Prevent Tuberculosis

Tuberculosis, or TB, is a disease (usually of the lungs) that's easily transmitted through the air when an infected person speaks, laughs or coughs. Although TB is rare and highly treatable in the US, you will still need to take measures to prevent tuberculosis in certain situations, especially if you have already tested positive for latent TB ( an inactive form of TB which affects approximately 1/3 of the world's population). Start with Step 1 below to find out more.

Steps

How to Avoid Contracting TB

  1. Avoid exposing yourself to people with active TB. Obviously the most important precaution you can take to prevent TB is to avoid being around people with active TB, which is highly contagious, especially if you have already tested positive for latent TB. More specifically:
    • Don't spend long periods of time with anyone who has an active TB infection, especially if they have been receiving treatment for less than two weeks. In particular, it is important to avoid spending time with TB patients in warm, stuffy rooms.
    • If you are forced to be around TB patients, for example if you work in a care facility where TB is currently being treated, you will need to take protective measures, such as wearing a face mask, to avoid breathing in the TB bacteria.
    • If a friend or family member has active TB, you can help to rid them of the disease and lessen your own risk of contracting it by ensuring that they strictly follow treatment instructions.[1]
  2. Know if you are "at-risk". Certain groups of people are considered to be more at-risk of developing TB than others. If you are a member of ones of these groups, you need to be more vigilant about protecting yourself from TB exposure. Some of the main at-risk groups are as follows:
    • People with weakened immune system, such as those with HIV or AIDs.
    • People who live with or care for someone with active TB, such as a close relative or a doctor/nurse.
    • People who live in crowded, confined spaces such as prisons, nursing homes or homeless shelters.
    • People who abuse drugs and alcohol, or have little or no access to proper health care.
    • People who live in or travel to countries where active TB is common, such as countries in Latin America, Africa and parts of Asia [2].
  3. Lead a healthy lifestyle. People who are in poor health are more susceptible to the TB virus, as their disease resistance is lower than in healthy people. Therefore, it is important to do your best to lead a healthy lifestyle.
    • Eat a healthy, balanced diet with plenty of fruit, vegetables, whole grains and lean meat. Avoid fatty, sugary and processed foods.
    • Exercise often, at least 3 to 4 times a week. Try to incorporate some good cardiovascular exercise into your workouts, such as running, swimming or rowing.
    • Cut down on alcohol consumption and avoid smoking or taking drugs.
    • Get plenty of good quality sleep, ideally between 7 and 8 hours a night.
    • Maintain good personal hygiene and try to spend as much time as possible outdoors, in the fresh air.[3]
  4. Get the BCG vaccination to prevent TB. The BCG (Bacille Calmette-Guerin) vaccine is used in many countries to help prevent the spread of TB, especially among small children. However, the vaccine is not commonly used in the US, where infection rates are low and the disease is highly treatable. Therefore, the CDC does not recommend the vaccine as a routine immunization. In fact, the CDC only recommends the BCG vaccine for U.S. citizens in the following situations:
    • When a child has been tested negative for TB but will continue to be exposed to the disease, especially strains that are resistant to treatment.
    • When a healthcare worker is continually exposed to tuberculosis, especially strains that are resistant to treatment.
    • Before travelling to another country where tuberculosis is prevalent.

How to Diagnose and Treat TB

  1. Schedule a TB test if you have been exposed to someone with tuberculosis. If you have recently been exposed to someone with active TB and believe there is a chance you might have contracted the disease, it is important to consult your health care provider immediately. There are 2 methods for TB testing:
    • Skin test: The Tuberculin Skin Test (TST) requires injecting a protein solution sometime between 2 and 8 weeks after contact with an infected person. The patient must return to the medical provider 2 or 3 days later to have the skin reaction interpreted.
    • Blood test: Although it's not as commonplace as the skin test, the TB blood test only requires a single doctor visit and is less likely to result in misinterpretation by a medical professional. It is the necessary option for anyone who has received the BCG vaccination, as the vaccine can interfere with the accuracy of the tuberculin skin test.
    • If your TB test is positive, you will need to undergo additional testing. Health professionals will need to determine whether you have a latent TB (which is not contagious) or active TB disease before proceeding with treatment. Tests may include a chest x-ray and a sputum test.[4]
  2. Begin immediate treatment for latent TB. If you test positive for latent TB, you should consult with your doctor about the best course of action.
    • Although you don't feel sick with a latent TB, and it isn't contagious, you will probably be prescribed a course of antibiotics to kill the inactive TB germs and prevent tuberculosis from turning into an active disease.
    • The 2 most common treatments are: Taking isoniazid daily or twice a week. The duration of the treatment is 6 or 9 months. Or taking rifampin daily for 4 months.
  3. Begin immediate treatment for active TB. If you test positive for active TB, it is essential that you begin treatment as soon as possible.
    • Symptoms of active TB include cough, fever, weight loss, fatigue, night sweats, chills and a loss of appetite.
    • Nowadays, active TB is highly treatable with a combination of antibiotic medications, however the duration of treatment can be quite long, usually between six to twelve months.
    • The most common medications to treat TB include isoniazid, rifampin (Rifadin, Rimactane), ethambutol (Myambutol) and pyrazinamide. With active TB, you will usually need to take a combination of these drugs, especially if you have a particularly drug-resistant strain.
    • If you follow your treatment plan exactly, you should start to feel better within a matter of weeks and you should no longer be contagious. However, it is essential that you finish your course of treatment, otherwise the TB will remain in your system and potentially become more drug resistant.[5]

How to Avoid Spreading TB

  1. Stay at home. If you have active TB, you will need to take precautionary steps to avoid passing the disease onto others. You will need to stay at home from work or school for several weeks following diagnoses and avoid sleeping or spending long periods of time in a room with other people.
  2. Ventilate the room. The TB virus spreads more easily in enclosed spaces with stagnant air. Therefore, you should open any windows or doors to let fresh air in and contaminated air out.
  3. Cover your mouth. Just like when you have a cold, you will need to cover your mouth whenever you cough, sneeze or even laugh. You can use your hand if necessary, but using a tissue is preferable.
  4. Wear a mask. If you are forced to be around people, it's a good idea to wear a surgical mask that covers your mouth and nose, at least during the first three weeks following infection. This helps to lessen the risk of you passing the virus to someone else.
  5. Finish your course of medication. It is absolutely essential that you finish whatever course of medication your doctor prescribes. Failing to do so gives the TB bacteria a chance to mutate, making the virus much more resistant to medications, and therefore more deadly. Finishing your course of medications is the safest option not only for you, but for those around you.[6]

Warnings

  • Individuals who have received an organ transplant, have an HIV infection or are considered to be at risk for complications for other reasons can't receive treatment for a LTBI.
  • The BCG vaccination should not be given to someone who is pregnant, immunosuppressed or likely to become immunosuppressed. There have not been sufficient studies to determine the safety of the BCG vaccination on a developing fetus.

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Sources and Citations

  1. ↑ http://www.webmd.com/lung/tc/tuberculosis-tb-prevention
  2. ↑ http://www.niaid.nih.gov/topics/tuberculosis/Understanding/Pages/prevention.aspx
  3. ↑ http://www.info.gov.hk/tb_chest/contents/c1212.htm
  4. ↑ http://www.webmd.com/lung/tc/tuberculosis-tb-exams-and-tests
  5. ↑ http://www.mayoclinic.org/diseases-conditions/tuberculosis/basics/treatment/con-20021761
  6. ↑ http://www.mayoclinic.org/diseases-conditions/tuberculosis/basics/prevention/con-20021761

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