Tuberculosis

What is Tuberculosis (TB)?
How is TB transmitted?
Does everyone exposed to TB become infected?
Is there a vaccine to prevent a person from getting TB?
What are the symptoms of TB?
How is tuberculosis diagnosed?
Who should get tested for TB?
What does one do if they think they have symptoms of TB?
How is TB treated?
How does one get tested for TB?
What does UHS do if students possibly have been exposed to TB?

What is Tuberculosis (TB)?

Tuberculosis is caused by the bacterium Mycobacterium tuberculosis. The bacteria usually attack the lungs, but can attack other parts of the body such as the lymph nodes, kidneys, bones, or brain. Medications can treat TB, but if not recognized and treated, TB can progress and even be fatal. Identifying and treating those who are infected, but have not yet become ill with Active TB, can prevent the spread of TB.

How is TB transmitted?

Tuberculosis spreads through the air when a person with Active TB of the lungs coughs, sneezes, speaks, or sings. Bacteria in respiratory droplets can then be inhaled by others. It usually takes being in close proximity to a person with Active TB for prolonged periods of time in an enclosed environment to be at a higher risk for infection. TB is not as contagious as influenza.

TB is NOT spread by:

shaking someone's hand
sharing food or drink
touching bed linens or toilet seats
sharing toothbrushes
kissing

Does everyone exposed to TB become infected?

No. For many, their immune system is able to remove the bacteria, and they do not develop the disease. In other cases, the person’s immune response ”walls off” the bacteria inside the body, causing the bacteria to become dormant. The person does not develop Active TB during this time, and is said to have Latent TB infection (LTBI). The person is well and cannot spread the infection. If treated at this stage, Active TB can usually be prevented.

Active TB develops when the body can no longer keep the bacteria dormant. The bacteria become "active" and cause the person to become ill. This is called TB disease and may occur if LBTI is not fully treated, if a resistant strain of TB has developed, if the individual's immune system becomes weakened (e.g. cancer, HIV, malnutrition, diabetes, aging with subsequent weakening of the immune system, or long-term steroid use. Sometimes it occurs for unknown reasons.

Active TB develops when the body is no longer able to keep the bacteria dormant. In other words the bacteria become "active" and cause the person to become ill. This is called TB disease. It occurs for a variety of reasons such as: if LBTI is not fully treated, or if a resistant strain of TB has developed or if the individual's immune system becomes weakened (like with cancer, HIV, malnutrition, diabetes, or long-term use of steroids). It can also occur with aging and weakening of the immune system, or it may also occur for other, unknown reasons.

Is there a vaccine to prevent a person from getting TB?

A TB vaccine called Bacillus Calmette-Guerin (BCG) is given in many countries to prevent TB. Usually given to infants, it may be re-administered at other times. BCG offers protection against TB in children but typically does not offer protection into adulthood. It is not routinely used to prevent TB in the United States.

What are the symptoms of TB?

Latent TB - The person with LTBI has no symptoms

Active TB - Symptoms of TB disease depend on where in the body the TB bacteria are growing.

TB disease in the lungs (pulmonary TB) may cause:

A bad cough that lasts 3 weeks or longer
Coughing up blood or sputum (phlegm from deep inside the lungs)

Other symptoms of TB disease include:

Weakness or fatigue
Unexplained weight loss
No appetite
Fever and chills
Night sweats

How is tuberculosis diagnosed?

Latent TB infection (LTBI) can be diagnosed with a skin test or with a blood test:

Skin testing - This test, called a purified protein derivative (PPD) test, involves injecting a solution with a small amount of an inactivated portion of TB bacteria just beneath the surface of the skin, usually on the inside of the forearm. The person returns in 48-72 hours to have the reaction on the arm “read”. Most individuals previously infected with TB develop a red or swollen bump at the injection site. It usually takes 4 to 10 weeks after exposure to a person with Active TB for a PPD to become positive.

Blood tests - This test is known as an interferon gamma release assay (IGRA). Blood tests simplify TB testing, because they do not require a return trip to read the test reaction, and they are not affected by prior immunization with BCG vaccine. Two approved types provide similar results: Quantiferon Test (QFT) and the T-Spot. UHS uses the QFT.

