Protect Yourself – Get Tested TB

Tuberculosis (TB) is spread through the air from one person to another when an infectious person coughs, speaks or sings. When a person inhales TB bacteria, it can settle in the lungs and begin to grow. From there, the bacteria can move through the blood to other parts of the body, such as the kidney, spine and brain.

People with TB disease are most likely to spread it to those they spend time with every day. This includes family members, friends, coworkers or classmates.

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.

How do I prevent TB Disease?

Because TB bacteria is spread through the air, it is difficult to prevent acquiring either latent TB infection or TB disease. A person who may have TB, or thinks they may have been exposed to TB, should be tested.

Preventing Latent TB Infection from Progressing to TB Disease

Many people who have latent TB never develop TB disease. However, some individuals who have latent TB infection are more likely to develop TB disease than others. Those at high risk for developing TB disease include:

People with HIV infection
People who are contacts to a person with active TB disease
People who became infected with TB bacteria in the last 2 years
Babies and young children
People who inject illegal drugs
People who are sick with other diseases that weaken the immune system
Elderly people
People who were not treated correctly for TB in the past

If you have latent TB infection and are in one of these high-risk groups, medicine is recommended to keep from developing TB disease.

Preventing Exposure to TB Disease While Traveling Abroad

TB is much more common in countries outside of the United States. Those who travel to areas of sub-Saharan Africa, Asia and parts of Central and South America are at greatest risk. Travelers who anticipate possible prolonged exposure to individuals with TB (e.g. those who routinely spend time in clinics, hospitals, prisons or homeless shelters) 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.

TB Vaccine

Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis (TB) disease. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. Unfortunately, BCG is only partially effective. It provides some protection against severe forms of pediatric TB, but is not completely protective against disease in infants and is unreliable against adult pulmonary TB. BCG does not always protect people from getting TB.

In the United States, BCG should be considered for only select individuals who consult with a TB expert and meet specific criteria. Health care providers who consider BCG vaccination for their patients are encouraged to discuss this intervention with the TB Control Program.

Who should get tested for TB?

Some individuals are at a higher risk of being infected with TB bacteria and should be tested, including:

People who have spent time with someone who has TB disease
People from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe and Russia)
People who live or work in high-risk settings (e.g. correctional facilities, long-term care facilities or nursing homes and homeless shelters)
Health care workers who care for patients who are at increased risk for TB disease
Infants, children and adolescents exposed to adults who are at increased risk for latent tuberculosis infection or TB disease

TB tests are generally not needed for individuals who are considered low risk for TB bacteria infection.

How is TB diagnosed?

Two tests are available to help detect TB infection: a skin test or TB blood test.

The Mantoux tuberculin skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm
- A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm
The TB blood test (IGRA) measures how the patient’s immune system reacts to the germs that cause TB

Testing for TB is available at your primary care provider or some local public health units. Additional testing may be necessary if either the skin test or blood sample is positive. Your health care provider will determine which additional tests are needed.