Basic TB Facts

7/27/2019 Basic TB Facts

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Basic TB Facts

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but

TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can

be fatal.

How TB Spreads

TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB

disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria andbecome infected.

TB is NOT spread by

shaking someones hand sharing food or drink touching bed linens or toilet seats sharing toothbrushes kissing

Latent TB Infection and TB Disease

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection andTB disease.

Latent TB Infection

TB bacteria can live in the body without making you sick. This is called latent TB infection. In most people who breathe in

TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB

infection do not feel sick and do not have any symptoms. People with latent TB infection are not infectious and cannot

spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will go from

having latent TB infection to being sick with TB disease.

TB Disease

TB bacteria become active if the immune system can't stop them from growing. When TB bacteria are active (multiplying

in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to

people they spend time with every day.

Many people who have latent TB infection never develop TB disease. Some people develop TB disease soon after

becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years

later when their immune system becomes weak for another reason.

For people whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is

much higher than for people with normal immune systems.

TB Symptoms

Symptoms of TB disease include:

a bad cough that lasts 3 weeks or longer pain in the chest coughing up blood or sputum weakness or fatigue weight loss no appetite chills fever


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sweating at nightTB Risk Factors

Once a person is infected with TB bacteria, the chance of developing TB disease is higher if the person:

Has HIV infection; Has been recently infected with TB bacteria (in the last 2 years); Has other health problems, like diabetes, that make it hard for the body to fight bacteria; Abuses alcohol or uses illegal drugs; or Was not treated correctly for TB infection in the past

Testing & Diagnosis

On this Page Testing for TB Infection Who Should Get Tested for TB Testing for TB in BCG-Vaccinated Persons Choosing a TB Test Diagnosis of Latent TB Infection or TB Disease Diagnosis of TB Disease Related LinksTesting for TB Infection

Tuberculosis (TB) is a disease that is spread through the air from one person to another. There are two kinds of tests that

are used to determine if a person has been infected with TB bacteria: the tuberculin skin test and TB blood tests.

A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whethe

the person haslatent TB infection(LTBI) or has progressed toTB disease. Other tests, such as a chest x-ray and a

sample of sputum, are needed to see whether the person has TB disease.

Tuberculin skin test: The TB skin test (also called the Mantoux tuberculin skintest) 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. The health care worker will look for a raised, hard area or

swelling, and if present, measure its size using a ruler. Redness by itself is no

considered part of the reaction.

The skin test result depends on the size of the raised, hard area or swelling. It

also depends on the persons risk of being infected with TB bacteria and the progression to TB disease if infected.

Positive skin test: Thismeans the persons body was infected with TB bacteria. Additional tests are needed todetermine if the person has latent TB infection or TB disease. A health care worker will then provide treatment as

needed. Negative skin test: This means the persons body did not react to the test, and that latent TB infection or TB

disease is not likely.

TB blood tests: TB blood tests (also called interferon-gamma release assays orIGRAs) measure how the immune system reacts to the bacteria that cause TB. An

IGRA measures how strong a person s immune system reacts to TB bacteria by

testing the persons blood in a laboratory.

Two IGRAs are approved by the U.S. Food and Drug Administration (FDA) and are

available in the United States:
http://www.cdc.gov/tb/topic/testing/default.htm#testinghttp://www.cdc.gov/tb/topic/testing/default.htm#testinghttp://www.cdc.gov/tb/topic/testing/default.htm#whohttp://www.cdc.gov/tb/topic/testing/default.htm#whohttp://www.cdc.gov/tb/topic/testing/default.htm#bcghttp://www.cdc.gov/tb/topic/testing/default.htm#bcghttp://www.cdc.gov/tb/topic/testing/default.htm#choosinghttp://www.cdc.gov/tb/topic/testing/default.htm#choosinghttp://www.cdc.gov/tb/topic/testing/default.htm#latenthttp://www.cdc.gov/tb/topic/testing/default.htm#latenthttp://www.cdc.gov/tb/topic/testing/default.htm#diagnosishttp://www.cdc.gov/tb/topic/testing/default.htm#diagnosishttp://www.cdc.gov/tb/topic/testing/default.htm#relatedhttp://www.cdc.gov/tb/topic/testing/default.htm#relatedhttp://www.cdc.gov/tb/topic/basics/default.htm#ltbihttp://www.cdc.gov/tb/topic/basics/default.htm#ltbihttp://www.cdc.gov/tb/topic/basics/default.htm#ltbihttp://www.cdc.gov/tb/topic/basics/default.htm#activetbhttp://www.cdc.gov/tb/topic/basics/default.htm#activetbhttp://www.cdc.gov/tb/topic/basics/default.htm#activetbhttp://www.cdc.gov/tb/topic/basics/default.htm#activetbhttp://www.cdc.gov/tb/topic/basics/default.htm#ltbihttp://www.cdc.gov/tb/topic/testing/default.htm#relatedhttp://www.cdc.gov/tb/topic/testing/default.htm#diagnosishttp://www.cdc.gov/tb/topic/testing/default.htm#latenthttp://www.cdc.gov/tb/topic/testing/default.htm#choosinghttp://www.cdc.gov/tb/topic/testing/default.htm#bcghttp://www.cdc.gov/tb/topic/testing/default.htm#whohttp://www.cdc.gov/tb/topic/testing/default.htm#testing


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1. QuantiFERONTB Gold In-Tube test (QFT-GIT)2. T-SPOT.TB test (T-Spot)

Positive IGRA: This means that the person has been infected with TB bacteria. Additional tests are needed todetermine if the person has latent TB infection or TB disease. A health care worker will then provide treatment as

needed.

