FAQ

Tuberculosis (TB) is a serious bacterial disease that spreads through the air when a person with TB disease coughs, sneezes, laughs, sings, or even speaks. TB is found most often in the lungs, but can spread to other parts of the body. If untreated, it can destroy lung tissue and make breathing difficult or impossible. If improperly treated or left untreated, TB can be fatal.

TB disease develops when the immune system cannot keep tuberculosis bacteria under control, and bacteria begin to rapidly multiply and destroy tissue in the body: the bacteria can actually create a cavity or hole in the lung. People with TB disease are sick, and usually have symptoms.

TB disease can develop very soon after infection, or may appear many years after infection. People with TB disease can spread TB to others.

People with TB Disease:

• Usually have signs and symptoms
• Usually feel sick
• May spreads TB bacteria to others
• Usually have a positive TB test
• May have an abnormal chest x-ray, or positive sputum smear or culture
• Need treatment to stop the disease

TB disease normally affects the lung and is known as pulmonary TB. When TB occurs outside the lung it is referred to as extra-pulmonary TB. TB in the lungs or throat can be infectious, meaning the bacteria can be spread to other people. People with TB disease are most likely to spread it to those they spend time with every day, including family members, friends, coworkers, classmates, commuters, etc. TB disease in other parts of the body – such as the kidney or spine – is usually not easily spread to others.

The likelihood that TB will be transmitted heavily depends on the following factors.

• Infectiousness of the person with TB disease
• Environment in which exposure occurred
• Duration of exposure

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 and become infected. TB is most commonly spread to others in confined, poorly ventilated spaces. Although anyone can be exposed to TB disease, certain groups are at higher risk for exposure, including health care professionals, the homeless, and individuals from countries where TB is highly prevalent like Kenya.

TB is NOT spread by:

• shaking someone’s hand
• sharing food or drink
• touching bed linens or toilet seats
• sharing toothbrushes
• kissing

strong>The general symptoms of TB disease include

• Unintentional Weight loss
• Fever
• Drenching Night sweats.
• Cough of any duration

For Children below 10 years

• Irritability
• Failure to thrive
• Reduced playfulness
• History of contact with a TB case

Symptoms of TB disease occurring outside of the lungs depend on the area affected.

Note: Since symptoms of TB usually start gradually, often TB is not suspected, or is misdiagnosed as another illness.

TB disease can be treated by taking anti-tuberculosis drugs for 6 to 12 months or longer. It is very important that people who have TB disease finish this medicine, and take their drugs exactly as ordered. 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.

Health Care Workers or trained community health volunteers 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.

Treatment is usually divided into two phases: the initial phase and the continuation phase. The initial phase begins with four drugs given daily for fourteen consecutive days. The remainder of the initial phase (usually about 2 months) may be daily or twice weekly depending on the patient’s drug tolerance and the extent of the disease or the patient’s other conditions. The continuation phase typically will last an additional 4 to 7 months with not less than 2 drugs. Laboratory testing is performed at regular intervals or as needed to monitor the patient’s progress and drug tolerance.

When a person is diagnosed with TB infection, it means that they have been exposed to someone with TB disease, have inhaled TB bacteria, and become infected with TB. About 5% of infected people progress to TB disease within the first two years after becoming infected. Another 5% will develop the disease later. People who are infected:

• Have no symptoms
• Don’t feel sick
• Cannot spread TB to others
• Usually have a positive TB skin test or TB blood test (Interferon Gamma Release Assay)
• May develop TB disease if not treated for TB infection

People at greater risks of progressing to TB disease usually have a weakened immune system. Older people; children under the age of 5; people with chronic illness (especially diabetes), lung diseases, or certain cancers; those who smoke, abuse substances, or take immune-suppressive medications; or those with HIV infection have much higher risk of developing TB disease if not treated.

Sometimes people are given treatment to prevent TB infection even if their TB test is negative. This is often done with infants, children and HIV-infected people who have recently spent time with someone who has infectious TB disease. These groups are at very high risk of developing serious TB disease soon after they are exposed to TB bacteria. If you are prescribed treatment for TB infection, it is important that you take all of your pills exactly as prescribed. You should follow-up regularly with your health care provider while on medication so they can monitor how you are doing.

A person with TB infection needs to take anti-tuberculosis drugs in order to kill the TB germs and prevent TB disease from developing in the future. 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, smokers, people with certain medical conditions such as diabetes and kidney problems, and persons taking immunosuppressive drugs.

The newest and best treatment for TB infection requires two drugs given in one directly observed dose per week for 12 weeks. Other single drug treatment options take from four to nine months to complete.

TB exposure occurs when a person shares air with someone who has active infectious TB disease. You may have been exposed to TB if you spent time near someone with TB disease of the lungs or throat. You can only get infected by breathing in TB germs that a person expels into the air.

You cannot get TB from someone’s clothes, drinking glass, eating utensils, handshake, toilet, or other surfaces where a TB patient has been. Most people are never exposed to a person with active infectious tuberculosis disease for a period long enough to become infected. People most likely to become infected are those that share air with a TB case for prolonged period of time, either in a single or group setting. Individuals more likely to be exposed to TB include health care workers, the homeless, persons living or working in congregate or long-term care facilities, and persons traveling to or living in countries with high TB prevalence. A TB Interferon Gamma Release Assay (blood test) will identify TB infection.

Untreated, TB infection can progress to TB disease. A person with TB infection does not feel sick and has no symptoms. Persons with TB infection cannot spread the infection to others. A skin test or blood test can detect the presence of TB infection. TB infection should be treated to prevent it from progressing to TB disease which can be spread to others.

Untreated, TB infection can progress to TB disease. A person with TB infection does not feel sick and has no symptoms. Persons with TB infection cannot spread the infection to others. A skin test or blood test can detect the presence of TB infection. TB infection should be treated to prevent it from progressing to TB disease which can be spread to others.