Tuberculosis (TB) is a
disease caused by bacteria called Mycobacterium tuberculosis. The bacteria can
infect any part of the body, but most of the time it settles in the lungs. TB
can be spread in the air by someone who has TB in the lungs or throat when he
or she is coughing, singing, talking or sneezing. TB is not spread by touching
someone who has TB. Once someone breathes
in the bacteria, they can develop latent tuberculosis infection, a condition
where the body stops the bacteria from growing. Someone with latent TB
infection does not have symptoms of the disease and is not able to spread the
bacteria to others. About 10 percent of the people who have latent TB infection
will develop the active disease at some time during their life.
the TB bacteria continue to grow in the body, the infected person will develop
the active form of the disease. Symptoms of active TB disease include:
· Having a bad cough
that lasts three weeks or longer;
· Coughing up blood;
· Experiencing weakness
· Losing weight;
· Having no appetite; and
· Having chills and
fever and/or sweating at night.
for TB consists of taking medications to kill the bacteria. The TB bacteria
grow slowly, so treatment is required for at least six months to completely
kill the germs.
to experts at the Centers for Disease Control and Prevention (CDC) and the
American Thoracic Society, patients should be started on four anti-tuberculosis
drugs to prevent the development of drug resistance. Drug resistance leads to
TB that is more difficult to treat. The standard of care in Pennsylvania is to
begin all suspected and confirmed cases of tuberculosis on four-drug therapy.
Observed Therapy (the visual monitoring by a health care worker of patients'
ingestion of medications) is the standard of care for all active cases of TB
treated by providers at the Pennsylvania Department of Health. This ensures
that all doses of the medications are taken to stop the spread of the disease
and prevent the development of drug-resistant TB.
Risk Factors for
Generally, persons at
high risk for developing TB disease fall into two categories:
· Persons who have been
recently infected with TB bacteria; and
· Persons with medical
conditions that weaken the immune system.
Persons who have been Recently Infected with TB Bacteria
· Close contacts of a
person with infectious TB disease;
· Persons who have
immigrated from areas of the world with high rates of TB;
· Children less than 5
years of age who have a positive TB test;
· Groups with high
rates of TB transmission, such as homeless persons, injection drug users, and
persons with HIV infection; and
· Persons who work or
reside with people who are at high risk for TB in facilities or institutions
such as hospitals, homeless shelters, correctional facilities, nursing homes,
and residential homes for those with HIV.
Persons with Medical Conditions that Weaken the Immune System
Babies and young
children often have weak immune systems. Other people can have weak immune
systems, too, especially people with any of these conditions:
· HIV infection* (the
virus that causes AIDS);
· Substance abuse;
· Diabetes mellitus;
· Severe kidney disease;
· Low body weight;
· Organ transplants;
· Head and neck cancer;
· Medical treatments
such as corticosteroids or organ transplant;
· Specialized treatment
for rheumatoid arthritis or Crohn’s disease; and
· Taking medications
that suppress the immune system like chemotherapy.
* TB is the leading killer among people living with HIV, who have weakened immune systems.
Please check with your healthcare provider if you have more questions about TB
and your health.
Pennsylvania Department of Health, along with county and municipal health
departments, provide information and assistance to residents with questions or
concerns about TB.
· Outpatient examination and diagnostic
· Laboratory and X-ray services, if there is no
source of payment;
· Medication for the treatment and prevention of
· In-field, Directly Observed Therapy (DOT) for
patients to complete recommended therapy;
· Hospitalization for persons with tuberculosis
who are very ill, require inpatient care and have no source of payment; and
· Identifying close contacts of patients with
infectious TB, evaluating those contacts for TB infection or active disease,
and providing treatment to close contacts as needed.
Individuals can also work with their private healthcare providers.
· In 2015,
the United States reported 9,563 cases of TB. During that same year,
Pennsylvania had 200 cases.
number of tuberculosis cases in Pennsylvania decreased from 208 in 2014 to 200
in 2015, which represents a 3.8 percent decrease.
· Over the
past five years, the number of TB cases in Pennsylvania has decreased by a
total of 23 percent - from 260 in 2011 to 234 in 2012, 214 in 2013, 208 in 2014 and
now 200 in 2015.
World TB Day is celebrated every
year on March 24, commemorating the day in 1882 when the discovery
of the bacteria that causes TB was first announced.
For more information about TB, contact the Bureau of
Communicable Diseases, Division of TB/STD at 717-787-6267.