Tuberculosis

Answer the following questions based on your

experience or your knowledge
1. What is Tuberculosis?
2. What is the difference between TB infection and
TB disease?
3. Who can develop TB disease?
4. How does TB spread?
5. What are the symptoms of TB disease?
6. What is the Treatment for TB disease?
 Tuberculosis
• What is Tuberculosis?
• Tuberculosis (TB) is an infectious disease
caused by the bacteria Mycobacterium
tuberculosis. TB disease most often affects the
lungs, but can occur anywhere in the body.
• What is the difference between TB infection and TB
disease?
• In TB infection, the TB bacteria are in the body but are
asleep or inactive. This means that a person with TB
infection is not sick and cannot spread TB to other people.
A person with TB infection usually has a positive TB skin
test, a normal chest x-ray and no symptoms of TB disease

TB infection can sometimes turn into TB disease. Many

people (90%) who have TB infection never develop TB
disease. However, about 10% of the people with TB
infection develop TB disease.
• In TB disease, the TB bacteria in the body
awaken or become active. This means that a
person with TB disease is sick and may spread
TB to other people. A person with TB disease
has a positive TB skin test, an abnormal chest
x-ray (usually) and symptoms of TB disease
(coughing for more than 3 weeks, fever, night
sweats, fatigue, unexplained weight loss, and
loss of appetite). A person with TB disease
needs to take medication to become well.
 Who can develop TB disease?
• Persons most likely to develop TB disease are
those who have recently become infected with TB
through someone with whom they live or have
close contact. TB disease usually develops within
the first two years after getting infected with TB.
After the two years is over, the risk of developing
TB disease decreases. However, it may still be
possible to develop TB disease if the immune
system is weakened by another medical
condition, drug abuse, malnutrition or old age
 How does TB spread?
• TB spreads through the air. When a person with
contagious TB coughs, laughs, sings, etc., the TB
bacteria are released into the air. These TB
bacteria can remain in the air for many hours.
Anyone who breathes this air that contains TB
bacteria may become infected.

To prevent spreading TB to another person,

anyone with contagious TB disease should cover
their mouth and nose when coughing or
sneezing.
• Fact: Persons with TB disease who have taken
the correct TB medications for a specified
period of time do not continue spreading TB
to others.
• Fact: TB bacteria do not spread by kissing or
sharing drinking glasses, dishes, or other
objects. TB bacteria must be inhaled in order
for infection to occur.
What are the symptoms of contagious
TB disease?
• The most common symptom of contagious TB
disease is a cough that lasts for more than a three
weeks, sometimes producing mucous and/or
blood. Other symptoms may include fatigue, loss
of appetite, weight loss, fever, and night sweats.
Chest pain may also occur.

For TB disease outside the lungs, the symptoms

vary by where in the body the disease occurs.
People can have TB disease without having any
symptoms.
What is the Treatment for TB disease?
• Treating TB disease requires a minimum of 4
different medicines. Persons with TB disease
who have taken the correct TB medications for
a specified period of time do not continue
spreading TB to others. However, it will take a
minimum of 6 months to complete the
treatment for TB disease. Sometimes, it may
take longer
• Persons with TB disease must take every dose of
medicine as prescribed, even if the symptoms of
the disease disappear completely. Not taking the
proper dosage of TB medications over a
prescribed amount of time can result in the
return of TB disease that does not respond to the
TB drugs. Persons whose TB does not respond to
the most commonly used TB drugs will need to
take other medicines that may not work and have
serious side effects.
 Symptoms of Tuberculosis Disease
(TB)
• Tuberculosis Disease (TB) is a very contagious
disease of the respiratory system. It is a
bacterial infection that begins in the lungs and
is able to spread by the circulatory system to
other parts of the body, such as the Meninges
(the tissue covering the brain), spine, kidneys,
and other abdominal organs and may be fatal.
Tuberculosis symptoms are loss of appetite
and weight, sweating at night, and fever.
• Tuberculosis Disease is more often spread (through
coughs and sneezes). In crowded, unsanitary
conditions most people who get it have lowered
immunity because of other infections (AIDS) or age. In
some cases Tuberculosis symptoms may not appear
until later in life because the body’s immune system
has kept the disease under control until the person
becomes elderly and their immune system is somehow
lowered. Thus this disease is common in some nursing
homes where there is crowding and ventilation isn’t
enough to prevent the spread of TB.
• Symptoms of tuberculosis
• Depending on how effectively your immune
system fights the infection, you may have:
• no symptoms at all
• minor symptoms, which then go as you fight the
infection off
• symptoms that develop in the months following
infection
• symptoms that develop years after you were
infected
• The symptoms of tuberculosis infection in your lungs may
include:
• a persistent cough - there may also be lots of phlegm,
sometimes containing blood
• fever
• tiredness
• loss of appetite
• weight loss
• night sweats
• chest pain when you breathe in, caused by inflammation of
the membranes lining your lungs (pleurisy)
• If you have TB in other parts of your body, you may also
have other symptoms such as swollen glands in your neck,
pain in your joints or a headache.
 Causes of tuberculosis
• You can catch TB by breathing in droplets in the
air that contain the bacterium M. tuberculosis.
These are spread through the air when someone
with TB coughs or sneezes. Only some people
with TB in their lungs are infectious to others.
• Although it's spread through the air, you need to
be closely exposed to a person with TB for some
time before you catch it. People most commonly
catch TB from people they live or work with.
When you start treatment for TB, you remain
infectious to others for the first two weeks
• Although anyone can get TB, it's quite difficult to catch in
the UK. You're more likely to get TB if you:
• already have a weakened immune system (for example if
you have HIV/AIDS or are taking medicines that suppress
your immune system)
• have diabetes
• have regular close contact with people who have TB lung
infection
• are young or elderly
• live in overcrowded housing
• are dependent on drugs or alcohol
• are in poor health generally and have been for some time
 Diagnosis of tuberculosis