Active TB is diagnosed by further testing of those with a positive test, and/or those with symptoms:

Chest x-ray to determine if a person has signs of past or Active TB.

Sputum evaluation and culture - to grow the bacterium to determine its sensitivities to TB medications. The person is referred to the TB Clinic for this evaluation.

Who should get tested for TB?

You should get tested for TB if:

They have been contacted by a health authority (e.g. University Health Services, HealthPoint Occupational Health Program, or Austin Public Health) informing them that they’ve possibly been exposed to someone with TB; or
They have spent prolonged periods of time in close proximity in a closed environment with a person known or suspected to have TB disease; or
They have HIV infection or another condition that weakens their immune system and puts them at high risk for TB disease; or
They are from (or have spent an extended period in) a country where TB disease is common (e.g. most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia); or
They live or have lived in the United States in a place where TB disease is more common, such as a homeless shelter, migrant farm camp, prison or jail, and some nursing homes; or
They inject or have injected illegal drugs; or
They have symptoms of TB disease.

What does one do if they think they have symptoms of TB?

People who think they have tuberculosis should consult a physician.

Students, should call the University Health Services (UHS) Nurse Advice Line at (512) 475-6877 before coming in to UHS if they think they have TB symptoms. The nurse will make arrangements with the student to reduce the risk of exposing others in case they do have TB. Students concerned that they might have TB should not use MyUHS to schedule an appointment.

Faculty and staff who think they may have tuberculosis from an exposure at work should refrain from coming to work and contact the HealthPoint Occupational Health Program (LWC) at (512) 417-4647 for guidance. Workers' Compensation insurance may apply. They can provide referrals for testing and, if indicated, the faculty/staff member may obtain free treatment from the Austin Public Health TB clinic.

How is TB treated?

TB can almost always be treated and cured. It may require up to 9 months of therapy, depending on the medical regimen used. Those with TB disease need to take several different drugs, because multiple medications do a better job of killing all of the bacteria and preventing them from becoming resistant to medicines used to treat TB.

How does one get tested for TB?

Students

Students who have been contacted by UHS as a possible contact of a person with Active TB should follow the instructions provided to in the email.
Students who think they might have been exposed to a person with Active TB, but have not been contacted by UHS or Austin Public Health as a possible contact, should first call the UHS Nurse Advice Line at (512) 475-6877.
Students needing testing before they can register for classes at The University of Texas at Austin can find instructions at Medical Clearance Requirements for International Students.
Students needing TB testing for professional schools, volunteer work, travel, etc. will usually require a TB skin test, which is available at UHS. Call the UHS Allergy, Immunization, and Travel Clinic at (512) 475-8301 to schedule an appointment.

Faculty and staff

Faculty/staff who have been in close contact with someone on campus with or suspected of having TB may be contacted by the Austin Public Health TB Clinic or HealthPoint Occupational Health Program (LWC) to determine their testing needs.
Faculty/staff who are concerned about having been exposed to TB in the work place should contact the HealthPoint Occupational Health Program (LWC) at (512) 471-4647. LWC can arrange for TB screening using a blood test with St. David's Occupational Health at no cost to the employee.
Employees needing TB testing related to their job assignment or research work will usually get a TB skin test, which is also available through HealthPoint LWC.
Faculty/staff who are not a close contact but are still interested in TB screening may contact their personal physician or schedule a testing appointment with the Austin/Travis County TB Clinic (512) 972-5460.

What does UHS do if students possibly have been exposed to TB?

When UHS becomes aware of a case of Active TB (either diagnosed in UHS or notified by Austin Public Health) we work closely with the Austin Public Health TB clinic to identify campus individuals who are close contacts (see "How is TB transmitted?" above) of the person with TB. Those individuals are contacted by the UHS Chief Medical Officer, informed of their potential exposure, given information about TB, offered testing, and, if necessary, treated.

Using an abundance of caution, UHS may also email students if they were in a class with a person with Active TB, even if they have not been identified as being at high risk for exposure. Emails inform the student of their possible exposure and provide information about TB, and how to get tested if they wish.

Confidentiality laws prohibit UHS from revealing any identifying information about an individual who has or is suspected of having TB.

For more information, go to the U.S. CDC's Tuberculosis page at or go to their FAQs for TB