Tuberculosis Testing & Treatment

Tuberculosis (TB) is a disease that usually affects the lungs.  TB sometimes affects other parts of the body, such as the brain, kidneys, or spine.  TB disease can cause death if untreated.

TB germs are spread from person to person through the air.  These germs are spread when a person with TB disease of the lungs  or throat coughs, sneezes, laughs, or sings.

The symptoms of Tuberculosis (TB) are:

•  weakness
• weight loss
• fever
• night sweats
• cough
• chest pain
• coughing up blood
• other symptoms depending on body part affected

TB Infection,  aka LATENT TUBERCULOSIS INFECTION (LTBI):

• The person has NO SYMPTOMS.
• The person is NOT CONTAGIOUS.
• The TB Skin Test (also known as PPD) is POSITIVE.
• The Chest X-Ray is NORMAL.
• With LTBI, TB germs are in the body but are sleeping or dormant.
• The person’s immune system is healthy.
• The immune system creates a hard shell around the TB  germ and contains it.
• There is potential for the bacilli to become active, multiply and lead to TB disease at some point in the future.
• A person with LTBI cannot spread TB germs to other people.
• You DO NOT need to be tested if you have spent time with a person with LTBI.
• LTBI medication is started on persons who are at risk for developing TB Disease.
• The decision to treat depends on several risk factors. These include people with HIV Infection, people who were recently exposed to someone with active TB Disease, and people with certain medical conditions. Routine treatment for LTBI consists of 9 months of  Isoniazid (INH) or 4 months of daily Rifampin (if INH cannot be used) or 3 months of INH along with 3 months of Rifapentine.

 ACTIVE TUBERCULOSIS DISEASE (TB)

• TB germs are in the body and GROWING.
• The Tuberculin Skin Test (PPD) is USUALLY POSITIVE.
• Chest X-Ray is USUALLY ABNORMAL
• Sputum Smears may be POSITIVE.
• Sputum Cultures are POSITIVE.
• The person has SYMPTOMS.
• The person may be CONTAGIOUS (before an adequate amount of TB medications are taken by the person).
• The person is considered to be an ACTIVE TB CASE.
• Active TB Disease is CURABLE. The treatment for TB Disease is a 4-drug therapy that includes Isoniazid (INH), Rifampin (RIF), Pyrazinamide (PZA), and  Ethambutol (EMB) for 2 months. After drug susceptibility is known a medical provider can reduce  the medication to INH and RIF for 4 months. A healthcare provider from the health department delivers the TB medication to the person and watches the person swallow the medication. This is known as directly observed therapy (DOT), which is the standard of care for the State of Georgia TB Program. TB is not a casual contact disease like the common cold. A person has to spend a lot of time with the person with active TB disease to become infected.  You may get a Tuberculin Skin Test (PPD) from your doctor or the local health department if you have been around someone who has TB disease.

For a TB skin test, a health care provider uses a small needle to administer tuberculin, just under the skin.  This is usually done on the lower inside part of the arm.  After the test, the patient  must return in two  to three  days to see if there is a reaction.If there is a reaction, the size of reaction is measured. There is also a blood test called a QFT that can be performed in place of the TB skin test.

A positive skin test usually means that a person has been infected with the TB germ.  It does not necessarily mean that you have TB disease.  Other tests, such as an x-ray and/or sputum samples, are needed to verify that a person has TB disease