• To diagnose active TB infection you will usually be

asked to give at least three separate samples of
your phlegm for testing. These will be examined
in a laboratory. A chest X-ray can also be used to
diagnose active TB.
• To diagnose latent TB you can have a skin test
called a Mantoux test. This test involves injecting
the tuberculin protein just under your skin,
usually on the inside of your forearm. Over the
next two to three days a reaction to the injection
will develop. This reaction is then graded.
 Treatment of tuberculosis

• TB can be completely cured by taking antibiotics.

Most people with either active or latent TB are
treated with a combination of four antibiotic
tablets which kill the bacteria. Treating latent TB
prevents the infection from becoming active in
the future.
• You will probably have treatment at home and
won't need to go to hospital, unless you're very
unwell. There are teams of doctors and nurses
who specialise in caring for and treating people
with TB.
 Medicines
• You will usually need to take antibiotics for six months.
You're likely to have a combination of four antibiotics
for the first two months. After this time, you will
usually stop taking two of the tablets and continue
with the remaining two for another four months.
• It's very important to take the full six-month course of
antibiotics, and to take them regularly, otherwise the
bacteria may develop resistance to the antibiotics.
Treatment with antibiotics is usually effective, provided
that you take the full course as prescribed.
• Some people may get side-effects from the
antibiotics and occasionally these can be serious.
Your doctor will monitor you closely during your
treatment. Side-effects can include:
• a red-orange colour to your urine, saliva and
other body fluids
• feeling sick or being sick
• fever
• jaundice (yellowing of your skin and eyes)
• pins and needles
 Prevention of tuberculosis
• Until quite recently, there was a large-scale immunisation
programme in the UK to help prevent TB. However, this has
been replaced by a more targeted programme of
immunisation. The vaccination strategy in the UK targets
people who are most at risk of getting TB, such as:
• babies born in areas where TB is common
• children who have a parent or grandparent born in a
country where TB is common
• those who have immigrated from a country where TB is
common
• people who have had a family member with TB within the
last five years
• healthcare workers and laboratory staff who have contact
with TB
• Immunisation is given as the BCG (Bacille
Calmette-Guérin) vaccination. This protects
between seven and eight out of 10 people
who receive it. Before giving the vaccination,
your doctor or nurse will first check whether
you are already immune to TB. This is done
with a Mantoux test. If the test is negative,
then you will be given the BCG vaccine. The
vaccine is given as a single injection usually in
the top of your arm.
 How common is TB, and who gets it?
• Over 8 million new cases of TB occur each year
worldwide. In Indonesia, it is estimated that 20-
30 million people are infected with the TB
bacteria and 50,000 new cases of TB occur each
year.
• Anyone can get TB, but certain people are at
higher risk, including
• people who live with individuals who have an
active TB infection,
• poor or homeless people,
• foreign-born people from countries that have
a high prevalence of TB,
• nursing-home residents and prison inmates,
• alcoholics and intravenous drug users,
• people with diabetes, certain cancers, and HIV
infection (the AIDS virus),
• health-care workers.