| Frequently Asked Questions
What
is TB?
Tuberculosis (often called TB) is an infectious disease that
usually attacks the lungs, but TB can attack almost any part of
the body. Tuberculosis is spread from person to person through
the air.
When people with TB in their lungs or throat cough, laugh,
sneeze, sing, or even talk, the germs that cause TB may be
spread into the air. If another person breathes in these germs
there is a chance that they will become infected with
tuberculosis.
It is important to understand that there is a difference between
being infected with TB and having TB disease. Someone who is
infected with TB has the TB germs, or bacteria, in their body.
The body's defenses are protecting them from the germs and they
are not sick.
Someone with TB disease is sick and can spread the disease to
other people. A person with TB disease needs to see a doctor as
soon as possible.
It is not easy to become infected with tuberculosis. Usually a
person has to be close to someone with TB disease for a long
period of time. TB is usually spread between family members,
close friends, and people who work or live together. TB is
spread most easily in closed spaces over a long period of time.
Even if someone becomes infected with tuberculosis, that does
not mean they will get TB disease. Most people who become
infected do not develop TB disease because their body's defenses
protect them.
Experts believe that about 10 million people in America are
infected with TB germs. Only about 10 percent of these people
will develop TB disease in their lifetime. The other 90 percent
will never get sick from the TB germs or be able to spread them
to other people.
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Who
gets it?
Anyone can get
TB. People of all races and nationalities. The rich and poor.
And at any age. But for many reasons, some groups of people are
at higher risk to get active TB disease. The groups that are at
high risk include:
-
People with
HIV infection (the AIDS virus)
-
People in
close contact with those known to be infectious with TB
-
People with
medical conditions that make the body less able to protect
itself from disease (for example: diabetes, the dust disease
silicosis, or people undergoing treatment with drugs that
can suppress the immune system, such as long-term use of
corticosteroids)
-
Foreign-born
people from countries with high TB rates
-
Some racial
or ethnic minorities
-
People who
work in or are residents of long-term care facilities
(nursing homes, prisons, some hospitals)
-
People who
are underfed
-
Alcoholics
and IV drug users
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What
are the symptoms of TB?
A person with TB
infection will have no symptoms. A person with TB disease may
have any, all or none of the following symptoms:
These symptoms can
also occur with other types of lung disease so it is important
to see a doctor and to let the doctor determine if you have TB.
It is also important to remember that a person with TB disease
may feel perfectly healthy or may only have a cough from time to
time. If you think you have been exposed to TB, get a TB skin
test.
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How
does TB disease develop?
-
There are two
possible ways a person can become sick with TB disease:
-
The first
applies to a person who may have been infected with TB for
years and has been perfectly healthy. The time may come when
this person suffers a change in health. The cause of this
change in health may be another disease like AIDS or diabetes.
Or it may be drug or alcohol abuse or a lack of health care
because of homelessness.
-
Whatever the
cause, when the body's ability to protect itself is damaged,
the TB infection can become TB disease. In this way, a person
may become sick with TB disease months or even years after
they first breathed in the TB germs.
-
The other way
TB disease develops happens much more quickly. Sometimes when
a person first breathes in the TB germs the body is unable to
protect itself against the disease. The germs then develop
into active TB disease within weeks.
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What
is the TB Skin Test
The TB
skin test is a way to find out if a person has TB infection.
Although there is more than one TB skin test, the preferred
method of testing is to use the Mantoux test.
For this test, a small amount of testing material is placed just
below the top layers of skin, usually on the arm. Two to three
days later a health care worker checks the arm to see if a bump
has developed and measures the size of the bump. If the bump is
of a certain size the test is positive and the person has TB
infection.
Once the doctor knows that a person has TB infection he or she
may want to determine if the person has TB disease. This is done
by using several other tests including a chest X-ray and a test
of a person's mucus (the material that is sometimes coughed up
from the lungs).
Q:
Should you get a skin test each year to check on TB?
A:
Only if you are at high risk for getting TB.
The advice for most people is to get a tuberculin test if you
have symptoms or if you are living in close contact or have
otherwise been in close contact with someone who recently came
down with TB disease. (Some people get skin tests because of
their jobs, in a school or hospital, for example, to make sure
they will not infect others if they have TB.)
However, if you fall
into one or more of the high-risk categories for TB noted
earlier, for example, if you are HIV-positive, or if you've
never had a skin test before, or if there is no record of the
last result, you should be tested.
If you're not sure, ask your doctor. TB can be prevented, even
if you are at risk.
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What
is the treatment for TB?
Treatment for TB
depends on whether a person has TB disease or only TB infection.
A person who has become infected with TB, but does not have TB
disease, may be given preventive therapy. Preventive therapy
aims to kill germs that are not doing any damage right now, but
could break out later.
If a doctor decides a person should have preventive therapy, the
usual prescription is a daily dose of isoniazid (also called
"INH"), an inexpensive TB medicine. The person takes
INH for six months (up to a year for some patients), with
periodic checkups to make sure the medicine is being taken as
prescribed.
