On March 24, public health advocates around the world will be holding events for this year’s World Tuberculosis (TB) Day. TB is a serious, complex disease that is often overlooked in the United States because it is thought of as a “historic disease” with a complicated history of sanatoriums and people being sent away from their home for long periods of time for treatment.

While worldwide public health efforts are doing a great job at reducing the burden of TB, it still remains a top-10 cause of death globally. In Virginia, rates of TB have stayed slightly below the national average, remaining relatively low at about 2.4 per 100,000 people. In the past 20 years, Virginia has seen an overall downward trend in TB cases, but there has been a slight increase in cases since 2013. This has presented public health and healthcare workers with the challenge of creating new ways to lower the number of TB cases.

What is tuberculosis (TB)?

TB is a serious infectious disease that attacks the lungs but also can affect many other parts of the body, including lymph nodes, kidneys, brain and spinal cord. TB spreads through the air, from person to person, when someone with the “active TB disease” talks, coughs, sings or sneezes. Transmission usually occurs between people who are in close contact for an extended period of time. Without adequate treatment, TB can be deadly.

What is the difference between latent TB infection and active TB disease?

There are two types of tuberculosis — “latent TB infection” and “active TB disease”:

» Latent TB iInfection (“latent TB”) does not make you sick. An individual with latent TB infection was exposed to the TB bacteria, which is now present in his or her body. With latent TB, the bacteria are “sleeping.” However, these bacteria can “wake up” and turn into active TB disease, which can make someone very sick.

» Active TB disease (“active TB”) is a serious disease that requires immediate medical attention. Active TB needs to be treated right away with a rigorous antibiotic treatment regime. People with active TB disease often have symptoms like a long-lasting cough, unexplained fever, night sweats, fatigue and unexplained weight loss.

According to the Centers for Disease Control and Prevention (CDC), people who are at highest risk of developing TB disease are generally those who have been very recently exposed to the bacteria. People also can be at highest risk if they have medical conditions that weaken the immune systems, such as:

» Diabetes mellitus

» HIV

» Substance abuse

» Severe kidney disease

» Medications that suppress the immune system, like corticosteroids

There have been many improvements in diagnosing and treating both latent and active TB. The most common way to know if someone has TB is to get a tuberculin skin test or a blood test. These tests will help find out if TB bacteria are in the body. If your doctor thinks you could have TB, you also may need to get a chest X-ray.

In November, the Virginia Department of Health updated the list of diseases that must be reported to local health departments to include latent TB infection among persons of any age. This will help healthcare providers to better identify and treat people who have TB infection. This statewide effort is an important step to help prevent TB, and, hopefully, reverse the recent increasing trends in active TB cases.

To learn more about TB, visit CDC.gov/TB, or call your local health department.

Kate Baker is TB program specialist for the Thomas Jefferson Health District.

VITAL SIGNS

This column, which promotes community health, is sponsored by Sentara Martha Jefferson Hospital, Region Ten Community Services Board, Thomas Jefferson Health District and the University of Virginia Health System.

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