Frequently Asked Questions
- What is Tuberculosis?
- Who gets Tuberculosis?
- How is TB spread?
- What is TB infection?
- What is TB disease?
- What are TB symptoms?
- How can I get tested for TB?
- Where can I get tested for TB?
- What if my skin test is positive?
- If I have TB infection, how can I keep from developing TB disease?
- How is TB disease treated?
- Why do I need to take TB medicine regularly?
- What is Multidrug-Resistant TB (MDR-TB)?
1. What is Tuberculosis?
Tuberculosis is a bacterial disease usually affecting the lungs (pulmonary TB) caused by Mycobacterium tuberculosis. Other parts of the body (extrapulmonary TB) can also be affected; for example, brain, lymph nodes, kidneys, bones, joints, larynx. intestines or eyes.
2. Who gets Tuberculosis?
Tuberculosis can affect people of any age. Most often, it is associated with older people who have had previous tuberculosis exposure. Individuals with weakened immune systems including those with AIDS or those infected with the human immunodeficiency virus-HIV are at increased risk.
3. How is TB spread?
TB is spread through the air from one person to another. The bacteria are put in the air when a person with TB disease of the lungs or throat coughs or sneezes. People nearby may breathe bacteria and become infected.
When a person breathes in TB bacteria the bacteria can settle in the lungs and begin to grow. From there, they move through the blood to other parts of the body, such as the kidney, spine and brain.
TB in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.
People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers.
Remember, TB is spread through the air. People cannot get infected with TB bacteria through handshakes, sitting on toilet seats, or sharing dishes and utensils with someone who has TB.
4. What is TB Infection?
In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain alive in the body and can become active later. This is called TB infection.
- have no symptoms
- don't feel sick
- can't spread TB to others
- usually have a positive skin test reaction
- can develop TB disease later in life if they do not receive preventive therapy
Many people who have TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active and cause TB disease.
5. What is TB disease?
TB bacteria become active if the immune system cannot stop them from growing. The active bacteria begin to multiply in the body and cause TB disease. Some people develop TB disease soon after becoming infected, before their immune system can fight the TB bacteria. Other people may get sick later, when their immune system becomes weak for some reason.
Babies and young children often have weak immune systems. People infected with HIV, the virus that causes AIDS, have very weak immune systems. Other people can have weak immune systems, too, especially people with any of these conditions:
- substance abuse
- diabetes mellitus
- cancer of the head or neck
- leukemia or Hodgkin's disease
- severe kidney disease
- low body weight
- certain medical treatments (such as corticosteroid treat or or organ transplants)
6. What are Tuberculosis symptoms?
Symptoms of TB depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs. TB in the lungs may cause:
- a bad cough that lasts longer than 2 weeks
- pain in the chest
- coughing up blood or sputum (phlegm from deep inside the lungs)
7. How can I get tested for TB?
A TB skin test is the only way to find out if you have TB infection. You can get a skin test at the health department or at your doctor's office. You should get tested for TB if:
- you have spent time with a person with infectious TB
- you have HIV infection or another condition that puts you at high risk for TB disease
- you think you might have TB disease
- you are from a country where TB disease is very common (most countries in Latin America and Caribbean, Africa, and Asia except for Japan)
- you inject drugs
- you live somewhere in the U.S. where TB disease is common (most homeless shelters, migrant farm camps, prisons and jails, and some nursing homes)
A health care worker can give you the TB skin test. He or she will inject a small amount of testing fluid (called tuberculin) just under the skin on the lower part of your arm. After 2 or 3 days, the health care worker will measure your reaction to the test. You may have a small bump where the tuberculin was injected. The health care worker will tell you if your reaction to the test was positive or negative. A positive reaction usually means that you have TB infection.
8. Where can I get tested for TB?
City of Milwaukee residents who are in certain risk high groups can get free TB Skin Tests at the three Health Centers during Walk-In Clinic times. WALK-IN CLINIC SCHEDULE
The test is applied at the first clinic visit. A return appointment 48-72 hours later is needed to evaluate the skin test.
