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Tuberculosis

Tuberculosis (TB) is an infectious disease caused by the bacterium mycobacterium tuberculosis.

It mostly affects the lungs, but it can affect other parts of the body.

In the Northern Territory (NT), around 20 to 40 cases of tuberculosis (TB) are reported each year.

However, in other countries, TB is a widespread disease.

Forms of TB

There are 2 forms of TB, including active TB and latent TB.

Latent TB

You might not know if you have latent TB, it means the bacteria is inside your body but you have not yet developed an illness.

Latent TB means you:

  • were exposed to TB in the past
  • have no TB symptoms
  • can't spread TB to anyone else.

You can still be at risk of developing active TB in the future. Risk factors can include a weakening immune system caused by:

  • ageing
  • serious illnesses
  • diabetes
  • medication such as steroids
  • drug or alcohol use
  • HIV infection
  • treatments for cancer such as chemotherapy.

Sometimes there are no risk factors for TB becoming active.

Active TB

If you have active TB it means you have developed TB after:

  • having latent TB, or
  • being in close contact with someone who has active TB.

Active TB means you might:

  • have TB symptoms
  • spread it to other people.

How it spreads

When someone has TB in their lungs, they can release tiny droplets containing the bacteria into the air by:

  • coughing
  • sneezing
  • talking
  • singing.

These infected droplets can be inhaled by another person, which can cause them to develop latent or active TB.

TB can't be spread by handling objects that infected people have come into contact with. This includes dishes, drinking glasses, sheets or clothing.

Symptoms

If you have active TB you may experience:

  • a persistent cough for more than 2 weeks, sometimes with blood
  • fevers
  • weight loss
  • night sweats
  • tiredness and weakness
  • loss of appetite
  • swollen glands.

If you have latent TB, you will have no symptoms.

Diagnosis

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

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

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.

A 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 2 to 3 days later and the result is recorded.

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 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
  • 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.

It means that the person is infected by TB germs, but does not mean that he or she has TB disease.

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.

Treatment

TB is treated with antibiotics for a period of time.

If you have latent TB, you may not need treatment. This will depend on various factors related to your health risks and circumstances.

Active TB treatment can last for at least:

  • 4 months for children
  • 6 months for adults.

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.

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.

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.

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.

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.

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.

Control measures

To prevent spreading TB to others, practise good hygiene by:

  • covering your mouth and nose when coughing and sneezing
  • using a tissue and throw it in the bin immediately
  • washing your hands with water and soap, especially after coughing and sneezing
  • wearing a mask if you have any type of respiratory illness.

If you have latent TB, you may be offered medication to prevent getting active TB.

If you have active lung TB, you may be asked to isolate until you are no longer infectious.

Prevention

The BCG vaccine can offer protection and is available for people who meet the eligibility criteria.

To find out more, get the fact sheet from the NT Health digital library.

Find out more by contacting the TB clinic.

Information for health professionals

To find out more, go to the NT Health website.

Contact

For more information about TB or to get tested, contact the TB clinic.

You can also call your nearest Public Health Unit’s Centre for Disease Control.