Tuberculosis

Tuberculosis Control

 


What is Tuberculosis?

Tuberculosis (TB) is caused by bacteria called Mycobacterium Tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body like the kidneys, spine, lymph nodes, and brain. If it is not treated properly, TB can be fatal. 

Brief History

TB was once the leading cause of death in the United States. The bacteria that causes TB were discovered by Robert Koch in 1882. The first of several antibiotics used to treat tuberculosis was discovered in 1946. The first United States public health campaign was implemented to fight tuberculosis. 

How does TB spread? 

TB is spread through the air    when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected. People in close contact such as household members of someone with TB are most at risk of infection.

Latent TB infection

In most people who become infected with TB, the body can fight the bacteria and keep it from growing. The bacteria become inactive but can become active later This is called latent TB. Treatment for latent TB can be treated to prevent active TB disease from developing. Those with latent TB (LTBI):

Have no symptoms

Don’t feel sick

Cannot spread the TB bacteria to others

May develop TB disease if they do not receive treatment

 

TB disease

This occurs if the body’s immune system can’t stop the bacteria from growing. Some people develop TB disease soon after becoming infected (within weeks) and others may get sick later when their immune system becomes weak for other reasons.   

What Are the Symptoms of TB?

The general symptoms of TB disease include feelings of  weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected.

How Do You Get Tested for TB?

There are two tests that can be used to help detect TB infection: a skin test or TB blood test. The tuberculin skin test (TST) is performed by injecting a small amount of protein  into the skin in the lower part of the arm. A person given a TST  must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm. The TB blood tests measure how the patient’s immune system reacts to the germs that cause TB. People should consult with their health care professional to discuss which TB test is best for them.

How is TB Disease Treated?

TB disease can be treated by taking a combination of antibiotics for several months. It is very important that people who have TB disease complete the treatment and take the medication exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. This can result in a more expensive and prolonged treatment plan.

The Bureau of Tuberculosis Control (BTBC) is dedicated to stopping the spread of Tuberculosis in Nassau County. This is accomplished through:

 

Surveillance

Directly Observed Therapy (DOT) 

Nursing Case Management

Contact Investigations

TB Targeted Testing 

Community education 

TB Management Consultation 

 

SURVEILLANCE

Surveillance is the collection of information which leads to controlling and or preventing TB. This is done electronically from laboratories and/or from health care providers. The CDC also reports certain immigrants for TB evaluation. Any person suspected of having tuberculosis must be reported to the BTBC by a health care provider. 

 

DIRECTLY OBSERVED THERAPY (DOT)

DOT is the program whereby an outreach health care professional watches patients take their TB medication for 5 days a week. This helps the patient stay on track with medications and allows the patient to have access to a health care professional to assist with health care needs.  This method decreases the risk of developing complications of TB. In some circumstances Skype Observed Therapy (SOT) can be offered to patients. This is when the patient is observed taking medication remotely via SKYPE. This use of technology is more cost and time efficient.

 

NURSE CASE MANAGEMENT

An individual being treated for active TB is assigned to a public health nurse to act as case manager. The case manager is responsible for overseeing the tuberculosis treatment of the patient. The case manager is  responsible for ensuring completion of appropriate therapy for all active TB cases in Nassau County.

CONTACT INVESTIGATION

TB contact investigations are a necessary part of TB control and are conducted by the BTBC. Individuals at risk of exposure to an active TB case of the lungs or throat are identified and screened for TB infection and offered treatment for either LTBI or active TB disease if necessary. In addition, if a child under age 5 is diagnosed with latent TB infection, TB control will interview the parents or guardians in order to determine, if possible, the source of the infection.


TARGETED TESTING

 BTBC will test high risk individuals in the community to identify TB infection. 

 

COMMUNITY EDUCATION

BTBC participates in community education programs to improve TB education and awareness. 

 

TB MANAGEMENT CONSULTATION

Health care professionals tasked with treating any active TB case in Nassau County are encouraged to contact the BTBC to discuss any challenging management issues.

 

The Nassau County Dept of Health does not offer TB testing for school or employment purposes. Please contact you physician or contact any of the Long Island Federally Qualified Health Centers in Nassau County for TB testing at (516) 296-3742

 

Reports & Additional Resources

Tuberculosis Information for Patients (PDF)

Tuberculosis in Nassau County, 2017 Brief (PDF)

Tuberculosis in Nassau County, 2016 Brief (PDF)

Tuberculosis in Nassau County, 2015 Brief (PDF)

Tuberculosis in Nassau County, 2014 Brief (PDF)

Epidemiology of Tuberculosis (PDF)

New York State Department of Health TB page

CDC TB page