Tuberculosis Screening and Treatment Process

Why do we test?1. We want to prevent an outbreak of

Tuberculosis in our campus community2. We want to find those that are affected

and get them treated so you are able to continue to participate in your schooling.

TuberculosisWhat is it?

Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with TB can die if they do not get treatment.

About 10-20% of the international students that we screen each semester will be positive for a tuberculosis infection and will need further work up!

Tuberculosis ContinuedHow is it spread?

TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection.

http://www.cdc.gov/tb/

Active versus Latent DiseaseThe Difference between Latent TB Infection and TB Disease

A Person with Latent TB Infection A Person with TB Disease • Has no symptoms • Has symptoms that may include:

- a bad cough that lasts 3 weeks or longer - pain in the chest - coughing up blood or sputum- weakness or fatigue - weight loss - no appetite - chills - fever - sweating at night

• Does not feel sick • Usually feels sick • Cannot spread TB bacteria to others • May spread TB bacteria to others • Usually has a skin test or blood test result indicating TB infection • Usually has a skin test or blood test result indicating TB

infection • Has a normal chest x-ray and a negative

sputum smear • May have an abnormal chest x-ray, or positive sputum smear or culture

• Needs treatment for latent TB infection to prevent active TB disease • Needs treatment to treat active TB disease

QFTWhat is it?The QuantiFERON®-TB Gold test (QFT-G) is a

whole-blood test for use as an aid in diagnosing Mycobacterium tuberculosis infection, including latent tuberculosis infection (LTBI) and tuberculosis (TB) disease. This test was approved by the U.S. Food and Drug Administration (FDA) in 2005.

QFTA positive result suggests that M.

tuberculosis infection is likely; a negative result suggests that infection is unlikely

Positive Test ResultsYou will see the provider at Student Health

Sent to the hospital to have a Chest x-ray You will then come back to Student Health for

results and evaluation.

Treatment OptionsActive TB cases will be sent to an infectious

disease physician to manageLatent TB cases (the majority):

Take the treatment Rifampin daily treatment for 4 months. You will

have blood taken before treatment and the 1st, 2nd, and 3rd month of treatment

You will come into student health for monthly visits to identify signs or symptoms of adverse drug effects and for medication refills.

Treatment OptionsYou have to decide the risk and benefits of

treatment versus the latent infection becoming active.You may decide not to take treatment

If so, you will be asked to come in every 6 months and review signs and symptoms of active disease at Student Health.

You should be aware of your chances of getting active tuberculosis

AdherenceImportant that once you start treatment that

you adhere to the medication regime. If we need to stop the treatment because of

side effects we will discuss options from there.

Drug resistant Tuberculosis has been associated with the incomplete treatment of Latent Tuberculosis.

We are here for youWe want to keep you healthy and also keep

the campus community healthy.The goal is to keep you in class so that you

are able to complete your degree and move on to your professional life.

It is important that you review this information and then we can answer questions as they arise.

References• Center for Disease Control and Prevention,

Tuberculosis, http://www.cdc.gov/tb/ACHA guidelines: Tuberculosis screening and

targeted testing of college and university students (2012).

http://www.acha.org/Publications/docs/ACHA_Tuberculosis_Screening_Apr2012.pdf