Tuberculosis (TB)

What is tuberculosis?

Tuberculosis, commonly known as TB, is a bacterial infection that can cause disease in any part of the body, but most often in the lungs.

How TB is spread

TB is spread from person to person through the air when someone with active TB disease in the lungs or throat coughs, sings or sneezes. People nearby may breathe in the exhaled bacteria and become infected. The bacteria can settle in the lungs and begin to grow.

From there, the bacteria can move through the blood or lymphatic system to other parts of the body such as the kidney, spine and brain. Although TB infection in the lungs or throat can be spread to other people, TB in other parts of the body is usually not infectious.

You cannot get TB from shaking hands or from clothes, food, dishes or touching things.

How TB affects the body

TB infection

Infection with TB means the person has TB bacteria in their body. Usually the person’s immune (defence) system is able to fight these bacteria, causing them to become inactive. People with TB infection are not sick and cannot spread TB to others. This is called latent TB infection.

TB disease

TB disease is an illness caused by active TB bacteria. The illness may occur shortly after the bacteria enter the body, or many years later when the body’s immune system is weakened due to other factors such as diabetes, HIV infection or cancer. A person with TB disease has active TB bacteria in their body which can cause signs of illness.

High-risk groups for TB

In Australia, there are around 1,500 people who are diagnosed with TB each year, with approximately 450 to 500 of these in Victoria. Most cases are in people who were born overseas. TB can be contagious, but to be infected, you usually need close, face-to-face contact with someone who has TB disease in the lungs.

People who are at higher risk of TB exposure include:

• close contacts of a person with TB disease in the lungs (especially household members)
• migrants and refugees
• healthcare workers who were born or have worked in countries with a high number of TB cases
• people recently returned from countries with a high number of TB cases, especially those that have spent a long period of time there
• people living in overcrowded conditions where TB cases are known to occur, for example in some Australian Aboriginal and Torres Strait Islander communities or correctional facilities.

People who are at higher risk of developing TB disease following infection include:

• children under the age of 5 years
• elderly people
• people with severe malnourishment
• people living with human immunodeficiency virus (HIV) infection,
• people with poorly controlled diabetes
• people with kidney failure
• people with weakened immune systems
• people receiving treatment that can weaken their immune system.

Symptoms of active TB

Symptoms of active TB disease include:

• persistent cough
• fever
• tiredness or fatigue
• malaise (feeling generally unwell)
• night sweats
• unexplained weight loss
• swollen glands.

Sometimes, a person with TB may cough up blood-stained sputum (or phlegm). Some people with active TB disease may have only mild symptoms.

Diagnosis of TB

If your doctor thinks you have TB, methods used to diagnose TB may include:

• medical history
• skin test (the tuberculin skin test using the Mantoux procedure)
• blood test
• a chest x-ray – to show whether TB has affected the lungs
• a sputum test – to see if TB bacteria are present in coughed-up sputum.

You should be tested for TB if you:

• have any TB symptoms
• live or work in close contact with someone who has recently been diagnosed with TB disease of the lungs
• have other conditions that put you at higher risk for TB disease, such as HIV infection or poorly controlled diabetes.

Treatment for TB

If you have TB infection, your doctor may prescribe a course of tablets or suggest regular chest x-rays.

If you have TB disease, you will be treated with a combination of special antibiotics that are taken for at least 6 months, usually at a major public hospital or by a specialist physician.

It is very important to remember that TB can be cured if the treatment prescribed by your doctor is taken correctly, and the treatment course has been completed.

Side effects of TB medications

Like all medications, your anti-tuberculosis tablets can cause side effects. Your doctor will monitor your progress during treatment to make sure the medication is working. This will usually involve blood, sputum or urine tests and chest x-rays.

Side effects may include:

• nausea or vomiting
• jaundice – yellowish skin or eyes, dark urine (orange/red urine is a normal side effect and is not harmful)
• unexplained fever or tiredness
• tingling (pins and needles) or numbness of hands or feet, or joint pains
• skin rash, itching skin or bruising
• visual changes, such as blurred vision or a change in red-green colour vision.

Immunisation against TB

The vaccine against TB is called Bacillus Calmette–Guérin (BCG). It is no longer recommended for the general population of Victoria, as the risk of exposure to TB is low. BCG vaccination is only recommended for a small number of people who are at increased risk of TB.

These people include:

• Aboriginal and Torres Strait Islander children aged under 5 years in certain parts of Australia
• children under 5 years who are travelling to high risk countries for long periods of time, based on an individual risk assessment
• children under 5 years who are a household contact of a person with leprosy (TB and leprosy are caused by similar bacteria).

Speak with your doctor about whether you (or your child) need immunisation against TB.

Where to get help

• In an emergency, always call triple zero (000)
• Your GP (doctor)
• Victorian Tuberculosis Program Tel. (03) 9342 9428