Tuberculosis, Mycobacteriosis

Tuberculosis, Mycobacteriosis is a disease caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. The bacteria can cause two types of illness, latent or active. TB is latent when the body's immune system forms a wall around the TB bacteria so they cannot multiple or spread. A person with latent TB has no symptoms. People can have latent TB for long periods of time. If a person with latent TB does not get treatment, the TB bacteria can "activate" and cause disease, often if the person's health declines due to sickness, stress, or aging. Active TB is when the body cannot adequately fight the TB bacteria and the person has symptoms.

At-Risk Populations

People at high risk for Tuberculosis (TB) exposure and infection include:

  • Close contacts of persons exposed to contagious cases of TB
  • Foreign-born persons, including children, who have immigrated within the last 5 years from areas that have a high TB incidence
  • Residents and employees of high-risk congregate settings (prisons, nursing homes, homeless shelters, drug treatment facilities, and healthcare facilities)
  • Healthcare workers who serve high-risk clients
  • Some medically under served, low-income populations as defined locally
  • High-risk racial or ethnic minority populations defined locally as having an increased prevalence of TB
  • Infants, children, and adolescents exposed to adults in high-risk categories
  • Persons who inject illicit drugs or any other locally identified high-risk substance users

People at high risk for progression to TB disease once infected include:

  • Persons with human immunodeficiency virus HIV infection
  • Persons who were infected with M. tuberculosis within the past 2 years, particularly infants and very young children
  • Persons who have underlying medical conditions known to increase the risk of progression to active disease
  • Persons who inject illicit drugs
  • Persons with a past history of inadequately treated TB

Symptoms

  • Fever
  • Weakness or fatigue
  • Unexpected weight loss (i.e. not from dieting)
  • Loss of appetite
  • Night sweats
  • Persistent coughing
  • Coughing up blood (if disease in lungs or throat)
  • Chest pain (if disease in lungs)
  • Shortness of breath (if disease in lungs)
  • Other symptoms based on the site of disease

How It Spreads

TB is spread from one person to another through the air. When someone with active TB disease in the lungs or throat coughs, sings, or even speaks, TB bacteria can be released into the air where it can stay in the air for hours. Someone who breathes in the TB bacteria, is exposed, and may get either latent infection or active disease. You cannot get TB from someone's clothes, drinking glass, handshake or toilet.

Prevention

Testing & Diagnosis

If you have been around someone who has TB disease, you should get a skin test. Individuals with a positive TB skin test should also get additional tests as recommended by their healthcare provider. You should ask your healthcare provider about being tested for TB if you:

  • Live or work closely with someone who has active TB disease
  • Were born outside the US (except Canada, Europe and some other areas with low TB incidence)
  • Live or work in a prison, residential institution or nursing home
  • Inject recreational drugs
  • Are immunocompromised
  • Are a healthcare worker that cares for people in any of the above groups

Treatment

If you have active active TB in your lungs, you should be treated and kept away from other people until you are no longer at-risk of spreading it. Treatment, as with latent TB may take several months.

If you have latent TB you should be evaluated to see which specific treatment is right for you - usually one medication for several months.

The Department of Health helps support two TB clinics in Rhode Island the RISE Clinic, the state's TB specialty clinic and the Hasbro TB Clinic, a pediatric clinic. These clinics provide diagnostic testing (chest x-rays, bacteriology tests), and medications that treat TB. more