Tuberculosis: Symptoms and treatment, and who should be tested

There has been an uptick in tuberculosis cases in California illnesses after years of decline,  health officials have announced.

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The U.S. Centers for Disease Control and Prevention provides the following information on tuberculosis:

How is it spread?

The bacteria that cause the disease can be spread through the air by coughing, sneezing or even just speaking. People nearby can inhale the airborne germs.

What are the symptoms?

Many people who are infected have latent TB, without symptoms. If untreated, the latent infection can become active. Some common symptoms of the active disease are:

Cough that lasts 3 weeks or longer
Pain in the chest
Coughing up blood or mucus
Weakness or fatigue
Loss of appetite
Chills, fever, night sweats

Is there a vaccine?

The vaccine Bacille Calmette-Guérin (BCG) is not recommended for the general population by the CDC, because it is of limited effectiveness and, given the low rate of TB in the United States, the drawbacks of vaccination can outweigh the benefits. It also can cause a false positive result on a TB skin test. The vaccine, however,  is often given to infants and small children in other countries where tuberculosis is common.

What is the test?

Tuberculosis can be detected by a blood test or a skin test. The skin test, which is generally less expensive though also less precise, is a two-part process: A small amount of a substance is injected under the skin, and then two to three days later the site is examined for a reaction.

Who should be tested?

People who have spent time with someone who has TB disease
People from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe, Russia)
People who live or work in high-risk settings (correctional facilities, long-term care facilities, homeless shelters)
Health-care workers whose patients are at increased risk for TB disease
Infants, children and adolescents exposed to adults who are at increased risk for latent tuberculosis infection or TB disease

What is the treatment?

A person who has latent infection is usually treated with the antibiotic isoniazid, a single daily pill for six to nine months.
A person who has active tuberculosis disease is treated with isoniazid and other antibiotics for six to 12 months.
If the disease has become drug-resistant in a person, the course of treatment can be 20 to 30 months.