The City of Milwaukee Clinics cannot do routine testing for a job or for school.
Non-city residents should contact their local health department for TB skin testing.
9. What if my skin test is positive?
If you have a positive reaction to the skin test, your doctor or nurse may do other tests to see if you have TB disease. These tests usually include a chest x-ray and a test of the phlegm you cough up. Because the TB bacteria may be found somewhere besides you lungs, the doctor or nurse may check your blood or urine, or do other tests. If you have TB disease, you will need to take medicine to cure the disease.
10. If I have TB infection, how can I keep from developing TB disease?
Many people who have TB infection never develop TB disease. But some people who have TB infection are more likely to develop TB disease than others. These people are at high risk for TB disease. They include:
- people with HIV infection
- people in close contact with a person who has infectious TB
- people who became infected with TB bacteria in the last 2 years
- babies and young children
- people who inject drugs
- people who are sick with other diseases that weaken the immune system
- elderly people
If you have TB infection (a positive skin test reaction) and you are in one of these high-risk groups, you need to take medicine to keep from developing TB disease. Anyone with TB infection should consider taking preventive medication. Discuss this with your doctor or a Milwaukee Health Department TB Clinic nurse.
People who have TB infection but do not receive preventive therapy need to know the symptoms of TB. If they develop symptoms of TB disease later on, they should see a doctor right away.
The medicine usually used for preventive therapy is a drug called isoniazid or INH. INH kills the TB bacteria that are inactive in the body. If you take your medicine as prescribed, preventive therapy will keep you from ever developing TB disease. Most people must take INH for at least 6 months. Children and people with HIV infection need to take iNH for a longer time.
11. How is TB disease treated?
There is good news for people with TB disease! TB disease can almost always be cured with medicine. But the medicine must be taken as the doctor or nurse tells you.
The most common drugs used to fight TB are:
- isoniazid (INH)
If you have TB disease, you will need to take several different drugs. This is because there are many bacteria to be killed. Taking several drugs will do a better job of killing all of the bacteria and preventing them from becoming resistant to the drugs.
Having TB should not stop you from having a normal life. When you are no longer infectious or feeling sick, you can do the same things you did before you had TB. The medicine you are taking should not affect your strength, sexual function, or ability to work. If you take your medicine as your doctor or nurse tells you, the medicine will kill all the TB bacteria. This will keep you from becoming sick again.
Think about people who may have spent time with you, such as family members, close friends, and coworkers. The local health department may need to test them for TB infection. TB is especially dangerous for children and people with HIV infection. If infected with TB bacteria, these people need preventive therapy right away to keep from developing TB disease.
12. Why do I need to take TB medicine regularly?
TB bacteria die very slowly. It takes at least 6 months for the medicine to kill all the TB bacteria. You will probably start feeling well after only a few weeks of treatment. But beware! The TB bacteria are still alive in your body. You must continue to take your medicine until all the TB bacteria are dead, even tough you may feel better and have no more symptoms of TB disease.
If you do not continue taking your medicine after you feel better or you are not taking your medicine regularly, this can be very dangerous. The TB bacteria will grow again and you will remain sick for a longer time. The bacteria may also become resistant to the drugs you are taking. You may need new, different drugs to kill the TB bacteria if the old drugs no longer work. These new drugs must be taken for a longer time an usually have more serious side effects.
If you become infectious again, you could give TB bacteria to your family, friends, or anyone else who spends time with you. It is very important to take your medicine the way your doctor or nurse tells you.
13. What is Multidrug-Resistant TB (MDR TB)?
When TB patients do not take their medicine as prescribed, the TB bacteria may become resistant to a certain drug. This means that the drug can no longer kill the bacteria.
Drug resistance is more common in people who:
- have spent time with someone with drug-resistant TB disease
- do not take their medicine regularly
- do not take all of their prescribed medicine
- develop TB disease again, after having taken TB medicine in the past
- come from areas where drug-resistant TB is common (Southeast Asia, Latin America, Haiti, and the Philippines)