Tuberculosis (TB) is an infectious disease caused by bacteria Mycobacterium tuberculosis (M. tuberculosis). It typically affects the lungs, but may also affect other parts of the body such as the kidneys, bones, or the brain. TB can spread by infected people who release the bacteria into the air on tiny, invisible droplets by coughing, laughing, sneezing, or speaking. It can spread by infected tissue during autopsy, mortuary operations, and certain laboratory work. Because it can be fatal, diagnosis and treatment of TB is not only important for personal health, it's also important for preventing the spread of TB.
What your employees need to know about TB
Anyone can be exposed to TB. Most people infected with TB will never develop active TB disease because the body’s immune system keeps the bacteria under control and inactive. Certain work situations are at higher risk for exposure to TB such as:
- Nursing homes
- Correctional facilities
- Homeless shelters
- Drug treatment centers
- Home-based healthcare
- Emergency medical transportation and service providers
- Other places that serve clients who are at risk for being infected with TB
Also at risk are people coming from countries with high TB rates, and those whose immune systems are weak and are more susceptible to infections, such as the elderly and people with HIV and AIDS.
How is TB Spread?
When a person with active TB disease coughs, sneezes, speaks, or sings, some microscopic droplets containing M. tuberculosis may be expelled into the air. In confined or poorly ventilated spaces, the droplets can remain suspended in the air for several hours. Anyone inhaling these droplets can become infected with TB. The longer the exposure and the more contagious the diseased person, the more likely the exposed person will become infected.
Latent TB Infection (Inactive)
A person who has been infected with TB but has not developed the disease or symptoms, has a condition called latent TB infection (LTBI). Latent TB infection means the M. tuberculosis bacteria is in the body but inactive and cannot be spread to others. Although many people are infected with LTBI, very few will develop the disease in their lifetime. For people with weakened immune systems, however, the risk of developing TB disease can greatly increase.
TB Disease (Active)
People with TB disease have active M. tuberculosis bacteria multiplying in their body that can spread to other people. Those who have the disease almost always have symptoms. Symptoms may include:
- Persistent cough (3 weeks or longer)
- Bloody sputum
- Weight loss or loss of appetite
- Night sweats
TB disease is curable, but it may be fatal if not treated properly.
What your employees need to do if exposed to TB
TB Testing and Diagnosis
The only way to know if an employee has TB is for them to get a TB skin test. A skin test will show if the M. tuberculosis bacteria is in the body. During the test, a healthcare professional places a small amount of solution under the skin with a needle to see if a reaction occurs. Within 2-3 days after the test, a healthcare professional will measure the reaction area and evaluate the skin test results. In some cases, a second test may be needed to confirm results.
A “positive” TB skin test result means the person tested may have been infected with the M. tuberculosis bacteria and may have either TB infection or TB disease. Additional tests such as chest x-rays and sputum analysis can determine whether the infection is latent or active. After evaluating test results, a healthcare professional will advise appropriate treatment.
If an employee is diagnosed with TB, the supervisor should ensure that the employee does not return to work until cleared to do so by a healthcare professional. Coworkers may need to be notified as well.
Treatment for Latent TB Infection
TB will not go away on its own. To prevent latent infections from becoming active, treatment is indicated for most cases. Prescribed medication usually cures TB, but only if all medication is taken and all instructions are followed—even after symptoms have stopped. This usually keeps the infection from developing into the disease. If anyone stops medication before using the full prescription, they could develop a form of TB that is resistant to subsequent medication and is harder to cure (drug-resistant TB).
Treatment for TB Disease
Treatment of the disease often requires more than one prescribed medication. Medical evaluation and testing helps healthcare professionals determine which medications are right for each patient. Treatment may last many months. Taking all the medication as prescribed normally cures the disease. If medication is stopped before using the full prescription, symptoms may come back and could develop a form of TB that is resistant to subsequent medication and is harder to cure (drug-resistant TB).