Tuberculosis (TB)

What is tuberculosis (TB)?

Tuberculosis (TB) is an infectious disease caused by a bacteria called Mycobacterium tuberculosis. It mainly affects the lungs, but it can affect many other organs, including the kidneys, spine and brain. TB spreads through the air when someone infected with it coughs, sneezes, talks, spits or sings and releases tiny respiratory droplets containing the bacteria. 

It’s easy for TB to spread to other people, especially in places that are crowded or poorly ventilated. A small amount of bacteria can cause an infection. So early detection and treatment are important. 

With proper care and support, many people make a full recovery from TB. But untreated, it can be fatal.

How does tuberculosis spread?

Someone who has TB can send droplets into the air when they cough, sneeze, speak or sing. These droplets contain the bacteria and if you’re nearby and you inhale them, you could get infected. They can stay in the air in an enclosed space that doesn’t have good airflow for several hours.

Who is at risk for tuberculosis?

You’re more likely to get TB if:

• You spend a lot of time with someone who has untreated TB.
• You have a weakened immune system from HIV/AIDS, malnutrition, diabetes or immunosuppressant medications.
• You live in or travel to areas outside the United States where there are a lot of people who have TB.
• You work in health care or another area where you are in close contact with people who have TB.

Symptoms of active and latent tuberculosis

Early symptoms of TB may be mild, so you might not think about getting medical care right away. Knowing these symptoms may help you seek care more quickly and manage TB better if you have it. Symptoms are different for active versus latent TB.

Although active TB can spread to other organs, it is most common in the lungs. People with active TB disease in the lungs typically have symptoms and can spread the disease to other people. These symptoms may include:

• A cough that lasts for more than three weeks, sometimes producing phlegm (mucus) or blood
• A low-grade fever that doesn’t go away
• Night sweats
• Significant weight loss without dieting or other obvious causes
• Feeling more tired or weak than usual
• Chest pain
• Difficulty breathing

Not everyone who gets infected with TB gets sick. The bacteria could stay in your body for years without causing symptoms. This is called a latent TB infection.

People with latent TB have TB bacteria in their bodies but do not have symptoms and cannot spread the disease. Latent TB can eventually become active TB if it’s not treated, especially if your immune system is weakened.

If you think you may have been exposed to TB or you have symptoms, get medical attention as soon as you can. It can make a difference in your treatment and recovery.

How is tuberculosis diagnosed?   

For a TB diagnosis, your provider may use different tests to check for Mycobacterium tuberculosis bacteria:

• Chest X-rays: X-rays can show problems in the lungs that may be signs of TB and can show how much TB is affecting your lungs.
• Tuberculin skin test (TST): This TB test is also known as the PPD or Mantoux test. A small amount of TB protein (tuberculin) is injected under the skin of your forearm. If a raised, hard area or swelling appears after 48 to 72 hours, you may have a TB infection.
• Interferon-gamma release assays (IGRAs): These blood tests check for an immune response to TB bacteria. These tests are more sensitive than TST and are a better choice for people who have received the Bacillus Calmette-Guérin (BCG) vaccine.

Early diagnosis is important because it may give you a better outcome and lower your risk of complications. It can also make it less likely that you spread TB to others. And you can start the right antibiotic treatment quickly, which may help stop drug-resistant strains of TB from developing.

Treatments for active and latent tuberculosis

Antibiotics are prescribed to treat TB. They kill the bacteria or prevent them from multiplying. Treatment for TB depends on whether the infection is active or latent.

The standard treatment for active TB is a combination of antibiotics taken for at least six months. Isoniazid, rifampin (Rimactane), ethambutol (Myambutol), pyrazinamide, rifabutin (Mycobutin) and rifapentine (Priftin) are commonly prescribed.

You usually take a combination of these antibiotics for the first two months to quickly reduce the number of TB bacteria. Then, you take fewer medications for four more months to get rid of any remaining bacteria.

Latent TB is treated to help keep it from becoming active TB. An antibiotic, usually isoniazid, is taken every day for six to nine months. In some cases, shorter courses of antibiotics or other medications may be recommended based on your circumstances and local health department.

Most people tolerate these antibiotics well, but they could cause side effects such as liver or digestive system problems. Your health care provider will monitor you closely during treatment.

It’s important to take all of your antibiotics as prescribed. Otherwise, the infection could return, make you sick again and increase the risk of TB spreading to other people. Plus, any bacteria that survive may be more resistant to antibiotics. That could make it harder to treat TB in the future.

How to prevent tuberculosis

Many countries use the BCG vaccine to help prevent severe forms of TB in young children. The BCG vaccine may not fully prevent pulmonary TB (the most common form), but it may protect against TB meningitis and disseminated TB in infancy. 

The BCG vaccine is not routinely recommended in the U.S. because TB rates are relatively low compared to other parts of the world and the vaccine isn’t always effective in preventing pulmonary TB in adults.

The BCG vaccine may be used in the U.S. in:

• Infants and children who are at high risk of exposure to TB due to travel or exposure to someone with drug-resistant TB.
• Health care workers who are at high risk of exposure to TB and who can’t take other preventive medications.

These steps can also help prevent tuberculosis:

• Quickly treating TB to reduce the risk of it spreading.
• Covering your mouth and nose with a tissue or elbow when coughing or sneezing to help prevent bacteria in the air.
• Using good ventilation to lower the amount of bacteria in the air.
• Following the instructions of health care providers if you have active TB.
• Washing your hands often, especially if you may have touched contaminated surfaces or objects.
• Limiting the time you spend in crowded, enclosed spaces.
• Eating a balanced diet, exercising regularly, and getting plenty of rest to help keep your immune system strong.

Living with tuberculosis: What to expect

If you have TB, these steps can help you recover and make it less likely you’ll spread the disease to other people:

• Take your antibiotics exactly as prescribed.
• Eat a nutritious diet to support your immune system. 
• Get enough rest.
• Avoid smoking and limit alcohol. Both can weaken your immune system.
• Cover your mouth and nose with a tissue or your elbow when you cough or sneeze. Seal these tissues in a bag, throw them in the trash right away and wash your hands thoroughly afterward.
• Follow your health care provider’s guidelines about staying away from other people to help keep from spreading it to others. For the first two to three weeks, your provider may want you to stay home and away from other members of your household, open the window if possible, blow air outside with a fan and wear masks if you need to be around other people.
• Go to your follow-up appointments to see how your treatment is working and check for any side effects. Your provider may want to check your progress with X-rays or sputum (spit) tests.

Tuberculosis care at Banner Health

At Banner Health, we provide exceptional care for tuberculosis (TB). Our health care providers are experts in diagnosing and treating infectious diseases, including tuberculosis. With our approach, you receive personalized care tailored to your needs.