Negative IGRA:This means that the persons blood did not react to the test and that latent TB infection or TBdisease is not likely.

IGRAs are the preferred method of TB infection testing for the following:

People who have receivedbacille CalmetteGurin (BCG). BCG is a vaccine for TB disease. People who have a difficult time returning for a second appointment to look for a reaction to the TST.

There is no problem with repeated IGRAs.

Who Should Get Tested for TB

TB tests are generally not needed for people with a low risk of infection with TB bacteria.

Certain people should be tested for TB bacteria because they are more likely to get TB disease, including:

People who have spent time with someone who has TB disease People with HIV infection or another medical problem that weakens the immune system People who have symptoms of TB disease (fever, night sweats, cough, and weight loss) People from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia,

Eastern Europe, and Russia)

People who live or work somewhere in the United States where TB disease is more common (homeless shelters, prisonor jails, or some nursing homes)

People who use illegal drugsTesting for TB in BCG-Vaccinated Persons

Many people born outside of the United States have beenBCG-vaccinated.

People who have had a previous BCG vaccine may receive a TB skin test. In some people, BCG may cause a positive

skin test when they are not infected with TB bacteria. If a TB skin test is positive, additional tests are needed.

IGRAs, unlike the TB skin tests, are not affected by prior BCG vaccination and are not expected to give a false-positive

result in people who have received BCG.

Choosing a TB Test

The persons health care provider should choose which TB test to use. Factors in selecting which test to use include the

reason for testing, test availability, and cost. Generally, it is not recommended to test a person with both a TST and an

IGRA.

Diagnosis of Latent TB Infection or TB Disease

If a person is found to be infected with TB bacteria, other tests are needed to see if the person has TB disease.

TB disease can be diagnosed by medical history, physical examination, chest x-ray, and other laboratory tests. TB

disease is treated by taking several drugs as recommended by a health care provider.
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If a person does not have TB disease, but has TB bacteria in the body, then latent TB infection is diagnosed. The

decision about treatment for latent TB infection will be based on a persons chances of developing TB disease.

Diagnosis of TB Disease

People suspected of having TB disease should be referred for a medical evaluation, which will include

Medical history, Physical examination, Test for TB infection (TB skin test or TB blood test), Chest radiograph (X-ray), and Appropriate laboratory tests

What to Do If You Have Been Exposed To TB

You may have been exposed to TB bacteria if you spent time near someone with TB disease. The TB bacteria are put into

the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings. You cannot get TB

from

Clothes Drinking glass Eating utensils Handshake Toilet Other surfaces

If you think you have been exposed to someone with TB disease, you should contact your doctor or local healthdepartment about getting a TB skin test or a special TB blood test. Be sure to tell the doctor or nurse when you spent time

with the person who has TB disease.

It is important to know that a person who is exposed to TB bacteria is not able to spread the bacteria to other people right

away. Only persons with active TB disease can spread TB bacteria to others. Before you would be able to spread TB to

others, you would have to breathe in TB bacteria and become infected. Then the active bacteria would have to multiply in

your body and cause active TB disease. At this point, you could possibly spread TB bacteria to others. People with TB

disease are most likely to spread the bacteria to people they spend time with every day, such as family members, friends

coworkers, or schoolmates.

Some people develop TB disease soon (within weeks) after becoming infected, before their immune system can fight the

TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason. Many

people with TB infection never develop TB disease.

TreatmentOn this Page

Treatment for Latent TB InfectionTreatment for TB Disease
http://www.cdc.gov/tb/topic/treatment/default.htm#ltbihttp://www.cdc.gov/tb/topic/treatment/default.htm#ltbihttp://www.cdc.gov/tb/topic/treatment/default.htm#activetbhttp://www.cdc.gov/tb/topic/treatment/default.htm#activetbhttp://www.cdc.gov/tb/topic/treatment/default.htm#activetbhttp://www.cdc.gov/tb/topic/treatment/default.htm#ltbi


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Treatment CompletionRelated Links for Patients

Related Links for Healthcare Providers

Tuberculosis (TB) is caused by a bacterium calledMycobacterium tuberculosis. The bacteria usually attack

the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not

treated properly, TB disease can be fatal.

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent

TB infection and TB disease. Both latent TB infection and TB disease can be treated.Learn more about the

difference between latent TB infection and TB disease.

