Tuberculosis (TB)

Bacteria causes tuberculosis, and antibiotics can cure it. The two stages of TB are infection and disease. 

People with latent TB infection (LTBI) are infected with TB bacteria but their immune system has kept it under control. It is inactive or sleeping. People with latent TB are not sick and cannot infect other people. Yet, people with latent TB can develop active TB at any time and should talk to their healthcare provider about treatment. 

People with active TB have been infected with TB bacteria and their immune system is no longer able to control it. It is awake and active. People may become very sick and die without treatment. TB bacteria can infect any part of the body and cause disease, but most people who get sick with TB will have it in their lungs. A person with active TB in the lungs or throat can spread the bacteria to others when they cough, laugh, sneeze, sing or shout.

People with active TB usually have one or more of these symptoms:

• Unexplained cough for three or more weeks.
• Coughing up blood.
• Fever.
• Unexplained night sweats.
• Unexplained fatigue.
• Unexplained weight loss.

Anyone exposed to a person sick with active TB can become infected but TB is not easily spread. Spreading TB requires spending long periods of time in a closed space, such as a house with all the windows shut. TB is common in many parts of the world, and about one-third of the world’s population is infected with TB bacteria. TB is not common in the United States, Washington State, or Pierce County.

People at most risk for TB exposure are:

• People who were born in or travel to areas of the world where TB is common. TB is widespread in Central and South America, Eastern Europe, Africa and Asia.
• People who live or work in crowded areas such as shelters, nursing homes, treatment centers or jails. This happens because someone who is sick can spread TB to others in closed spaces.
• People who work in healthcare.
• People who live with someone with active TB.

If someone has TB bacteria in their body, there is always a chance it can wake up. Certain people have conditions or factors that make their immune system less able to control it and keep it asleep.

• People with HIV/AIDS.
• People recently exposed to someone with TB.
• Children less than 4 years of age.
• People with diabetes, lung disease, kidney disease, cancer, organ transplants, or other conditions that weaken the immune system.
• People who are underweight or take medications that lower immune system function.
• People who smoke tobacco.

The two types of tests to screen for TB infection are:

• a skin test (TST).
• a blood test.

For a skin test, medical staff inject a very small amount of test liquid (not TB bacteria) into a person’s arm. Medical staff then read the test 2-3 days later by looking for a reaction.

For a TB blood test, you will have blood drawn. It requires only one visit and the results usually are available within one week.

Talk to your healthcare provider about TB screening tests. Many clinics and provider offices can do the testing. Call the provider first to see if you need to schedule an appointment and the cost of the test. If you do not have a regular provider, please go to one of the clinics listed but call first for pricing information. 

Your healthcare provider can test you for TB. If the test is positive, you need a chest x-ray and physical exam to make sure you are not sick with TB. People with a positive test, no TB symptoms and a negative physical exam do not have TB disease. They are infected with TB but are not contagious. This is called latent TB infection or LTBI.

If you are concerned that you have been exposed to TB, contact your healthcare provider or the health department.

If your provider says you are infected with TB, they will talk with you about taking antibiotics to kill the TB bacteria. The treatment for LTBI can prevent TB bacteria from waking up and making you sick.

Washington State Law requires healthcare providers to report all cases of active TB to the local health department. Health department staff work with all patients who have active TB to make sure they get treatment to cure the disease.

We do not vaccinate against TB in the United States. In countries where TB is common, many children receive BCG vaccine. This vaccine works well to prevent infants and children from dying of TB. However, it wears off over time and doesn’t protect children or adults from becoming infected with TB. The BCG vaccine does not affect the results for the TB blood test.