Tuberculosis (TB)

What is TB?
TB is caused by a bacterium called Mycobacterium tuberculosis. TB is spread from person to person through the air. There are two types of TB: TB infection (latent TB), and TB disease (active TB).

What is Latent TB?
A person who has latent TB has been infected with M. tuberculosis but his or her immune system has been able to control it. A person with latent TB is not sick and cannot infect other people. However, people with latent TB can go on to develop active TB at any time and should talk to their healthcare provider about treatment..

What is Active TB?
A person with active TB has been infected with the bacteria and his or her immune system is no longer able to control it. He or she will become sick with the disease and can die without treatment. The TB bacteria can infect any part of the body and cause disease, but most people who get TB will have it in their lungs. A person with active TB in the lungs or voice box can spread the bacteria to others through the air when they cough, laugh, sneeze, sing or talk.

How do I know if I have latent TB or active TB?
People with latent TB have no symptoms. Your healthcare provider can do a tuberculin skin test (TST) or blood test to see if you have been infected. If the test is positive, you need a chest x-ray and physical exam to make sure you are not sick with active TB.

People with active TB usually have symptoms. The most common symptoms of active TB are;

  • unexplained cough for 3 or more weeks,
  • coughing up blood,
  • chest pain, especially with coughing,
  • fevers,
  • unexplained night sweats,
  • unexplained weakness and fatigue,
  • decreased appetite, or
  • unexplained weight loss.

People with active TB may have all, some or none of these symptoms. Contact your healthcare provider if you develop these symptoms. A chest x-ray and lab testing of your phlegm or sputum can help to diagnose TB of the lungs.

Who is at risk for getting infected with TB?
Anyone can be exposed to TB and become infected because it is spread through the air. TB is still common in some parts of the world and, according to the World Health Organization, about one-third of the world's population is infected with the bacteria. (www.who.int/mediacentre/factsheets/fs104/en/index.html)

TB is not very common in the United States, Washington State, or Pierce County.

Pierce County residents with the most risk for being exposed to TB are;

  • people who were born in or travel to areas of the world where TB is common. TB is common, or "endemic", in Central and South America, Eastern Europe, Africa and Asia (except Japan),
  • people who live or work in crowded areas such as shelters, nursing homes, treatment centers or jails,
  • healthcare workers, or
  • people who live with someone with active TB.

Who is at risk of getting active TB?
Some people are more likely to become sick with TB once they have been infected:

  • People with HIV/AIDS
  • People who have recently been exposed to someone with TB
  • Children less than 4 years of age
  • Patients who have weakened immune systems because of diabetes, lung disease, kidney disease, cancer, organ transplants, malnutrition, or medications

Who is at risk of dying from TB?
In the United States it is rare to die from TB. Most people who complete the entire course of antibiotics will be cured. TB is most serious and can quickly become life-threatening for infants, young children and people with compromised immune systems.

Is there a vaccine for TB?
There is no vaccine for TB in the United States. In countries where TB is common, many infants and children receive the bacille Calmette-Guérin (BCG) vaccine. This vaccine works well to prevent infants and children from dying of TB, but it wears off over time and does not protect children or adults from becoming infected.

How do I get tested for TB?
There are two types of tests for TB infection, a skin test (usually called a TST or PPD) and a blood test. The most commonly used blood test in the United States is QuantiFERON®.

What is a TB Skin Test?
During a TB skin test, a small amount of protein solution (called purified protein derivative, or PPD) that is similar to TB is injected under the first layer of skin. This protein is similar to TB but is not the same and cannot give you TB. This is a test and not a vaccine.

The healthcare provider that applied the test will ask you to return in 2-3 days to get the results. He or she will touch the area where the test was applied to see if there is a bump that can be measured. If the bump is measured as positive you are likely infected with TB. Your healthcare provider will probably order an x-ray to make sure you are not sick with TB disease in the lungs. Since March 1, 2000, healthcare providers have been required (local board of health resolution 2000-3149) to report all positive skin tests for Pierce County residents to Tacoma-Pierce County Health Department.

What is a TB Blood Test?
The type of TB blood test currently used in Pierce County is called QuantiFERON-TB Gold In-Tube® (QFT). For this test, you will have blood drawn. This test requires only one visit and the results usually come back within a week. If the blood test is positive you are likely infected with TB. A person with TB infection can become sick with TB disease at any time. Your healthcare provider will probably order an x-ray to make sure you are not sick with TB disease in the lungs. If you have had a BCG vaccine in the past it will not make the blood test positive.

Tacoma-Pierce County Health Department requests that all positive QuantiFERON® results be reported to Communicable Disease Control via phone or fax.

Where can I get the skin or blood test?
Talk to your healthcare provider about getting the test. Many clinics in Pierce County offer TB skin tests and/or blood tests. Call the clinic first to see if you need to schedule an appointment and how much the test will cost. If you do not have a regular healthcare provider, you may be able to get a TB skin test at one of the following clinics listed in this link.

What if I have been exposed to TB?
If you are concerned that you have been exposed to TB, contact your healthcare provider or Tacoma-Pierce County Health Department.

What if I have been infected with TB?
If you have been infected with TB, your healthcare provider will do a chest x-ray and physical exam to make sure you are not sick with TB disease. He or she will talk with you about taking an antibiotic to prevent you from ever getting sick with TB.

What if I have TB disease?
According to Washington State Law (WAC 246-101), healthcare providers must report all cases of active TB in Pierce County residents to Tacoma-Pierce County Health Department immediately. Health Department staff work with all active TB patients to make sure they get the treatment and antibiotics needed to cure the disease.

Tacoma-Pierce County Health Department Tuberculosis Control Program
Tacoma-Pierce County Health Department partners with other healthcare agencies and providers in Pierce County to provide the following services:

  • Investigate all reports of suspected TB
  • Make sure that patients with active TB are isolated, treated and cured.
  • Observe active TB patients taking medications daily
  • Screen people who are exposed to patients with active TB and make sure they get tested and treated as needed
  • Screen all new refugees for TB and provide treatment for those infected
  • Screen immigrants at risk for TB to make sure they don't have active TB and provide treatment as needed
  • Provide latent TB testing and treatment for uninsured Pierce County residents who are at risk for getting TB
  • Provide TB education to community members and healthcare workers
  • Provide medical consultation