Tuberculosis: TB

Introduction

Tuberculosis (TB) is an infectious disease that usually affects the lungs but can affect any part of the body. 

This guide has information about all of the following:


About tuberculosis: TB

Tuberculosis (TB) is an infectious disease that usually affects the lungs but can affect any part of the body.

It is a serious illness caused by active TB germs.

After the TB germs enters the body, in most cases, body defences control the germs by building a wall around them, the way a scab forms over a cut.

The germs can stay alive inside these walls for years in an inactive or latent state.

This is known as latent TB infection.

While TB germs are inactive, they cannot harm the person and they cannot spread to other people.

The person is infected but not sick and is unlikely to be aware that he or she is infected.

The only way to tell whether the germs are there is by having a Mantoux test which is a skin test, or a special blood test.

Inactive TB germs cannot hurt you, but if body defences are weakened for any reason, the wall around the TB germs can become weakened and the germs can become active and multiply to progress to disease and make the person sick.

This may be years later due to:

  • ageing
  • a serious illness
  • developing diabetes
  • drug or alcohol abuse
  • HIV infection
  • treatments such as chemotherapy for cancer
  • steroid medication or other medications for medical conditions that alter the immune system such as for severe arthritis.

Signs and symptoms

TB can affect any part of the body but the lungs are the most common target.

People with TB disease may have some or all of the following symptoms:

  • persisent cough for more than two weeks
  • fevers
  • weight loss
  • night sweats.

How it's spread

TB is spread when people who have active untreated TB germs in their lungs or throat cough, sneeze or speak and send their germs into the air.

Other people who breathe these germs into their lungs can become infected.

People who breathe in TB germs usually have had close contact with someone who has the disease.

TB is not spread by handling objects that the patient has come in contact with such as dishes, drinking glasses, sheets or clothing.


Being tested for tuberculosis

Sometimes people can become infected with tuberculosis (TB) germs without getting the actual disease. 

The Mantoux test, also called the tuberculin skin test, can show if the person has ever been infected by TB germs. 

TB infection does not mean the person has the disease, but if someone has been infected there is a chance they might get sick with TB in the future. 

Who needs a Mantoux test

Recent contacts of someone who has active TB disease. This could be family members, friends, or co-workers.

You should get a test if any of the following apply:

  • you have had a chest X-ray suggesting that you have had untreated TB disease in the past
  • you have lowered immunity such as HIV infection or certain medical conditions (renal failure, certain cancers, diabetics, before starting steroids or other immunosuppressive drugs)
  • you are required to be tested for your employment reasons or as part of a school screening program, providing you have not had a previous positive Mantoux test
  • before administering a tuberculosis vaccine (BCG) to infants greater than 6 months of age
  • you are about to undergo organ donation
  • you are travelling to a high risk country.

What the test involves

A Mantoux test is a simple and safe test. 

A small amount of tuberculin purified protein derivative (Tubersol®) is injected just under the top layer of the skin on your arm using a small sterile needle and syringe. 

The skin reaction (lump) is measured two to three days later and the result recorded.

Possible side effects

Side effects are uncommon. However, if you have been exposed to TB germs you may occasionally have a sizeable reaction, which may cause some discomfort.

This swelling should disappear in about 2 weeks.
 
The reaction can get itchy. It is best not to scratch the arm – a cold compress can help relieve any itching. 

If your test is negative

If the lump is below a certain size the result of the test is negative. Usually this means that the person has not been infected with TB germs. However, under some circumstances it can be negative even when someone has been infected. 

This can happen if the exposure to TB has been in the last few weeks and the body has not had time to develop a reaction or if the body’s defences are weakened and unable to react to the skin test. 

In these situations the test may need to be repeated or interpreted differently.

If your test is positive

It means that the person is infected by TB germs, but does not mean that he or she has TB disease. A Mantoux positive person cannot pass TB onto anyone else unless there is progression at some stage to active pulmonary TB disease.

If you are infected and do not have TB

After TB germs enter the body, in most cases, body defences control the germs by building a wall around them, the way a scab forms over a cut. The germs can stay alive inside these walls for years in an 'inactive' or latent state.

While TB germs are inactive, they cannot harm the person and they cannot spread to other people. The person is infected but not sick and is unlikely to be aware that he or she is infected.

After the test

If the test is negative, no further testing is needed at this time, but you may need another test a few months later, depending on the reason for the test. 

If the test is positive, a chest X-ray and physical examination will be needed to ensure there is no sign of active disease. 

If there are no signs of active TB the doctor will discuss the possibility of taking medication to prevent the development of TB disease. 

The benefits of taking the medication depend on the person’s age, health and underlying risk of TB disease.

Contact

For more information, contact the TB clinic in your area.

