Should I worry about tuberculosis?
3/30/2023 by Jillian Lynaugh, APRN, C.N.P., D.N.P., and Julie L. Hanson, M.D.
March 24 is World Tuberculosis Day. It's a day to remember the discovery of the bacteria that cause tuberculosis, or TB, and increase awareness of the impact of tuberculosis in the world.
What is tuberculosis?
Tuberculosis is a health condition caused by a bacterium called Mycobacterium tuberculosis. Typically, the bacteria impact the lungs, but they can impact other parts of the body, such as the spine, brain and kidney.
There are two types of TB conditions, latent tuberculosis infection and active tuberculosis, or TB disease. Not everyone who has tuberculosis bacteria becomes ill.
- Latent TB: The bacteria are inactive and "hide" in the body. In this situation, people are not sick because the bacteria are inactive, but people can develop symptoms in the future if the bacteria become active. In latent TB, the bacteria cannot spread to other people.
- Active TB: The bacteria are active in the body. People often have symptoms of tuberculosis and can spread the bacteria to others. TB is spread to others when the bacteria move into the air from an infected person through tiny droplets. If someone has active TB disease, they can spread the germs by coughing, speaking, singing and sneezing.
What are symptoms of tuberculosis?
Those with tuberculosis disease often have symptoms. General symptoms of tuberculosis include weight loss, decreased appetite, fever, night sweats, weakness and feeling tired. If the bacteria are in the lungs, it often causes coughing that can last for at least several weeks, coughing up blood or phlegm, and chest pain. If the bacteria are in other places of the body, the symptoms depend on where the bacteria have affected.
Who needs testing for tuberculosis?
If you have symptoms of TB, you should see your health care clinician to help determine if you should be tested for TB. The Centers for Disease Control and Prevention (CDC) also recommends testing for latent TB in people that are at higher risk for this condition. This includes people that are around someone with TB, have travelled to or are from countries with high rates of TB (such as Latin America, Asia and Africa), have AIDS/HIV, use IV drugs, work in health care and treat people with a higher risk of TB, work or live in a setting where TB is more common (such as prisons or nursing homes), or children who are around adults at risk of TB. If you are at higher risk for latent TB, your health care clinician will help you determine how often you should be tested.
How is TB testing done?
There are two main tests for tuberculosis, a skin test and a blood test. In the skin test, a small amount of a liquid called tuberculin is injected just under the skin in your forearm. After 48 to 72 hours, your arm will be checked by health care staff to determine if there is a reaction. If there is a hard bump at the injection site, it is possible that person has TB bacteria in their body. The size of the bump is used to determine if the test is positive. The blood test requires a blood draw and can generally be used for anyone 2 and older.
Some people born outside of the U.S. have received the bacilli Calmette-Guerin (BCG) vaccine. The BCG vaccine is used in countries with high prevalence of TB and is given at birth. The BCG vaccine can make people have a false positive TB skin test, which means people can test positive, but they do not have the TB bacteria in their body. If a patient has had the BCG vaccination in the past, health care clinicians will typically order the blood test method when testing for TB.
What if you test positive?
When people test positive for TB, it means they have the TB bacteria in their body. Their health care clinician will order additional testing, such as a chest X-ray, to help determine if the person has TB disease (active infection) or latent TB (hidden infection). People with TB disease will be treated with a combination of medications for six to 12 months. It's important that people with TB disease take all recommended medications so the bacteria does not become resistant. Since latent TB can turn into active TB, those with latent TB also are treated so they do not become sick.
Jillian Lynaugh, APRN, C.N.P., D.N.P., is a primary care pediatric nurse practitioner in Primary Care in Rochester and Kasson's Division of Community Pediatric and Adolescent Medicine. She practices at Mayo Family Clinic Northwest in Rochester. She spent several years working overseas in health and nutrition project management in conflict and disaster areas and continues to have a passion for global health and refugee care.
Julie L. Hanson, M.D., is a pediatrician in Primary Care in Rochester and Kasson's Division of Community Pediatric and Adolescent Medicine. She practices at Mayo Family Clinic Northwest in Rochester. She has a particular interest in refugee and global health and has received her Certificate of Knowledge in Clinical Tropical Medicine and Traveler’s Health (CTropMed).