Tuberculosis (TB) symptoms & causes

Are you experiencing trouble breathing or a fever? The pandemic may have you concerned that you’re infected with COVID-19. However, the novel virus is not the only thing that can cause these symptoms. Similar to COVID-19, tuberculosis also targets the lungs.

What is Tuberculosis (TB)?

Tuberculosis is a contagious disease caused by bacteria that is spread through the air when a person with tuberculosis coughs or sneezes. There are many strains of tuberculosis, making it difficult to treat. Someone diagnosed with this disease will have to take many types of medications over several months in order to treat it.

What are the symptoms of tuberculosis?

There are two types of tuberculosis: latent and active. People with latent tuberculosis have no symptoms and are not contagious. Latent tuberculosis is categorized as an infection that your body is likely to fight off. However, it can lead to active tuberculosis, especially in people with a weakened immune system. The jump from latent to active can occur within the first few weeks of being infected with the bacteria, or even years later. However, 90% of individuals with a strong immune system will be cleared of the infection or will enter a latent phase.

The first symptom of active tuberculosis is often fatigue, which can later be accompanied by:

• Fever
• Night Sweats
• Chills
• Chest pain when breathing or coughing
• Loss of appetite
• Weight loss
• Chronic Coughing
• Coughing up blood

What are the complications of tuberculosis?

Without treatment, tuberculosis can be life-threatening. Tuberculosis can spread outside the lungs and affect other parts of the body through the bloodstream, such as your kidneys, spine, and brain. Signs that the infection has spread outside your lungs may include back pain (if your spine is infected) or blood in your urine (if kidneys are infected). Other complications of tuberculosis are:

• Back pain and stiffness
• Joint damage, specifically in the hips or knees
• Meningitis or swelling around your brain
• Liver or kidney impairment
• Heart disorders, such as cardiac tamponade

What causes tuberculosis?

Tuberculosis is caused by a bacteria called Mycobacterium tuberculosis. This bacteria has been found in mummies dating back 6,000 years. Scientists believe tuberculosis began during a period called the Neolithic Transition when humans began domesticating wild animals. Their research indicates the bacteria originated in one of these animals and mutated into humans. Due to poor hygiene standards in congested cities, tuberculosis became the leading cause of death in the 19th and 20th centuries. Cases also peaked in 1985 due to the emergence of HIV, which weakened people’s immune systems and made it easier for tuberculosis to spread.

How Does Tuberculosis Spread?

Someone infected with tuberculosis can spread the bacteria when they sneeze, cough, spit, laugh or talk. These actions release microscopic droplets (germs) in the air that can be passed from person to person. While every sneeze may have you suspicious of whether you’ve been infected, tuberculosis is not that easy to catch. You’re more likely to catch tuberculosis from someone you’re in close proximity with on a regular basis, such as a roommate or coworker, versus a stranger you cross on the street. Most people who are treated for tuberculosis are no longer contagious after two weeks.

Who is at Higher Risk for Tuberculosis?

While anyone can contract tuberculosis, there are certain circumstances that can put some people at higher risk than others. People who are more vulnerable to being infected by tuberculosis include:

• Those who live, work or spend time in close contact with a person(s) infected with active tuberculosis.
• Those who travel or immigrate to areas with high cases of tuberculosis.
• Employees of prisons, nursing homes, homeless shelters, and other healthcare facilities where exposure is increased.
• Healthcare workers who serve high-risk clients.
• Those without access to healthcare or low-income populations.
• Children and adolescents living with or in contact with adults are at high risk.

Those at high risk for the infection progressing to active tuberculosis are:

• People with a weak immune system, such as those suffering from kidney disease, HIV infections, cancer, and those taking immunosuppressants.
• Young children under the age of five.
• Older adults over 65 years.
• People infected with tuberculosis within the last two years.
• Anyone who uses intravenous drugs, smokes, or abuses alcohol.
• People who received inadequate treatment for tuberculosis in the past.

How is Tuberculosis Treated?

Treatment will differ depending on the type of tuberculosis. Latent tuberculosis may only require one or two types of medications. Treating active tuberculosis typically involves taking a combination of antibiotics for at least six months. The type of medication and length of the treatment will depend on the person’s age, medical history, overall health, and the location of tuberculosis in the body. Medications often used to treat tuberculosis include:

• Isoniazid
• Rifampin (Rifandin, Rimactane)
• Ethambutol (Myambutol)
• Pyranzinamide

How to Test for Tuberculosis?

If you believe you’ve been exposed to someone with tuberculosis or are showing symptoms, it’s important that you get tested right away. At GoHealth Urgent Care, our providers can administer a PPD test, but a blood test is another option from your primary care provider. Depending on test availability and cost, your provider can help you select the best option. This is how the two tests compare:

Tuberculosis Skin Test

In order to conduct a skin test, your provider will inject a fluid known as tuberculin into the skin of your lower arm using a small needle. This will cause a tiny, pale bump to appear. You will return in two or three days so your provider can examine the reaction on your arm. If you have a raised, hard bump or swelling in your arm, the results will be positive for tuberculosis. However, a positive test does not mean tuberculosis is active. No reaction to the skin test indicates a negative tuberculosis result.

Tuberculosis Blood Test

For those who have been vaccinated for tuberculosis or received a negative skin test, a blood test can help confirm whether someone is infected. If your blood test comes back positive, additional tests will be given to see if the tuberculosis is active or latent.

How to Prevent Tuberculosis?

The best way to prevent getting tuberculosis is to keep your distance from those who may have it. Moreover, practice good hygiene to reduce your chances of picking up germs, such as washing your hands regularly and using hand sanitizer after touching public surfaces. If you have active tuberculosis, avoid spreading it to others by:

• Staying home until you have completed treatment and are no longer contagious.
• Cover your mouth when you sneeze or cough.
• Throwing used tissues away in a sealed bag.
• Wearing a mask when around others.

When Should I See a Healthcare Provider?

If you’re experiencing fever, chills, or a persistent cough, schedule a visit at your local GoHealth Urgent Care. If you have a compromised immune system, don’t wait to come in. Our experienced providers are here seven days a week to test and diagnose tuberculosis, so you can get the proper treatment you need quickly.

Written by Sarah Thebarge, Physician Assistant