The average case of TB requires 180 days of medications, in addition to x-rays, labs, follow-ups and testing of contacts1
Cost of TB cases in US
Cases of TB cost the US $480 million in 20181
People became sick with TB
In 2018, 5.7 million men, 3.2 million women and 1.1 million children became sick with TB2
7 out of 10 TB cases in the US occur in non-US born persons1
Latent tuberculosis infection (LTBI) vs. active TB disease
It is important to note the distinction between LTBI and active TB disease. People living with LTBI are not infectious and cannot spread TB infection to others. In some of those people, active TB bacteria defeats the immune system and begins to multiply, resulting in the progression from LTBI to active TB disease. Some people develop active TB disease soon after infection, while others develop active TB disease later when their immune system becomes weak.3
There are many factors that can cause the disease to become active. 5-10% of people with latent TB who don’t receive treatment will develop active TB disease at some point in their lives.3
TB bacteria are most commonly found in the lungs. They can, however, spread to other parts of the body, in which case the symptoms would be localized in those areas. LTBI has no symptoms. Common symptoms of TB disease in the lungs include:
A bad cough that lasts 3 weeks or longer
Pain in the chest
Coughing up blood or sputum (phlegm from deep inside the lungs)
Weakness or fatigue
Loss of appetite
There are two categories of commercially available tests to detect TB infection:
Tuberculin skin test (TST)5
The TST has been used to detect TB infection for over 100 years. It requires an intradermal injection of a small amount of purified protein derivative (PPD), a TB antigen, into the skin. In 48 – 72 hours, the resultant induration is measured.
Tuberculin is injected into the skin on the lower part of the arm
Subject returns 48 to 72 hours later to have their test “read” to determine whether there has been a reaction to the tuberculin
Limited sensitivity, especially in the immunocompromised, young and elderly
Poor specificity; caused by:
Prior bacille Calmette–Guérin (BCG) vaccination
Non-tuberculosis mycobacteria (NTM) infection
Requires 2 visits
Failure to return for second visit = no test result
Administration and interpretation steps are technique-dependent
Interferon-gamma release assays (IGRAs)
Three IGRAs currently approved by the FDA for use as an aid in diagnosing TB are: the T-SPOT.TB test, the QuantiFERON®–TB Gold Plus test (QFT®-Plus), and LIAISON® QuantiFERON-TB Gold Plus (LIAISON QFT-Plus). These tests each involve a blood draw, which is then processed by a lab.
People with active TB disease must be treated and must take all of their medication exactly as directed. If they do not do this, the TB bacteria can become resistant to the drugs used to treat it. A typical course of treatment for active TB lasts from 6 – 9 months and can often include the following drugs:6
It is is important to remember that TB is contagious and can be spread by an infected person coughing. For this reason, TB treatment often involves a period of isolation.
Exposure to TB occurs when you have spent time with someone who is infected with active TB disease. The bacteria are spread through the air when a person who has active TB sneezes, coughs or speaks. If you think you have been exposed to active TB , you should immediately contact your doctor or the local public health department.
Learning about TB and the risk factors for TB is important, as there are several different factors that can make a person susceptible to TB. However, these risk factors usually fall into two categories:
Being in close contact with someone who has been recently infected with TB
Having a medical condition that weakens the immune system
1. Close proximity3
The chances of a person getting infected with TB are higher for people that are in close contact with others who are infected. This includes:
Family and friends of a person with TB
People who come from areas of the world with high TB rates
People in groups with high rates of TB transmission – such as the homeless, injection drug users or a person with HIV
People who work or reside in a place where the people are at a high-risk for TB – such as hospitals, homeless shelters, correctional facilities or nursing homes
Huebner R et al., The tuberculin skin test. Clin Infect Dis 1993; 17: 968-975.
Treatment for TB Disease. Centers for Disease Control and Prevention. CDC Treatment for TB Disease. Published April 5, 2016. Accessed January 8, 2020.
Exposure to TB. Centers for Disease Control and Prevention. CDC Exposure to TB. Published March 21, 2016. Accessed January 8, 2020.
QFT and QuantiFERON are registered trademarks of The Qiagen Group. LIAISON is a registered trademark of DiaSorin.
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