Other languages

Mantoux Arabic translation  (Adobe PDF document - 454KB)
Mantoux Bahasa Indonesian translation  (Adobe PDF document - 76KB)
Mantoux Burmese translation  (Adobe PDF document - 217KB)
Mantoux Dari translation (Adobe PDF document - 165KB)
Mantoux Farsi translation  (Adobe PDF document - 447KB)
Mantoux French translation  (Adobe PDF document - 227KB)
Mantoux Hazaragi translation  (Adobe PDF document - 110KB)
Mantoux Nepalese translation  (Adobe PDF document - 188KB)
Mantoux Somali translation  (Adobe PDF document - 235KB)
Mantoux Swahili translation  (Adobe PDF document - 234KB)
Mantoux Tamil translation  (Adobe PDF document - 219KB)


Treatment of tuberculosis

In most cases TB can be cured by taking tablets for at least six months.

Most people who have TB will begin treatment by taking at least four different types of tablets, which may be reduced after several months.

Taking tablets

It's important to take the drugs as instructed and for the full treatment.

Even if you feel better you should keep taking your tablets as there can still be active TB germs in your body.

The tablets are usually given to you by a health care worker either daily or three times a week, depending on whether you have any underlying chronic illnesses, the type of TB and where you are infected.

It's best to take the tablets at the same time every day and on an empty stomach half an hour before meals or bedtime. 

You should take the tablets with milk, water or juice.

Avoid drinking alcohol while taking TB medication as it increases the risk of serious liver problems. 

You should eat healthy food and get enough rest. 

Where you will be treated

If you have lung TB or extensive disease you may need to be admitted to hospital for the first few weeks of treatment.

You may be infectious for a month or so so you should limit your contacts until the doctor says you are no longer infectious.

Most patients who are no longer infectious live at home and continue as normal, including contact with people and children.

You can continue your regular activities and return to work as long as you take your medication.

Resistant TB

Sometimes TB germs are resistant and tablets will not kill the germs.

If this happens, you will be given combinations of other medications.

Resistant TB is harder to cure and takes more time to control, but most people with resistant TB can be treated.

Your doctor will make sure specific tests are done to check for health resistance.

Drug resistant TB

You can develop drug resistant TB if you don't take the medication as prescribed. 

If you have untreated drug resistant TB of the lungs or throat you can spread those drug resistant germs.

Side effects and other medication

Most people do not experience any problems but you may have side effects.

Tell your doctor or health care worker if you have unexplained illness or any of the following symptoms happen:

  • nausea and/or vomiting
  • jaundice - yellow skin or eyes, dark urine
  • unexplained fever or tiredness
  • tingling or numbness of hands or feet or joint pains
  • skin rash, itching or bruising
  • blurred vision or colour blindness to red or green.

You should tell your doctor if you are taking any other medication especially any of the following:

  • contraceptives
  • diabetic tablets
  • anti-epilepsy drugs
  • anti-coagulation tablets.

One of the drugs, Rifampicin causes can turn your urine, sweat and tears to pink/orange.

This is normal and causes no problems if you wear contact lenses. 

Monthly check-ups

While you are taking the medication you must visit a TB clinic doctor monthly.

They will check your weight and general health, ensure your sputum has cleared of germs and your chest x-ray is improving.

They will also check to see if you are having any other side effects.

For more information, contact the TB clinic in your area.

Other languages

Preventive treatment for latent TB infection

LTBI Arabic translation (Adobe PDF document - 147KB)
LTBI Bahasa Indonesian translation (Adobe PDF document - 33KB)
LTBI Dari translation (Adobe PDF document - 118KB)
LTBI Hazaragi translation (Adobe PDF document - 117KB)
LTBI Swahili translation (Adobe PDF document - 84KB)
LTBI Somali translation (Adobe PDF document - 85KB)
LTBI Filipino translation (Adobe PDF document - 90KB)
LTBI Tamil translation  (Adobe PDF document - 90KB)
LTBI Vietnamese translation (Adobe PDF document - 153KB)

Treatment for TB

TB treatment Arabic translation  (Adobe PDF document - 412KB)
TB treatment Burmese translation  (Adobe PDF document - 163KB)
TB treatment Dari translation  (Adobe PDF document - 535KB)
TB treatment Farsi translation  (Adobe PDF document - 411KB)
TB treatment Filipino translation (Adobe PDF document - 84KB)
TB treatment Hazaragi translation  (Adobe PDF document - 327KB)
TB treatment Indonesian translation  (Adobe PDF document - 166KB)
TB treatment Swahili translation  (Adobe PDF document - 146KB)
TB treatment Somali translation (Adobe PDF document - 82KB)
TB treatment Tamil translation  (Adobe PDF document - 80KB)
TB treatment Vietnamese translation (Adobe PDF document - 183KB)


TB clinic

The focus of the Tuberculosis and Leprosy Unit is on screening for TB in the local Aboriginal and Torres Strait Islander population and people born overseas, including international school and university students, newly arrived refugees and illegal foreign fishermen.

Darwin TB and Leprosy Unit
Building 4
Royal Darwin Hospital
Rocklands Drive
Tiwi NT 0810 

Phone: (08) 8922 8804
Fax: (08) 8922 8310 

For more information contact the Centre for Disease Control.