What is Tuberculosis?
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Tuberculosis is a bacterial disease that can affect any part of the body, but usually attacks the lungs. TB used to be a major cause of illness and death in the United States, but as a result of public health initiatives has declined. Worldwide, tuberculosis continues to be a major health problem. It is one of the most common infectious diseases in the world, and is estimated to kill 2 million people a year.
How is TB spread?
It is spread through the air from person to person.
What is latent 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 multiplying. The bacteria become inactive, but they remain alive in the body and can become active later. This is called latent TB infection. People with latent TB infection have no symptoms, are not infectious, usually have a positive skin test, and can develop active TB if not treated. Not everyone with latent TB will develop active TB, but in some people, especially those with weak immune systems active TB does develop. The risk for development of active TB is greatest in the first five years after infection.
What is active TB?
TB bacteria become active if the immune system cant stop them from multiplying. The active bacteria begin to multiply in the body and cause TB disease. Active TB usually causes symptoms such as cough, fever, sweats, and weight loss. With this form of TB chest x-rays are often abnormal and the disease can be spread to others.
Why Tuberculosis Skin Test?
To identify and treat active latent TB both of which can be identified by a positive (PPD) tuberculin skin test.
Who should get tested for TB?
Individuals at high risk for the development of TB. TB screening is complex and skin tested of all entering college students is NOT recommended.
Individuals at high-risk include: Those who have arrived within the past 5 years from countries where TB is common. Other categories of high-risk students include those with HIV infection, who inject drugs, have resided in, volunteered in or worked in high-risk congregate settings such as prisons, nursing homes, hospitals, residential facilities for patients with AIDS or homeless shelters; and those who have clinical conditions such as silicosis, end-stage kidney disease, diabetes mellitus, cancer of the head/neck or lungs, lymphoma or leukemia, immunosuppressive disorder or therapy, prolonged steroid therapy (e.g., prednisone 15mg/d for 1 month), recent weight loss (>10% of ideal body weight), or had gastrectomy or jejunoileal bypass.
What if I had been vaccinated with BCG?
BCG is a vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG vaccine does not always protect people from TB. If you were vaccinated with BCG, you may have a positive reaction to a TB skin test. TB skin test reactions to BCG vaccination in childhood usually returns to normal after 5 years. Thus, a positive reaction probably means that you have latent TB, especially if:
7 you recently spent time with a person who has TB disease
7 you are from an area of the world where TB disease is very common
7 you spend time where TB is common (homeless shelter, drug-treatment center, health care clinics, jails, prisons)
Should I Be Tested?
TB for testing is highly recommended for those who are at highest risk need to be especially vigilant. This group includes those who live in very crowded conditions with poor medial care (e.g., the homeless, prisoners, intravenous drug abusers), as well as those with HIV/AIDS. At Rutgers University, the largest group that is at increased risk are those who are born in, or travel to, countries where there is a high incidence of TB. This would include almost all of the underdeveloped world, such as places as most of South America, much of the Carribean, as well as Asia and parts of Africa. Rutgers requires TB testing for students with non-immigrant visas and who were born or grew up in a county where TB is prevalent.
What can be done?
If it is a positive, dont be alarmed, as this is a very common finding but it does mean you are carrying the bacterial in you body and do need further testing and treatment. A chest x-ray is then done to make sure that you dont have any signs of active TB. If the chest x-ray is normal, then you are treated. The treatment of latent infection includes taking an inexpensive (isoniazid or INH) one a day for 9-12 months.
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