Tuberculosis Control Program

What is TB?

Tuberculosis (TB) is an airborne communicable disease caused by Mycobacterium tuberculosis. While TB of the lungs (pulmonary TB) is the most common, tuberculosis can affect any organ in the body.

TB is spread from infectious to uninfected persons through the air by droplets that contain Mycobacterium tuberculosis. Droplets containing tuberculosis can spread when an infectious person coughs, speaks, sneezes, laughs, or sings. If an uninfected person inhales these droplets, he or she is at risk of becoming infected with tuberculosis.

TB is NOT spread by shaking hands or sharing food or drinks.

How do you get TB?

TB is spread through infectious droplets or particles that a person with infectious TB disease can spread when he or she coughs, speaks, sneezes, laughs, or sings. Persons nearby may breathe in these particles and become infected.

What is the difference between latent tuberculosis infection (LTBI) and TB disease?

LTBI is when a person is infected with M. tuberculosis but does not have TB disease. Persons with LTBI are at risk for developing TB disease but do not have symptoms and cannot spread tuberculosis to others.

TB Disease is when a person has a large number of M. Tuberculosis bacteria in his or her body. Once a person progresses to TB disease, they can spread tuberculosis to others and will begin experiencing symptoms.

Without adequate treatment, persons with TBI are at risk of developing TB disease.

How do you test for TB?

The two most common tests for TB are the tuberculin skin test and TB blood test. The skin test is commonly used by employers and schools and universities to screen for TB.

The skin test involves a small injection in the forearm. Results are called "positive" depending on the amount of swelling at the injection site 48-72 hours after the injection. Most persons who are infected with TB will have a positive skin test.

A positive result to a skin test or blood test only means the person may be infected, it does not indicate if the person has active TB disease. Further testing such as X-rays, physical examination, and various sputum tests will be conducted to determine if the person has TBI or TB disease. For more information on further diagnostic testing of persons with positive skin or blood tests, visit: https://www.cdc.gov/tb/topic/testing/diagnosingltbi.htm

Testing is considered safe throughout pregnancy.

Who is at risk of TB?

Not all those exposed to a person with infectious TB will become infected. Four factors influence the transmission of TB from an infectious to an uninfected person:

1. How infectious the TB patient is: If the infected person has been taking all medications of their TB treatment, their level of infectiousness will be lower than that of someone who is not being treated or is not taking the full course of their treatment.
2. Environment where exposure occurred: If the exposure occurred in an enclosed area with poor ventilation, transmission is more likely than if the exposure occurred in an outdoor setting with better airflow and sunlight.
3. Frequency and duration of exposure: The more time spent with an infectious TB patient, the more likely the disease will spread to the uninfected person.
4. Immune status of the uninfected person: If the person exposed to an infectious TB patient has a compromised immune system potentially caused by HIV/AIDS or taking other medications that suppress the immune system, they are more likely to become infected with tuberculosis.

The following are persons considered at higher risk of becoming infected with TB and developing TB disease, according to national TB standards:

• Close contacts of persons with infectious TB
• Children under 5 years of age
• Persons who have recently visited or immigrated from areas of the world with high rates of TB
• Persons with medical conditions that weaken the immune system
• Persons who work in congregate settings such as hospitals, nursing homes, correctional facilities, etc.
• Persons with a history of inadequately treated TB

What are the signs and symptoms of TB?

Persons with TB infection (TBI) are infected with tuberculosis but do not experience symptoms.
Persons with TB disease will likely experience the following symptoms.

Initial symptoms can include:

• Fatigue
• Weight loss
• Loss of appetite
• Chills
• Night sweats
• Persistent low-grade fever
• General flu-like symptoms

Additional symptoms of Pulmonary TB (TB of the lungs) can include:

• Cough persisting for more than 3 weeks
• Cough-producing blood or sputum (phlegm coughed up from the lower airways)
• Tightness or aching in the chest

TB can affect any organ in the body. Symptoms of TB in organs other than the lungs vary among patients and can mimic other infections. Persons experiencing any of these symptoms who have been exposed to a person with infectious TB should notify their nurse or physician when making an appointment.

Is there a treatment for TB?

Yes, TB is curable and preventable. There are treatment plans for TBI and TB disease.

Directly observed therapy (DOT) is the standard of care for all TB cases in Louisiana. DOT ensures patients take all doses of their TB treatment regimen by having a healthcare provider observe the patient taking their medication. During a DOT visit, the healthcare worker also monitors the patient's response to treatment. DOT can be done in a healthcare facility, the patient's home, or another location agreed upon by the patient and the healthcare worker.

Standard treatment for TBI can last 3-6 months, depending on the regimen. Persons with TBI will discuss the different regimens with a TB physician to determine which regimen is best for the patient. 

Standard treatment for TB disease lasts 6-9 months and is initially comprised of four drugs. Treatment plans can vary if the patient is a young child or has a co-infection such as HIV or other medical conditions.

Treatment for persons with drug-resistant TB disease is significantly longer than standard treatment regimens. Testing is done before treatment starts to determine if the disease is resistant to any of the standard TB medications. In the event of resistance, the use of second-line drugs is initiated.

Inadequate treatment or lack of adherence to medications can lead to continued infectiousness and transmission, emergence of drug resistance, or recurrent disease.