introduction-to-tub....erculosis-508c.pptx

Tuberculosis

1. Introduction to Tuberculosis (TB)

2. This Slide Deck Covers the Following Topics about Tuberculosis (TB): What is Tuberculosis (TB)? How TB spreads Latent TB Infection and TB Disease Risk Factors TB Testing Treatment TB Elimination 2

3. What is Tuberculosis (TB)?

4. Tuberculosis (TB) TB is spread from person to person through the air. TB is a disease caused by bacteria called Mycobacterium tuberculosis . The bacteria, or TB germs, usually attack the lungs. However, TB germs can attack any part of the body such as the kidney, spine, or brain. Pulmonary TB is TB in the lungs. Extrapulmonary TB is TB in places other than the lungs, such as the kidney, spine, or brain. Not everyone infected with TB germs becomes sick. 4

5. TB is the World’s Top Cause of Death due to Infectious Disease TB is not a disease of the past. Too many people in the United States still suffer from TB. In 2019, there were 8,976 cases of TB disease in the United States, which is the lowest number on record. TB is a serious disease that can cause a person to become very sick if not treated with medicine. Treatments are available to prevent and cure TB. 5

6. Progress Toward TB Elimination, United States, 1982-2019 6

7. TB Impacts People From All Over the United States 7

8. Anyone Can Get TB 8

9. How TB Spreads

10. TB Spreads Through the Air TB spreads from person to person when someone with contagious TB coughs, speaks, or sings. 10

11. TB is NOT Spread by Sharing toothbrushes Saliva from kissing Shaking someone’s hand Touching bed linens or toilets Sharing food, drink, or utensils 11

12. Latent TB Infection and TB Disease

13. Two TB-Related Conditions Latent TB Infection (LTBI) People with latent TB infection Do not feel sick, do not have symptoms, and cannot spread TB germs to others. Can have latent TB infection for years. Have a small amount of TB germs in their bodies that are alive but inactive. Latent TB infection can develop into TB disease. TB Disease If TB germs become active and multiply, latent TB infection can turn into TB disease. 13

14. Not Everyone Who Is Infected with TB Becomes Sick Person with Latent TB Infection Person with TB Disease Has a small amount of TB germs in his/her body that are alive but inactive Has a large amount of active TB germs in his/her body Cannot spread TB germs to others May spread TB germs to others Does not feel sick, but may become sick if the germs become active in his/her body  May feel sick and may have symptoms such as a cough, fever, and/or weight loss Usually has a positive TB skin test or TB blood test result indicating TB infection Usually has a positive TB skin test or TB blood test result indicating TB infection Should consider treatment for latent TB infection to prevent TB disease Needs treatment for TB disease 14

15. Untreated Latent TB Infection Can Lead to TB Disease If the immune system can’t stop TB germs from growing, they become active (multiplying in your body); this is called TB disease.  Most people diagnosed with TB disease in the United States become sick after living with latent TB infection for years. It is estimated that up to 13 million people in the United States have latent TB infection. Latent TB infection treatment is 90% effective in preventing the development of TB disease. 15

16. Tuberculosis (TB) Disease: Only the Tip of the Iceburg There are two types of TB conditions: latent TB infection and TB disease. People with TB disease are sick from active TB germs. They usually have symptoms and may spread TB germs to others. People with latent TB infection do not feel sick, do not have symptoms, and cannot spread TB germs to others. But, if their TB germs become active, they can develop TB disease. Millions of people in the U.S. have latent TB infection Without treatment, they are at risk for developing TB disease. 16

17. Possible TB Disease Symptoms Night Sweats Fever Chills Weakness or fatigue Weight loss No appetite Cough lasting longer than 3 weeks Pain in the chest Coughing up blood or sputum (phlegm from inside the lungs) 17

18. People with TB Disease Are Sick and Can Spread TB Germs TB disease is a serious condition and can lead to death if not treated. TB disease can almost always be treated and cured with medicine. A person with TB disease typically requires the following: X-rays 180 days of medicine Lab tests Follow up and testing of close contacts 18

19. Public Health Workers are Responsible for Finding TB Contacts A TB contact is persons exposed to someone with contagious TB disease Contacts can include family members, roommates or housemates, close friends, coworkers, classmates, and others People with TB disease can spread TB germs to those around them The local health department will conduct a contact investigation by following up and testing those who have been close to someone with TB 19

