Tuberculosis: What You Need to Know

What is Tuberculosis?

According to the Centers for Disease Control and Prevention (CDC), Mycobacterium tuberculosis is an airborne bacteria known to cause tuberculosis (TB), a disease that mainly attacks the lungs, but can also affect the kidney, spine, or brain, sometimes resulting in death. TB is not contagious through direct contact and infection with M. tuberculosis does not indicate disease. An infected individual can either present with Latent TB when the bacteria is inactive, or TB disease when the bacteria is activated due to an immunity complication.

Latent TB

Latent TB (a dormant infection) is very common, since a normally functioning immune system can fight off the infection and hinder the bacteria from flourishing within the body. Individuals who have latent TB do not show symptoms and are not contagious. Proper latent TB treatment can prevent TB disease, and is vital to controlling the prevalence of TB in the US and around the world.

Treatment for latent TB is important to stop the bacteria from becoming active and causing illness. It is often easier to treat latent TB than it is to treat TB disease since the number of bacteria within the body is considerably lower. Three medications are available to treat latent TB, and should be administered after the possibility of developing TB disease has been ruled out. The three medications are:

• Isoniazid (INH)
• Rifampin (RIF)
• Rifapentine (RPT)

An individual who is infected with latent TB should always consult an expert before initiating treatment if the source of latent TB is a multidrug-resistant (MDR) TB infection. It is important for TB patients to follow up with their health care providers so that they do not develop MDR TB.

TB Disease

In the case that latent TB becomes active (either early on in the infection, before the body can stop bacteria growth, or due to developed immunodeficiencies), a person can fall ill and spread the infection to those close to them. The possibility of developing active TB disease is highest in those living with an HIV infection. Those with diabetes mellitus, or other immunocompromising complications, those who have been previously mistreated for TB, substance abusers, and alcoholics are also at an increased risk of developing TB disease.

Those with TB disease may present with the following symptoms:

• A bad cough lasting for three or more weeks
• Coughing up blood or sputum
• Chest pain
• Weakness or fatigue
• Weight loss
• Loss of appetite
• Chills or fever
• Night-time sweating

The treatment regimen for TB disease usually lasts between 6 to 9 months, and medications must be taken exactly as prescribed, for the full treatment period. Ending treatment early may result in a relapse, and cause the bacteria to develop drug resistance. Although MDR TB is curable, it is more difficult to treat and the medications are more costly.

Currently, there are 10 FDA approved medications for TB disease. The first-line TB-fighting agents found within the treatment regimens are:

• Isoniazid (INH)
• Rifampin (RIF)
• Ethambutol (EMB)
• Pyrazinamide (PZA)

TB Exposure

The CDC advises that individuals believed to be exposed to the M. tuberculosis should contact their health care provider or local health department. It is essential to notify your doctor or nurse of when you were exposed to the bacteria (if it is known).

If you plan on traveling, avoid prolonged contact with known TB patients in closed areas. The CDC recommends that health care providers who travel to work in an environment where TB is prevalent should first consult infection control or occupational health experts.