Tuberculosis

The Florida Department of Health in Washington County focuses our efforts on treatment until cure and case management of active tuberculosis cases and contact follow-up and treatment until completion of therapy of latent infected close contacts to an active TB case.  The health department works with the Florida Department of Health in investigating cases of active TB in Washington County. Preventive medication and nursing services can be provided to those with a positive skin test and negative chest x-rays.

What is TB?

Tuberculosis is caused by the bacteria called Mycobacterium tuberculosis. The bacterial infection can attack any part of the body, but is found most often in the lungs. In the early 1900's tuberculosis was the leading cause of death in the United States. In 1940 scientists began discovering drugs which would effectively treat the disease. The disease has declined over the years, but there is still approximately 16,000 cases in the United States each year. 

How is TB spread?

Tuberculosis is spread through droplets in the air. When an infected person coughs, sneezes or sings, the bacteria are put in the air. People nearby may breathe in the droplets and become ill. After the droplets are breathed in they begin to grow in the lungs. They may stay there, or they may move to other organs (kidney, liver, or spine). Most people who breathe in the bacteria never get sick because their immune system attacks the bacteria and destroys them. However, if a person has diabetes, HIV Infection, a sexually transmitted disease, or some other illness which has harmed the immune system, their body will be too weak to fight the disease.

Signs and Symptoms:

• Cough lasting longer than three (3) weeks, usually productive cough

• Fever

• Shortness of breath

• Unexplained substantial weight loss

• Night sweats

How can I get tested for TB?

Anyone may be tested for TB, including adults, children, pregnant women, people with colds, and people who have had the Bacille Calmette-Guerin (BCG) Vaccine.  Skin tests cost $10.00; however, they are provided free of charge to those who have had contact with a documented active TB case.  After skin testing, you must return to the Health Department for a reading in 48 to 72 hours.

TB skin testing is recommended in Florida only for:

•Persons with recent TB exposure and or

•Persons at risk for progression to active diseases

•Persons who are likely to complete treatment

The decision to test should always be a decision to complete treatment.

What if I have a positive test for TB?

If you have a positive reaction to the TB skin test or the QFT-G, your doctor or nurse may do other tests to see if you have active TB disease. These tests usually include a chest x-ray. It may also include a test of the phlegm you cough up. Because the TB bacteria may be found somewhere other than your lungs, your doctor or nurse may check your blood or urine, or do other tests. If you have active TB disease, you will need to take medicine to treat the disease. 

What if I have been vaccinated with BCG?

BCG is a vaccine for TB. This vaccine is not 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. History of BCG vaccination is not a contraindication to TB skin testing; a positive result is highly indicative of TB infection in a person who has received BCG. If you were recently (5 yrs) vaccinated with BCG, you may have a positive reaction to a TB skin test. This reaction may be due to the BCG vaccine itself or to latent TB infection. But your positive reaction probably means that you have latent TB infection if: 

• you recently spent time with a person who has TB disease

• you are from an area of the world where TB disease is very common (most countries in Latin America and the Caribbean, Africa, Asia, Eastern Europe, and Russia)

• you spend time where TB is common (homeless shelters, drug-treatment centers, health care clinics, jails, prisons

If I have latent TB infection, how can I keep from developing active TB disease?

Many people who have latent TB infection never develop active TB disease. But some people who have latent TB infection are more likely to develop active TB disease than others. These people are at high risk for active TB disease.

They include: 

• people with HIV infection

• people who became infected with TB bacteria in the last 2 years

• babies and young children

• people who inject illegal drugs

• people who are sick with other diseases that weaken the immune system

• elderly people

• people who were not treated correctly for TB in the past

What if I have a poistive test for TB?

If you have latent TB infection (a positive TB skin test reaction or positive QFT-G) and you are in one of these high-risk groups, you need to take medicine to keep from developing active TB disease. This is called treatment for latent TB infection.

What if I have HIV infection? 

HIV and TB form a lethal combination, each speeding the other’s progress. HIV weakens the immune system. Someone who is HIV-positive and infected with TB is many times more likely to become sick with TB than someone infected with TB who is HIV-negative. TB is a leading cause of death among people who are HIV-positive. It accounts for about 13% of AIDS deaths worldwide. In Africa, HIV is the single most important factor determining the increased incidence of TB in the past 10 years. 

How is active TB disease treated?

TB is treated with a number of special antibiotics given over 9-12 months.  The TB germs are very strong and slow to be killed.  It is important that persons infected with TB follow the medication schedule closely.  Failure to follow the medication schedule could result in a more serious "drug resistant" TB condition. 

How can I keep from spreading TB?

The most important way to keep from spreading TB is to take all your medicine, exactly as directed by your doctor or nurse.  If you are sick enough with active TB disease to go to a hospital, you may be put in a special room. These rooms use air vents that keep TB bacteria from spreading to other rooms. People who work in these special rooms must wear a special face mask to protect themselves from TB bacteria. You must stay in the room so that you will not spread TB bacteria to other people. If you are infectious while you are at home, there are certain things you can do to protect yourself and others near you: 

•The most important thing is to take your medicine.

•Always cover your mouth with a tissue when you cough, sneeze, or laugh. Put the tissue in a closed bag and throw it away. 

•Do not go to work or school. Separate yourself from others and avoid close contact with anyone. Sleep in a bedroom away from other family members. 

•Air out your room often to the outside of the building (if it is not too cold outside). TB spreads in small closed spaces where air doesn't move. Put a fan in your window to blow out (exhaust) air that may be filled with TB bacteria. If you open other windows in the room, the fan also will pull in fresh air. This will reduce the chances that TB bacteria will stay in the room and infect someone who breathes the air.

After you take medicine for about 2 or 3 weeks, you may no longer be able to spread TB bacteria to others. Remember, you will get well only if you take your medicine exactly as your doctor or nurse tells you.