A little more than a century ago, tuberculosis generated fear throughout the world. Sometimes called consumption (think Doc Holliday), tuberculosis ravaged young and old, rich and poor through out history. During the 18th, 19th and 20th centuries, epidemics claimed millions of lives in the United States and Europe.

After years of decline, TB is back and on the increase. Pima County has had the highest rates in the state. The disease is especially prevalent among people with weakened immune systems, i.e., the homeless, drug users, recent immigrants from other countries and people suffering from AIDS.

Each year, we suffer a number of potential exposures to TB, and several other members exhibit positive results to the skin tests. As often as not, these are not the same people. Often, the member may not even know that s/he has been exposed. This can prove confusing and frightening to the affected member and, possibly, his/her family. On top of this, the State of Arizona doesn’t list any infectious diseases that are presumed to be work related. This means that the follow up treatment after a positive TB skin test is usually not covered by industrial.

What follows are two fact sheets developed by the Centers for Disease Control and Dr. Wayne Peate. Hopefully, they will provide some insight into the disease and how you/we can better deal with it. In any event, the safest course of action is to wear gloves, glasses and mask when treating patients with a likelihood of infectious disease.

CENTERS FOR DISEASE CONTROL (General Information)

What Is TB?

Tuberculosis (TB) is caused by Mycobacterium tuberculosis, a microorganism that thrives in the moist environment of the human pulmonary system, including the throat and lungs. While in the respiratory track, the disease is highly contagious and spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine.

What Are the Symptoms of TB?

The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood and phlegm. Symptoms of TB disease in other parts of the body depend on the area affected.

How is TB Spread?

TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection.

What Is the Difference between Latent TB Infection and TB Disease?

People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease. People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease.

What Should I Do If I Have Spent Time with Someone with Latent TB Infection?

A person with latent TB infection cannot spread germs to other people. You do not need to be tested if you have spent time with someone with latent TB infection. However, if you have spent time with someone with TB disease or someone with symptoms of TB, you should be tested.

How Do You Get Tested for TB?

There are two tests that can be used to help detect TB infection. The Mantoux tuberculin skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm. A second test is the QuantiFERON-TB test. The QuantiFERON-TB test is a blood test that measures how the patient’s immune system reacts to the germs that cause TB.

What Does a Positive Tuberculin Skin Test or QuantiFERON-TB Test Mean?

A positive tuberculin skin test or QuantiFERON-TB test only tells that a person has been infected with TB. It does not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.

Why Is Latent TB Infection Treated?

If you have latent TB infection but not TB disease, your doctor may want you to take a drug to kill the TB germs and prevent you from developing TB disease. The decision about taking treatment for latent infection will be based on your chances of developing TB disease. Some people are more likely than others to develop TB disease once they have TB infection. This includes people with HIV infection, people who were recently exposed to someone with TB disease, and people with certain medical conditions.

How Is TB Disease Treated?

TB disease can be cured by taking several drugs for 6 to 12 months. It is very important that people who have TB disease finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy (DOT). DOT helps the patient complete treatment in the least amount of time.