FAQ: Tuberculosis

A person is at risk for TB if they have ever had contact with a person who has had infectious TB. Some of the people who are at increased risk for TB include:

• people born in less industrialized areas (i.e., Latin America, Asia, and Africa)
• medically underserved population usually in urban areas including children under the age of four
• the poor, the homeless, and substance users residents and employees of long-term institutions
• immuno-compromised persons (especially those with HIV infection)
• people with other medical risk factors such as diabetes and end-stage renal disease.

Mycobacterium tuberculosis is spread through airborne particles that can be generated from a person with infectious TB when they sneeze, cough, speak, or sing.

The mantoux tuberculin skin test is the preferred method of skin testing for TB. The skin test is performed by injecting purified protein derivative of killed tubercle bacilli under the skin on the inner forearm. The site of the injection is then examined by a trained health care worker 48-72 hours later for swelling.

If the skin test is positive or if symptoms suggestive of TB are present (productive and prolonged cough, fever, chills, loss of appetite, weight loss, fatigue, or night sweats), a chest x-ray and a QuantiFERON® TB Gold blood test are done to further evaluate for TB.

In the past medical experts have attributed positive skin tests to BCG vaccination and had assumed that these people were protected against tuberculosis. Unfortunately, recent medical evidence and experience suggests that the BCG vaccination did not work and was probably ineffective in preventing tuberculosis exposure.

As of August 2006, screening for all NEW International students for tuberculosis will utilize the QuantiFERON® TB Gold Blood Test. This blood test is NOT affected by prior BCG.

Please see the Tuberculosis FACT Sheet.

BCG is not used in the United States, but many countries around the world utilize this vaccaine to help prevent TB in children.

If you have a positive TB skin test and a normal chest x-ray (inactive latent TB), this means that your are not sick with TB and that you cannot transmit it to any other persons. It is very important to consider INH therapy (an antibiotic tablet) due to the possibility of developing active tuberculosis and becoming clinically ill.

It means that you are carrying dormant (sleeping) tuberculosis bacteria in the upper parts of your lungs. Without further treatment, there is a 5-10% chance that in your lifetime these bacteria would awaken. Without further treatment they would multiply to large enough numbers that you would become clinically ill with tuberculosis. At that time you would be considered contagious.

If you have inactive latent TB and are around small children, you should consider the medication. Pregnant females with inactive latent TB can activate their tuberculosis at the time of delivery. Thus, women with inactive latent TB and considering a pregnancy should also seriously consider INH therapy.

To prevent development of active tuberculosis, it is recommended by the World Health Organization and all the tuberculosis experts that you receive INH and a vitamin B6 tablet daily for 6 to 9 months. The medication also requires a blood test to check your liver before starting therapy, again at one month, and then every other month.

Watkins Health Center offers an INH Clinic during the fall and spring semesters. An appointment is required and can be made at 785.864.9507. Clinic staff are available to answer any questions about medications and possible side effects. INH is safe, has minimal side effects in people under 35, is very effective, and is offered at no charge for KU students.

Active Tuberculosis is diagnosed by a positive TB skin test or QuantiFERON® TB Gold blood test, an abnormal chest x-ray, and positive sputum test for the TB bacteria. TB is curable if it is diagnosed early and if effective treatments are instituted without delay. Because of the increase in multidrug-resistant TB, all person with TB should be treated with a four drug regimen of INH, Rifampin, Pyrazinamide, and Ethambutol or Streptomycin until the susceptibility results are known.

A major cause of treatment failure in drug resistant TB is non-adherence to treatment. Treatment failure and drug resistant TB threaten the health of TB patients. These factors also pose serious public health risks because they can lead to prolonged infectiousness and the transmission of TB within the community.

Tuberculosis-related services at Watkins Health Center are offered to KU students. These services include:

• tuberculin skin test.
• INH Clinic (includes INH medication, chest x-ray, and liver blood tests).
• active TB treatment (includes TB medications--four drug regimen, chest x-ray, and laboratory monitoring).
• QuantiFERON® TB Gold blood test for International students or for students with a positive tuberculin skin test.