, such as chemotherapy for cancer, steroids, or TNF-alpha blockers
- People who have a chest X-ray with evidence of old TB disease
Two Ways to Test for TB
There are two tests for TB — a skin test and a blood test. Your health care provider will talk to you about the tests and choose the right one for you.
The Skin Test
When you get a TB skin test, your doctor or other health care provider will use a small needle to put a few drops of test solution under your skin. You will be asked to return after 2-3 days. Your health care provider will examine the test site and give you the results.
The Blood Test
When you get a TB blood test, your health care provider will collect a small sample of your blood. The blood sample will be sent to a laboratory and tested for TB. Your provider will give you the test results in 2-3 days.
What TB Test Results Mean
A negative test result usually means you do not have TB germs in your body. Sometimes, the test may not work if the TB germs are new in your body, or if your immune system is weak (for example, if you have HIV). In this case, you may need a chest X-ray. Your health care provider will use the test results as part of a complete medical exam to determine if you have TB germs in your body.
A positive test result usually means you have TB germs in your body. However, it does not always mean you have active TB disease. Your health care provider will use other tests, such as a chest X-ray or sputum cultures (a test on mucus coughed up from your lungs), to look for signs of active TB.
Taking Medicine for TB Infection
Not everyone with TB infection needs to take medicine. People with TB infection who are more likely to get sick usually take medicine to kill TB germs and prevent active TB. These people include:
People who have had TB infection for only a short time
People whose TB test changed from negative to positive recently (within the past 2 years)
People who have recently spent a long time around someone who has active TB
People who have recently immigrated to the US from countries with a lot of TB
People with TB infection who have certain medical conditions
Your doctor will recommend a treatment that is right for you, based on your individual health needs and a complete medical exam. TB infection is usually treated with 1 medicine for 4-9 months.
Having HIV Makes It Easier to Get TB
Do you know your HIV status? Everyone should! Because HIV weakens the immune system, it makes it easier for a person to get TB. Get tested for HIV. It is important for your health.
In many parts of the world, TB is the #1 cause of death in persons with HIV. If a person with HIV gets TB, the two diseases can work together to make the person very sick, very quickly. Today’s medicines can prevent and cure TB, and that is especially good news for people with HIV.
If you have HIV and TB, proper care and treatment can protect your health.
Taking Medicine for Active TB
People with active TB must take medicine to get well and prevent others from getting their TB germs. Even though TB is hard for a person to get rid of, it can be cured with proper care and medicine. Active TB is usually treated with 3 or 4 medicines for 4-9 months.
When you first begin taking your medicine, you will still be able to give the TB germs to other people. After a few weeks, you will not be able to spread the TB germs anymore. Your doctor will tell you how to protect friends and family. Once you are no longer contagious, you can usually live at home, go to work, or attend school during your treatment.
Remembering to take your TB medicine every day can be hard. We can help you through a special program called directly observed therapy (DOT).
In a DOT program, a health care worker makes sure you take your TB medicine every day. It is a proven way to stay on schedule with your TB medicine, and it is free! Click here for more information on TB treatment at New York City Department of Health and Mental Hygiene Chest Centers.