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• What are the signs and symptoms of TB?
• How can I tell if I have TB?
• TB infection vs. TB disease?
• What is the tuberculin skin test?
• What do the results mean?
• Chest X-rays?
• Who should be tested for TB?
• How is TB cured?
• HIV and TB?
• What should I do if I become infected?
• What if I move during treatment?
• What can I expect at Lanakila Health Center?

What is TB?

TB is short for tuberculosis, a disease caused by a bacteria that is spread through the air. It usually affects the lungs, but may damage other parts of the body as well and cause serious illness. People catch TB from someone who already has it - no one is born with it. Anyone, of any nationality or age, can get TB, and without treatment, they can die. The good news is that with proper medication, TB can be cured.

How is TB spread?

TB is spread through the air from one person to another. The bacteria get into the air when a person with TB disease of the lungs or throat coughs, shouts, sings, or sneezes. People nearby may breathe in the bacteria and become infected. You may have been exposed to TB if you spent a lot of time near someone with TB disease of the lungs or throat. Most people get TB from a family member, spouse, friend, or close coworker. You are not likely to get TB from someone coughing in a restaurant or on a bus. And, it is not spread by shaking hands or sharing dishes, drinking glasses, or clothing. View transmission of TB

What are the signs and symptoms of TB?

A person with TB disease may feel some or all of these general symptoms:

• Prolonged cough Hear a typical TB cough
• Weight loss
• Fevers
• Sweating at night
• Feeling weak or tired

How can I tell if I have TB?

First, get a TB skin test. This is the only way to tell if you have TB infection. If it is positive, you will be given other tests to see if you have TB infection or TB disease.

What is the difference between TB infection and TB disease?

People with TB infection (without disease) have the germ that causes TB in their body. They may have been carrying this germ for a short or a very long time, but they are not sick because the germ lies inactive in the body. The body's strong immune system has the germs under control. While the TB germs are inactive in your body, they cannot hurt you and you cannot spread them to other people. In fact, if you are infected by the TB germs, you probably will not know it and you will not feel sick.

However, there is always the possibility that you may develop TB disease sometime in the future, when body defenses become weakened. Therefore, medicine is often prescribed to prevent TB disease from developing.

People with TB disease are sick from TB germs that are active in their body. It is possible to get TB disease shortly after the germs enter the body. And, it is also possible for inactive TB germs which have been in the body for many years to suddenly break loose and attack the lungs or other parts of the body.

People with TB disease usually have one or more of the symptoms of TB. They are often able to give the infection to others. Permanent body damage and death can result from this very serious disease, so it is important to get medical attention.

What is the tuberculin skin test?

The tuberculin skin test tells if TB germs are in the body. A small amount of harmless fluid will be put just under the skin on your arm. Two or three days later you must return to the clinic to have your arm checked for a reaction. (The skin test must be repeated if you are not able to return to the clinic within 3 days.) If there is a reaction, the size of the reaction is measured.

What do the tuberculin skin test results mean?

If there is little or no change to the spot on your arm, it usually means that TB germs have not entered your body. This is called a negative reading, and you will be given a TB clearance card.

If a bump about the size of a pencil eraser or bigger appears on your arm, this means that you probably are infected with TB germs. It is a positive reading, but it does not necessarily mean that you have TB disease. It is very important that you have other tests and/or a medical evaluation to see if TB disease is present. View positive skin test

If you are infected with HIV, the virus that causes AIDS, your body may not react to a TB skin test, and the health worker may give you other tests.

What does the chest x-ray show?

If TB disease is present, it is probably in the lungs. If your skin test is positive, you will be asked to get a chest x-ray on the day of your skin test reading. A chest x-ray takes a picture of the lungs and shows the doctor if there are any signs there of TB. View an abnormal X-ray

At the State TB Program, your waiting time for the x-ray will depend on the number of people ahead of you. After your chest x-ray, you will be given instructions to return to the clinic in four (4) working days to get your results. If your chest x-ray results are suspicious, it means that further tests need to be done to rule out active TB disease.

A normal result means that the TB germs are inactive and TB disease is not present. The clearance card will be issued and you will be notified by letter if preventive therapy is recommended for you.

Who should get tested for TB?

• People who have had exposure to someone who has active TB disease
• People who have symptoms of TB
• People who are required to for employment or school (see State TB Testing Rules)
• People who have weak immunity or certain medical conditions
• People newly arrived to Hawai'i who are immigrants, refugees, elderly, or students from countries where TB is common

How is TB Cured?
	There are medicines to fight TB. These may be pills, liquid to drink or shots. To cure TB, follow your doctor's advice and take your medication exactly as prescribed. If you stop too soon, the germs can come back even stronger than before, and you can give them to your family and friends. Take all the pills the doctor gives you. Anti-TB drugs only work when you take them.

How does HIV infection affect TB?

HIV (human immunodeficiency virus, the AIDS virus) helps TB germs make you sick by attacking the germ fighters in your body. If you are infected with HIV and with TB germs, you have a very big chance of getting TB disease. The TB germs are much more likely to attack your lungs and other parts of the body. You can be cured, but it takes longer to cure someone with TB disease who also has HIV infection.

If you think you might have HIV infection, talk to your doctor about getting an HIV test. If you have HIV infection and TB infection, the sooner you start taking anti-TB medicine, the better your chances to stay healthy.

If you have HIV infection, it is very important to get tested for TB infection at least once a year. Anti-TB drugs are strong. They can prevent or cure TB disease even in people with HIV infection.

What should I do if I have TB infection?

If you have TB infection, you need treatment so you will not get TB disease later. This is called preventive therapy. Isoniazid (INH) is the anti-TB drug used most often.

Unless you get preventive treatment, TB infection can turn into TB disease. Anyone who is infected can develop TB disease, but those who are more likely include:

• Substance abusers
• People with certain medical conditions such as diabetes, certain types of cancers and being underweight; and especially
• People with HIV infection (the virus that causes AIDS).

These things make your body weaker. When your body is weaker, it can't fight TB germs effectively any longer.

It is very important that you take your preventive treatment as your doctor recommends. It takes nine months to kill all the TB germs. Remember, you will always have TB germs in your body unless you kill them with the right medicine.

What if I move before I finish my medication?
	Ask a health worker where you should go to get the rest of your medicine. The local health department or your private doctor will make sure you get the medicine you need. Protect your family and friends from TB take all your anti-TB drugs!

What can I expect at the clinic?

• At Lanakila Health Center, TB clinic visits are first come, first serve. Waiting time for each visit will depend on the number of patients ahead of you.
• A visit for a TB skin test may take 30 minutes. A visit for a chest x-ray may take one hour or more. If you are on TB medication, you will need to return monthly for an evaluation and for a medication refill.
• A parent or legal guardian must always accompany minor children (under age 18).