Tuberculosis (TB) is one of the world’s deadliest diseases:
- One third of the world’s population are infected with TB.
- Each year, nearly 9 million people around the world
become sick with TB.
- Each year, there are almost 2 million TB-related deaths worldwide.
- TB is the leading killer of people who are HIV infected.
You can prevent TB
What is TB?
"TB" is short for a disease called tuberculosis. TB is spread by tiny germs that can float in the air. The TB germs may spray into the air if a person with TB disease of the lungs or throat coughs, shouts, or sneezes. Anyone nearby can breathe TB germs into the lungs.
TB germs can live in your body without making you sick. This is called TB infection. Your immune system traps TB germs with special germ fighters. Your germ fighters keep TB germs from making you sick.
But sometimes, the TB germs can break away and spread. Then they cause TB disease. The germs can attack the lungs or other parts of the body. They can go to the kidneys, the brain, or the spine. If people have TB disease, they need medical help. If they don’t get help, they can die.
How do I know if I have TB infection?
A skin test is the only way to tell if you have TB infection. The test is "positive" if a bump about the size of a pencil eraser or bigger appears on your arm. This bump means you probably have TB infection.
What should I do if I have TB infection?
If you have TB infection, you may need treatment so you will not get TB disease later. This is called "preventive" treatment. Isoniazid (INH) is the anti-TB drug used most often.
Unless you get preventive treatment, TB infection can turn into TB disease. Those who are more likely to get sick from TB disease include:
-
alcoholics or injection drug users;
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people with certain medical conditions such as diabetes, certain types of cancers, and being underweight; and especially
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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 any more and TB infection can turn into TB disease.
It is very important that your take your preventive treatment as soon as your doctor recommends. It takes at least six months to a year to kill all the TB germs. Remember, you will always have TB germs in your body unless you kill them with the right medicine.
Protect your family and friends from TB - take all your anti-TB drugs!
Multidrug-Resistant Tuberculosis (MDR TB)
Posted: January 2007
What is tuberculosis (TB)?
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. In most cases, TB is treatable and curable; however, persons with TB can die if they do not get proper treatment.
What is multidrug-resistant tuberculosis (MDR TB)?
Multidrug-resistant TB (MDR TB) is TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampin. These drugs are considered first-line drugs and are used to treat all persons with TB disease.
What is extensively drug resistant tuberculosis (XDR TB)?
Extensively drug resistant TB (XDR TB) is a rare type of MDR TB. XDR TB is defined as TB which is resistant to isoniazid and rifampin, plus resistant to any fluoroquinolone and at least one of three injectable second-line drugs (i.e., amikacin, kanamycin, or capreomycin).
Because XDR TB is resistant to first-line and second-line drugs, patients are left with treatment options that are much less effective.
XDR TB is of special concern for persons with HIV infection or other conditions that can weaken the immune system. These persons are more likely to develop TB disease once they are infected, and also have a higher risk of death once they develop TB.
How is TB spread?
Drug-susceptible TB and MDR TB are spread the same way. 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 float in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected.
TB is not spread by
- shaking someone’s hand
- sharing food or drink
- touching bed linens or toilet seats
- sharing toothbrushes
- kissing
- smoking or sharing cigarettes
How does drug resistance happen?
Resistance to anti-TB drugs can occur when these drugs are misused or mismanaged. Examples include when patients do not complete their full course of treatment; when health-care providers prescribe the wrong treatment, the wrong dose, or length of time for taking the drugs; when the supply of drugs is not always available; or when the drugs are of poor quality.
Who is at risk for getting MDR TB?
Drug resistance is more common in people who:
- do not take their TB medicine regularly
- do not take all of their TB medicine as told by their doctor or nurse
- develop active TB disease again, after having taken TB medicine in the past
- come from areas of the world where drug-resistant TB is common
- have spent time with someone known to have drug-resistant TB disease
How can MDR TB be prevented?
The most important thing a person can do to prevent the spread of MDR TB is to take all of their medications exactly as prescribed by their health care provider. No doses should be missed and treatment should not be stopped early. Patients should tell their health care provider if they are having trouble taking the medications. If patients plan to travel, they should make sure they have enough medicine to last while away.
Health care providers can help prevent MDR TB by quickly diagnosing cases, following recommended treatment guidelines, monitoring patients’ response to treatment, and making sure therapy is completed.
Another way to prevent getting MDR TB is to avoid exposure to known MDR TB patients in closed or crowded places such as hospitals, prisons, or homeless shelters. If you work in hospitals or health-care settings where TB patients are likely to be seen, you should consult infection control or occupational health experts. Ask about administrative and environmental procedures for preventing exposure to TB. Once those procedures are implemented, additional measures could include using personal respiratory protective devices.
Is there a vaccine to prevent TB?
There is a vaccine for TB disease called Bacille Calmette-Guérin (BCG). It is used in some countries to prevent severe forms of TB in children. However, BCG is not generally recommended in the United States because it has limited effectiveness for preventing TB overall.
What should I do if I think I have been exposed to someone with TB disease?
If you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin test.
What are the symptoms of TB disease?
The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs may also include coughing, chest pain, and coughing up blood. Symptoms of TB disease in other parts of the body depend on the area affected. If you have these symptoms, you should contact your doctor or local health department.
Additional Information
CDC. Multidrug-Resistant TB (MDR TB) MMWRs.
CDC. Questions and Answers About TB (2005).
CDC. Tuberculosis: General Information (2006).
CDC. Tuberculin Skin Testing (2006).
CDC. Tuberculosis Information for International Travelers (2006).
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