What is tuberculosis?
Tuberculosis, also known as TB, is a serious disease. TB is caused by bacteria that spread through the air. TB usually affects the lungs, but can also affect other parts of the body like glands, bones, joints, kidneys, the brain, and reproductive organs.
TB can be cured. In British Columbia, medicines to prevent TB, or to cure TB, are free through Provincial TB Service Clinics and public health units.
How does TB spread?
TB is spread from person to person through the air when someone sick with TB in the lungs coughs, sneezes, sings or talks. If you breathe in the air containing the TB bacteria, you can become infected. Usually a significant amount of close, regular contact with a person sick with TB in the lungs is needed for you to become infected with TB. Not everyone infected with TB bacteria will get sick with TB disease.
What is the difference between TB infection and TB disease?
TB infection occurs when you breathe TB bacteria into your lungs and your body's defenses stop the bacteria from growing and making you sick. A person infected with TB will not feel sick, and cannot spread TB bacteria to others. This is also called “sleeping TB” or latent TB infection.
TB disease occurs when you breathe TB bacteria into your lungs and the bacteria start to grow in number and they may spread throughout your body. You may or may not feel sick, and how you feel depends on where the TB bacteria is growing. When you have growing TB disease in the lungs you might spread TB bacteria to those around you. This is called active TB.
What are the chances of a TB infection becoming TB disease?
If you are a healthy person and have latent TB infection, you have a 5 to 10 per cent chance of developing active TB disease over your lifetime. However, if your body's immune system is weakened by a medical illness or strong medications, there is a higher risk you can develop active TB disease. For example, people with HIV infection and TB infection are at very high risk for active TB while those with diabetes and TB infection are at moderate risk.
What are the symptoms of TB disease?
Symptoms of active TB disease of the lungs include cough (dry or productive) for 2 weeks or longer, bloody sputum (hemoptysis), chest pain and shortness of breath. You may also have unexplained weight loss, fever, night sweats, loss of appetite and tiredness or fatigue. If TB has affected other parts of your body, the symptoms may vary.
How can I be tested for TB?
Visit your health care provider for a check-up if you have symptoms of TB disease or want to know if you have latent TB infection. Your health care provider will do a TB assessment and order the appropriate tests.
A tuberculin skin test or TB skin test is used to test for TB infection. It tells your health care provider if your body has “seen” the TB bacteria before. It does not tell whether the TB bacteria are latent or active.
The TB skin test is a two-part test.
First appointment: A tiny needle is used to inject a small amount of a test substance called Tubersol® under the first layer of skin on your forearm. It is important to stay in the clinic for 15 minutes after the test because there is an extremely rare possibility of having a life-threatening allergic reaction, called anaphylaxis, to the Tubersol®.
Second appointment: You must go back to the clinic 48 to 72 hours later to have the test read by a trained health care provider. People who have been infected with TB usually respond with a raised, firm reaction at the site where the Tubersol® was injected.
The TB skin test results, your reason for testing, and your general health may mean further TB testing is required. Further testing could include a TB blood test, chest x-ray, or sputum samples.
A chest x-ray and sputum samples are usually used to test for active TB disease. A chest x-ray is a picture of your lungs that your health care provider examines to see if TB bacteria are growing in your lungs. The sputum or deep mucous in your lungs produced from coughing is sent to a laboratory, and tested to see if there are TB bacteria present. For more information, see HealthLinkBC File #51b Sputum Testing for Tuberculosis (TB).
Where can I get tested?
You can get tested at your local health unit, your health care provider’s office, or one of the following clinics:
- Downtown Outreach TB Clinic
569 Powell Street, Vancouver
Phone (TB Nurse): 604 216-4264
- Island TB Program
1952 Bay Street, Victoria
Phone: 250 519-1510
- New Westminster TB Control Clinic
100 – 237 Columbia Street East, New Westminster
Phone: 604 707-2698
- Vancouver TB Control Clinic
655 West 12th Avenue, Vancouver
Phone: 604 707-2692
To find more TB testing locations, visit the HealthLinkBC FIND Services and Resources Directory: www.healthlinkbc.ca//services-and-resources/find-services.
What is the treatment?
Both latent TB infection and active TB disease can be treated. All pills for TB treatment are free and available through Public Health. You will be followed closely by your health care provider while taking the medication.
Latent TB Infection treatment: Treatment of latent TB infection helps prevent the “sleeping” TB bacteria from “waking up” and making you sick. This is called preventative treatment and it is recommended for those people most likely to get active TB.
Speak with your health care provider if you are interested in taking preventative treatment. It is important that they make sure you don’t have active TB disease before starting treatment for latent TB infection. It is also important to understand the medication side effects of each pill and to know when you need to call your health care provider.
Active TB Disease treatment: Treatment of active TB disease cures you and prevents spreading TB to other people. A combination of pills is used for 6 months or longer. It is important to take all the pills you are given, as directed. TB treatment takes a long time because the TB bacteria are strong and hard to get rid of. It is also important to understand the medication side effects of each pill and to know when you need to call your health care provider.
During your treatment for active TB you will visit your health care provider regularly and provide chest x-rays and sputum samples to check that you are responding to treatment. Your health care provider will let you know when your treatment is complete.
To help protect other people, it is important to tell your health care provider whom you have been in contact with to help identify people at risk for TB infection. All information you give will be kept confidential.
How can I reduce the risk of giving TB to other people?
If you have TB in the lungs or throat you can spread the TB bacteria to other people, even after weeks of starting treatment. Your health care provider will ask you to wear a mask and stay at home to decrease the risk of spreading the disease. This is called home isolation; it is a very important, mandatory step in protecting other people. Your health care provider will tell you when you can stop home isolation.
For more information, see HealthLinkBC File #51c Home Isolation for Tuberculosis (TB).