Treatment for Latent TB Infection

People withlatent TB infectionhave TB bacteria in their bodies, but they are not sick because the bacteria

are not active. People with latent TB infection do not have symptoms, and they cannot spread TB bacteria

to others. However, if TB bacteria become active in the body and multiply, the person will go from having

latent TB infection to being sick with TB disease. For this reason, people with latent TB infection are often

prescribed treatment to prevent them from developing TB disease. Treatment of latent TB infection is

essential for controlling and eliminating TB in the United States.

Because there are less bacteria in a person with latent TB infection, treatment is much easier.Four

regimensare approved for the treatment of latent TB infection. The medications used to treat latent TB

infection include:

isoniazid (INH) rifampin (RIF) rifapentine (RPT)

Certain groups of people (such as people with weakened immune systems) are at veryhigh risk o

developing TB diseaseonce infected with TB bacteria. Every effort should be made to begin appropriate

treatment and to ensure completion of the entire course of treatment for latent TB infection.

More:Treatment for Latent TB Infection

Treatment for TB Disease

TB bacteria become active (multiplying in the body) if the immune system can't stop them from growing.

When TB bacteria are active, this is calledTB disease. TB disease will make a person sick. People with TB

disease may spread the bacteria to people with whom they spend many hours.

TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently

approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the

first-line anti-TB agents that form the core of treatment regimens include:

isoniazid (INH) rifampin (RIF) ethambutol (EMB) pyrazinamide (PZA)

Regimens for treating TB disease have an initial phase of 2 months, followed by a choice of several

options for the continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment).Learn

more about the continuation phase of treatment.
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It is very important that people who have TB disease finish the medicine, taking 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 TB bacteria that are still alive may become resistant to those drugs. TB that is

resistant to drugs is harder and more expensive to treat.

More:Treatment for TB DiseaseTreatment Completion

Treatment completion is determined by the number of doses ingested over a given period of time.Although basic TB regimens are broadly applicable, there are modifications that should be made under

special circumstances (such as people with HIV infection, drug resistance, pregnancy, or treatment of

children).TB Can Be Treated

What is TB?

TB is short for a disease called tuberculosis. TB is spread through the air from one person to another. TB

germs are passed through the air when someone who is sick with TB disease of the lungs or throat

coughs, speaks, laughs, sings, or sneezes. Anyone near the sick person with TB disease can breathe TB

germs into their lungs.TB germs can live in your body without making you sick. This is called latentTB infection. This means

you have only inactive (sleeping) TB germs in your body. The inactive germs cannot be passed on to

anyone else. However, if these germs wake up or become active in your body and multiply, you will get

sick with TB disease.

When TB germs are active (multiplying in your body), this is called TB disease. These germs usually

attack the lungs. They can also attack other parts of the body, such as, the kidneys, brain, or spine. TB

disease will make you sick. People with TB disease may spread the germs to people they spend time

with every day.

If the TB disease is in your lungs, you may:

cough a lot,

cough up mucus or phlegm ("flem"),

cough up blood, or

have chest pain when you cough.You should always cover your mouth when you cough!

If you have TB disease, you may also:

feel weak,

lose your appetite,

lose weight,

have a fever, or sweat a lot at night.

These are symptoms ofTB disease. These symptoms may last for several weeks. Without treatment,

they usually get worse.

If you get TB disease in another part of the body, the symptoms will be different. Only a doctor can tell

you if you have TB disease.How do I know if I have latent TB infection or TB disease?

If you have been around someone who has TB disease, you should go to your doctor or your local health

department for tests.
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There are two tests that can be used to help detect latent TB infection: a TB skin test or a TB blood test

The skin test is used most often. A small needle is used to put some testing material, called tuberculin,

under the skin. In 2-3 days, you return to the health care worker who will check to see if there is a

reaction to the test. In some cases, a TB blood test is used to test for TB infection. This blood test

measures how a persons immune system reacts to the germs that cause TB.

Other tests are needed to show if you have TB disease. An x-ray of your chest can tell if there is damage

to your lungs from TB. TB disease may be deep inside your lungs. Phlegm ("flem") you cough up will be

tested in a laboratory to see if the TB germs are in your lungs.

IfTB disease is in your lungs or throat, you can give TB germs to your family and friends. They can get

sick with TB disease. You may have to be separated from other people until you cant spread TB germs.

This probably wont be for very long, if you take your medicine as your health care provider instructs.Can TB be treated?

If you have TB infection, you may need medicine to prevent getting TB disease later. This is called

preventive treatment.

TB disease can also be treated by taking medicine. If you have TB disease, it is very important that you

finish the medicine, and take the drugs exactly as you are told. If you stop taking the drugs too soon, you

can become sick again. If you do not take the drugs correctly, the germs that are still alive may becomedifficult to treat with those drugs. It takes at least six months and possibly as long as one year to kill all

the TB germs.

It is very important that you take your medicine as your doctor recommends.Protect your family and friends from TB take ALL your TB drugs!

Basic TB Facts

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