Guidelines on the Prevention and Control of Tuberculosis in Ireland

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<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2010HSE/HPSCAppendix 6: Questions and Answers about TuberculosisWhat is Tuberculosis?Tuberculosis or “TB” is a disease caused by a bacterium (germ) called Mycobacterium tuberculosis. TBusually affects the lungs but it can also affect other parts of the body, including the glands, the bones andrarely the brain.Tuberculosis used to be more common in Ireland. There were nearly 7,000 cases a year in the early 1950s.The incidence of TB has declined steadily since then. In 2006, there were 465 cases notified in Ireland.Doctors are obliged to notify each case of TB to the local departments of public health in the HealthService Executive.TB disease is preventable and curable.What are the symptoms of TB?Symptoms of TB can include any of the following:• Fever and night sweats• Cough (generally lasting more than 3 weeks)• Weight loss• Blood in the sputum (phlegm) at any time.A person with any of these symptoms should visit their family doctor for advice.How is TB spread?TB is usually spread in the air from another person who has TB of the lungs. It is spread by that personcoughing, sneezing or spitting. People with TB in the lungs or throat can be infectious. This means that thebacteria can be spread to other people. Even then close and prolonged contact with such a person (i.e.family, friends, childminder, co-worker) is needed to become infected. Most cases of infectious TB stopbeing infectious after a few weeks of treatment. TB in other parts of the body such as the kidney or spine isusually not infectious.Another type of TB called Mycobacterium bovis can arise from drinking contaminated milk. This form of TBis now rare as pasteurisation of milk removes the risk.The following people have a greater chance of becoming ill with TB, if exposed to it:• Those in very close contact with infectious people• Children• Elderly people• Diabetics• People on steroids• People on other drugs affecting the body’s defence system• People who are HIV positive• People in overcrowded, poor housing• People dependent on drugs or alcohol• People with chronic poor health.What happens when a person is found to have infectious TB?• Treatment for TB is started• Public health doctors talk to the infected patient to see if other people need to be checked for TB.What is the difference between latent tuberculosis infection and active tuberculosis disease?Infection with the TB bacterium may not develop into TB disease. Most people who are exposed to TB are-163-
<strong>Guidelines</strong> on the Prevention and Control of Tuberculosis in Ireland 2009HSE/HPSCable to overcome the bacteria. The bacteria become inactive but they remain dormant in the body and canbecome active later. This is called latent TB infection (LTBI).People with LTBI:• Have no symptoms• Don’t feel sick• Can’t spread TB to others• Usually have a positive skin test reaction• Can develop TB disease later in life.Most people who have LTBI never develop active TB disease. In these people, the TB bacteria remaininactive for a lifetime without causing disease. But in other people, who have weak immune systems, thebacteria can become active and cause TB disease.The difference between latent TB infection and active TB diseaseA person with Latent TB Infection• Has no symptoms• Does not feel sick• Usually has a positive skin test orblood test• Has a normal chest X-ray andsputum testA person with Active TB Disease• Has symptoms which may include:A bad cough which lasts three weeks or longerPain in the chestCoughing up sputum (phlegm) or bloodWeakness or fatigueWeight lossNo appetiteChillsFeverNight sweats• May spread TB to others• Usually has a positive skin test or positive blood test• May have an abnormal chest X-ray or positive sputumsmearor cultureHow is TB diagnosed?There are a number of tests that can be done to check for TB:• A skin test• A chest X-ray• A test of the sputum (phlegm)• A blood or urine test.How is TB treated?Yes, today TB is potentially completely curable, if the responsible organism is fully sensitive to theantibiotics being used and the patient takes his or her medication as prescribed.TB is treated with tablets which must be taken for at least six months. Without treatment, many peopleused to die from TB. It is essential to take the treatment regularly and to complete the course asprescribed.The most common medicines used to treat TB are: isoniazid, rifampicin, ethambutol and pyrazinamide. Avitamin B6 tablet called pyridoxine is also prescribed to help prevent some of the side effects that may becaused by isoniazid. Your doctor will decide which TB drugs are best for you.-164-
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Guidelines on the Prevention and Control of Tuberculosis in Ireland

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