What if the person has TB disease? Then treatment is needed.
Years ago a patient with TB disease was placed in a special
hospital for months, maybe even years, and would often have
surgery. Today, TB can be treated with very effective drugs.
Often the patient will only have to stay a short time in the
hospital and can then continue taking medication at home.
Sometimes the patient will not have to stay in the hospital at
all. After a few weeks a person can probably even return to
normal activities and not have to worry about infecting others.
The patient usually gets a combination of several drugs (most
frequently INH plus two to three others), usually for six to
nine months. The patient will probably begin to feel better only
a few weeks after starting to take the drugs.
It is very important, however, that the patient continue to take
the medicine correctly for the full length of treatment. If the
medicine is taken incorrectly or stopped the patient may become
sick again and will be able to infect others with TB.
If the medicine is taken incorrectly and the patient becomes
sick with TB a second time, the TB may be harder to treat
because it has become drug resistant. This means that the TB
germs in the body are unaffected by some drugs used to treat TB.
Multi-drug resistant TB is very dangerous, so patients should be
sure that they take all of their medicine correctly.
Regular checkups are needed to see how treatment is progressing.
Sometimes the drugs used to treat TB can cause side effects. It
is important both for people undergoing preventive therapy and
people being treated for TB disease to immediately let a doctor
know if they begin having any unusual symptoms.
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Can
a TB patient infect others?
Yes, if they
have TB disease and it is not being treated. Once treatment
begins, a patient ordinarily becomes quickly noninfectious; that
is, they cannot spread the disease to others.
There is little danger from the TB patient who is being treated,
is taking his or her medication continuously, and is responding
well. The drugs usually make the patient noninfectious within
days or weeks.
TB is spread by germs in the air, germs put there by coughing or
sneezing. Infection is not spread by handling a patient's bed
sheets, books, furniture, or eating utensils.
Brief exposure to a few TB germs rarely infects a person. It's
day-after-day close contact that usually does it.
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What
is Multi-Drug Resistant TB?
Multi-drug
resistant tuberculosis (called MDR TB for short) is a very
dangerous form of tuberculosis. Some TB germs become resistant
to the effects of some TB drugs. This happens when TB disease is
not properly treated.
These resistant germs can then cause TB disease. The TB disease
they cause is much harder to treat because the drugs do not kill
the germs. MDR TB can be spread to others, just like regular TB.
It is important that patients with TB disease follow their
doctor's instructions for taking their TB medicine so that they
will not develop MDR TB.
TB: What You Should Do
Find out if you're infected.
Everyone should be skin tested at least once and know whether
their test result is positive or negative. You should also be
tested if there's any chance you have been infected, recently or
many years ago.
If the test is negative:
A negative reaction usually means that you are not infected and
no treatment is needed. Sometimes, however, when a person has
only recently been infected, or when his or her immune system
isn't working properly, the test may be falsely negative.
If the test is positive:
A positive reaction usually means that you have been infected
with the TB germ. It does not necessarily mean that you have TB
disease. Cooperate with the doctor when he or she recommends a
chest X ray and possibly other tests.
If the doctor recommends treatment to prevent sickness, follow
the recommendations. If medicine is prescribed, be sure to take
it as directed.
If you don't need treatment, do what the doctor tells you to do
about follow-up. The doctor may simply say to return for another
checkup if you get into a special risk situation for TB sickness
or develop symptoms.
If you are sick with TB disease, follow the doctor's
recommendations for treatment.
If you're a health worker:
Your local American Lung Association can provide you with more
comprehensive information developed for health professionals on
the diagnosis, treatment and control of TB.
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Where
can I get a TB test?
Public
Health provides tuberculosis (TB) skin testing at four sites.
Private physicians and clinics also provide TB testing. Two
visits are required for a skin test. Skin tests are placed on
one day and read two or three days later.
Please Click here for clinic locations and
hours.
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What
are your hours?
Please Click here for clinic locations and
hours.
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What
is the cost of a TB skin test?
Due to reduction of services, TB skin testing is no longer provided for pre-employment, school or volunteer clearances.
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Who
is required to get a TB test?
In
California, children entering day care or kindergarten must be
cleared for tuberculosis. In addition, some school districts in
Orange County require testing for new entrants. Consult your
local school district office.
Most
employers require tuberculosis screening at time of hire.
Workers in sensitive or high risk occupations, such as health
care or education, may need periodic testing.
Public
Health may require a person in recent contact with someone with
communicable tuberculosis to be screened for tuberculosis.
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Can
I get a chest X-ray for work?
Chest X-rays for employment or volunteer work are no longer available.
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Is
there a charge for medical treatment or medicine if I have
tuberculosis?
No,
Public Health services to treat person with tuberculosis are
free to the patient. Insurance, Medi-Cal or other coverage is
billed if available, but the patient is not billed for care or
medication received.
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How
can I get more information about tuberculosis?
Other
frequently asked questions about tuberculosis, how it is spread,
infection, disease, etc., are available on the Centers
for Disease Control and Prevention website.
The
American Lung Association has a list of questions
and answers about TB.
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