Tuberculosis Information

Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with Active Tuberculosis can die if they do not get treatment.

• CDC TB General Information – English
• CDC TB General Information – Spanish
• CDC TB General Information – Haitian Creole

Symptoms of Active TB disease depend on where in the body the TB bacteria are growing. TB bacteria usually grow in the lungs (pulmonary TB). TB disease in the lungs may cause symptoms such as

• a bad cough that lasts 3 weeks or longer
• pain in the chest
• coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of TB disease are

• weakness or fatigue
• weight loss
• no appetite
• chills
• fever
• sweating at night

Symptoms of TB disease in other parts of the body depend on the area affected.

People who have latent TB infection

• do not feel sick,
• do not have any symptoms, and
• cannot spread TB to others.

Some people develop Active TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason.

Overall, about 5 to 10% of infected persons who do not receive treatment for latent TB infection will develop TB disease at some time in their lives. For persons whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for persons with normal immune systems.

Generally, persons at high risk for developing TB disease fall into two categories:

• Persons who have been recently infected with TB bacteria

• Persons with medical conditions that weaken the immune system

Persons who have been Recently Infected with TB Bacteria

This may include:

• 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

• 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

• Silicosis

• 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

Preventing Latent TB Infection from Progressing to TB Disease

Many people who have latent TB infection never develop Active TB disease. But some people who have latent TB infection are more likely to develop TB disease than others.

If you have latent TB infection and you are in one of these high-risk groups, you should take medicine to keep from developing TB disease. There are several treatment options for latent TB infection. You and your health care provider must decide which treatment is best for you. If you take your medicine as instructed, it can keep you from developing TB disease. Because there are less bacteria, treatment for latent TB infection is much easier than treatment for TB disease. A person with TB disease has a large amount of TB bacteria in the body. Several drugs are needed to treat TB disease.

Preventing Exposure to TB Disease While Traveling Abroad

In many countries, TB is much more common than in the United States. Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environments (for example, clinics, hospitals, prisons, or homeless shelters).

Air travel itself carries a relatively low risk of infection with TB of any kind. Travelers who will be working in clinics, hospitals, or other health care settings where TB patients are likely to be encountered should consult infection control or occupational health experts. They should ask about administrative and environmental procedures for preventing exposure to TB. Once those procedures are implemented, additional measures could include using personal respiratory protective devices.

Travelers who anticipate possible prolonged exposure to people with TB (for example, those who expect to come in contact routinely with clinic, hospital, prison, or homeless shelter populations) should have a TB skin test or a TB blood test  before leaving the United States. If the test reaction is negative, they should have a repeat test 8 to 10 weeks after returning to the United States. Additionally, annual testing may be recommended for those who anticipate repeated or prolonged exposure or an extended stay over a period of years. Because people with HIV infection are more likely to have an impaired response to TB tests, travelers who are HIV positive should tell their physicians about their HIV infection status.

Tuberculosis is a serious health threat, especially for people living with HIV. People living with HIV are more likely than others to become sick with TB. Worldwide, TB is one of the leading causes of death among people living with HIV.

Without treatment, as with other opportunistic infections, HIV and TB can work together to shorten lifespan.

• Someone with untreated latent TB infection and HIV infection is much more likely to develop TB disease during his or her lifetime than someone without HIV infection.
• Among people with latent TB infection, HIV infection is the strongest known risk factor for progressing to TB disease.
• A person who has both HIV infection and TB disease has an AIDS-defining condition.

People infected with HIV who also have either latent TB infection or TB disease can be effectively treated. The first step is to ensure that people living with HIV are tested for TB infection. If found to have TB infection, further tests are needed to rule out TB disease. The next step is to start treatment for latent TB infection or TB disease based on test results.

Treatment

Untreated latent TB infection can quickly progress to TB disease in people living with HIV since the immune system is already weakened. And without treatment, TB disease can progress from sickness to death.

Fortunately, there are a number of treatment options for people living with HIV who also have either latent TB infection or TB disease.

There are several treatment regimens recommended in the United States for Active TB disease. TB treatment can take 4, 6, or 9 months depending on the regimen.

For the exact treatment regimens, visit the CDC Webpage: Treatment for TB Disease