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Spokane, Washington  Est. May 19, 1883

Important to know symptoms, risks of TB

Dr. Alisa Hideg

You may think that tuberculosis is a disease you do not have to worry about. While it is far less common here than in the rest of the world – where an estimated one-third of the population is infected – there were still around 10,000 cases in the United States in 2013.

Long before TB was well understood, it was called “consumption” due to the weight loss and weakness it causes. People with active TB were sent to sanitariums to rest, breathe fresh air and hope their bodies could fight off the disease.

TB is a bacterial infection spread through the air. You have to breathe in the bacteria to get infected. An infected person can spread it by coughing, sneezing, speaking or breathing. You cannot get TB by shaking hands, sharing food or drink, or touching bed linens or toilet seats.

TB becomes active, causing symptoms, when your immune system cannot stop the bacteria from growing. In latent TB – before there are signs of the illness and when it cannot be spread – you are healthy enough to prevent the bacteria from growing, but it is still present in your body.

Latent TB can continue for years with no sign of illness, but it can become active and make you sick when something else has weakened your immune system like HIV infection, kidney disease, diabetes or cancer. We treat TB infection whether it is active or latent to reduce the risk of TB becoming active in the future.

Skin and blood tests are used to detect TB infections. The blood test is preferred for people previously vaccinated against TB. If your test is positive, a second TB test, X-rays and sputum testing determine whether you have active TB. Sputum – mucus that is coughed up – is also used to determine whether you have drug-resistant TB.

While TB can infect organs like the kidneys and brain, an infection in the lungs, called pulmonary TB, is the most common form. Symptoms include:

• a severe cough lasting three weeks or more,

• pain in the chest, and

• coughing up phlegm or blood from deep in the lungs.

Pulmonary TB also causes overall weakness, loss of appetite, chills, fever and night sweats.

There is a vaccine for TB called Bacille Calmette-Guérin. It is often given in countries where TB is common, but may not always protect against getting TB. An infectious disease specialist is usually consulted before giving this vaccine to residents of the United States because TB is not common enough here to warrant it for the general population.

Unless your work or travels frequently put you in close contact with people who have active TB, it is not an infection you are likely to get. Consult an infectious disease specialist if you are concerned about upcoming travel or a new work situation. Get a TB test before possible exposure, and again 8 to 10 weeks after exposure. If your exposure is ongoing, get tested at least annually.

Active and latent TB are treated with prescription medications. The length of treatment depends on the type of TB, severity of infection and response to medication. It is very important to take medication exactly as prescribed and for as long as it is prescribed to avoid developing TB that is resistant to medication. Regular follow up while taking medication is important to monitor for side effects.

It is one of the diseases the Centers for Disease Control and Prevention works very hard to prevent, control and treat here and in other countries to protect us all against the risk of it spreading.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section.