20. Risk Factors

21. Who Is at Higher Risk For Becoming Infected with TB Germs? Anyone can get TB Some people have a higher risk of getting infected with TB: People who have contact with someone who has infectious TB disease People who were born in or who frequently travel to countries where TB disease is common, including Mexico, the Philippines, Vietnam, India, China, Haiti, Guatemala, and other countries with high rates of TB Health care workers and others who work or live in places at high risk for TB transmission, such as homeless shelters, jails, and nursing homes 21

22. Since 2010, the Majority of U.S. TB Cases Occur in Persons Born Outside of the United States * *Percentages are rounded; data from 2019 22

23. Countries of Birth Among Non-U.S.-born Persons with TB, United States 2019 * *Percentages are rounded 23

24. Reported TB Cases by Race/Ethnicity, * United States, 2019 (N=8,868) † * All races are non-Hispanic; multiple race indicates two or more races reported for a person but does not include persons of Hispanic/Latino origin. † Excludes unknown/missing values 24

25. Who Is at Risk for Developing TB Disease? People at high risk for developing TB disease generally fall into two categories: Those who have been recently infected with TB germs Those with medical conditions that weaken the immune system, such as: HIV infection Substance abuse Specialized treatment for rheumatoid arthritis or Crohn’s disease Organ transplants Severe kidney disease Head or neck cancer Diabetes Medical treatments such as corticosteroids Silicosis Low body weight 25

26. TB Testing

27. Two Types of Tests Can Be Used to Diagnose TB Infection TB blood test or TB skin test OR If either test is positive , further tests are done to confirm a diagnosis of TB disease: Medical examination Chest x-ray 27

28. TB Blood Test Blood is drawn and sent to a lab for analysis. Positive blood test: A person likely has been infected with TB germs. Additional tests are needed to determine if the person has latent TB infection or TB disease. Negative blood test: A person’s blood did not react to the test and latent TB infection or TB disease is not likely. The TB blood test is also known as an Interferon-Gamma Release Assay (IGRA). 28

29. TB Skin Test The TB skin test, also called the Mantoux tuberculin skin test (TST), requires two visits with a healthcare provider. On the first visit, a test is placed . On the second visit, the test is read . 29

30. People Vaccinated with BCG Can Still Get TB Disease Bacille Calmette- Guérin (BCG) Is a vaccine for TB disease. Is often given to infants and small children in countries where TB is more common. Protects against severe forms of TB in children. The TB vaccine is not widely used in the United States. 30

31. TB Blood Tests Are Preferred for People Who have Received the TB Vaccine (BCG) The TB vaccine (BCG) may make a TB skin test hard to interpret. The TB vaccine does not affect TB blood tests results. TB blood tests give more accurate results in people who have received the TB vaccine. 31

32. Treatment

33. Treatment for Latent TB Infection Can Prevent the Development of TB Disease TB germs in the body of someone with latent TB infection are inactive, so they will not feel sick. As long as TB germs remain in the body, they can become active, multiply, and make someone sick with TB disease. People with latent TB infection Should take medicine to prevent the development of TB disease, even though they don’t feel sick. 33

34. Treatment for Latent TB Infection Compared to treatment for TB disease, latent TB infection treatment Is shorter. Is less costly. Has fewer side effects. 34

35. Treating TB Disease Protects Your Health and the Health of Others People with TB disease can pass TB germs to their family, friends, and others around them if they don’t take TB medicine the right way. People with TB disease need to take several medicines when they start treatment. After taking TB medicine for several weeks, a doctor will be able to tell TB patients when they are no longer able to spread TB germs to others. Most people take TB medicine for at least 6 months to be cured. 35

36. TB Elimination

37. Together We Can Work Toward TB Elimination in the United States Strengthen current TB programs to diagnose and treat TB disease. Increase efforts to identify and treat latent TB infection. 37

38. Health Care Providers and Communities Need to “Think TB!” Protect the health and well-being of community members at higher risk for TB: Know who is most at risk for TB Recognize the signs and symptoms of TB Test and treat patients who are at high risk for TB Be aware of latest TB research and shortest treatment options Encourage conversations about TB and how it affects the community to reduce stigma 38

39. Key Partners in TB Elimination Health care workers in doctors’ offices and hospitals, community health centers, and academic institutions State and local health departments Communities at higher risk for TB 39

40. Resources CDC TB website: www.cdc.gov/tb/ State & Local TB Control Offices: www.cdc.gov/tb/links/tboffices.htm Find TB Resources: https:// findtbresources.cdc.gov Facebook: www.facebook.com/CDCTB/ Twitter: www.twitter.com/cdc_tb The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. 40