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revised May 17, 2013

Arrow BulletTuberculosis (TB)

What is tuberculosis?

  • Tuberculosis (TB) is an infectious disease caused by the tuberculosis bacteria (germ). The TB germ usually causes an infection in the lungs but may travel in the blood stream and affect other parts of the body.

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How is tuberculosis spread?

  • Tuberculosis is only infectious if the disease is in the lungs (pulmonary TB) and the person is coughing the germ into the air. People then breathe the germ into their lungs and become infected. It usually requires close, prolonged contact with the case to get the TB germ. People cannot get TB by sharing cutlery, dinner plates, drinking cups or toilet seats.

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What is the difference between TB infection and Active TB disease?

  • When a person breathes the TB germ into their lungs, the body's defences (antibodies) usually destroy the TB germs or wall off the germs so no damage is done. People may not even know they have been infected.

  • A skin test is able to detect TB anti-bodies. It shows whether someone has been exposed to the TB germ. People who have had sufficient contact with the TB germ will have a positive skin test 2-12 weeks after initial exposure. This is known as TB infection. TB infection is not contagious.

  • At the time of TB infection only about 5 per cent of people become sick with active tuberculosis disease (where the germ is doing damage). These are usually children or people who are not healthy. Others may develop active disease later in life when the TB germs that were walled off start to grow again and cause damage in the body. This happens in approximately 10 per cent of those with a positive skin test. The elderly, the immunocompromised or those with poor general health are at highest risk, as their ability to fight infection is weaker.
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What are the symptoms of active TB disease?

  • Pulmonary tuberculosis may not produce any early symptoms until the infection in the lung has reached a size that is visible on x-ray. Symptoms in adults include cough, loss of appetite, fatigue, weight loss, fever and night sweats. TB may be misdiagnosed as bronchitis or pneumonia. Any cough lasting longer than three weeks should be thoroughly investigated.

  • Sometimes, the disease is outside the lung such as in the kidney, lymph nodes, bone, etc. causing symptoms such as pain and discomfort in those sites.

  • Infants are more likely to have symptoms than older children. The most common symptoms are: difficulty breathing, fever, night sweats, poor feeding, lethargy or irritability. Children may not gain weight or grow as they should. A cough may or may not be present. Usually an infant with TB is very sick. A prolonged infection that is not being cured by antibiotics can occasionally be TB. Because babies do not cough deeply it is very hard for them to spread TB.

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Is there treatment for tuberculosis?

  • Tuberculosis is curable. People are treated at home under the supervision of their doctor. Usually after two weeks they are no longer contagious and can return to work or school. Medication must be taken every day for at least 6 - 9 months or as the doctor orders. The full treatment must be completed to prevent drug resistance from developing. Drug resistance means that the drug is no longer effective in destroying the TB germ. Peel Health provides the free medication and a treatment program called Directly Observed Therapy (DOT).

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What is preventive treatment?

  • Preventive medicine, Isoniazid (INH) or Rifampin pills, may be prescribed for persons with a positive skin test. Taken daily, preventative medication has been shown to prevent TB infection from becoming TB disease. Before starting preventive treatment, a medical assessment and chest x-ray are necessary to rule out tuberculosis disease. People, who have a positive skin test and do not complete preventive therapy, run a risk of developing tuberculosis disease. Their doctor should have this information so that TB might be considered if a prolonged infection or chronic cough occurs.

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Revised: May 17, 2013

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