Tuberculosis (TB)
Overview

Tuberculosis (TB) is one of the world’s deadliest diseases. One third of the world’s population is infected with TB. In 2014, 9.6 million people around the world became sick with TB disease. There were 1.5 million TB-related deaths worldwide. A total of 9,421 TB cases (a rate of 2.96 cases per 100,000 persons) were reported in the United States in 2014.

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.

TB is spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.

Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease. TB bacteria become active if the immune system can't stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to people they spend time with every day (CDC).

Vaccine - BCG

Bacille Calmette-Guérin (BCG) is a vaccine for tuberculosis (TB) disease. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG does not always protect people from getting TB.

In the United States, BCG should be considered for only very select people who meet specific criteria and in consultation with a TB expert. Health care providers who are considering BCG vaccination for their patients are encouraged to discuss this intervention with the TB control program in their area (CDC).

Treatment

Latent Infection

People with latent TB infection have TB bacteria in their bodies, but they are not sick because the bacteria are not active. People with latent TB infection do not have symptoms, and they cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will go from having latent TB infection to being sick with TB disease. For this reason, people with latent TB infection are often prescribed treatment to prevent them from developing TB disease. Treatment of latent TB infection is essential for controlling and eliminating TB in the United States (CDC).

TB Disease

TB disease can be treated by taking several drugs for 6 to 9 months. There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens include:

isoniazid (INH)
rifampin (RIF)
ethambutol (EMB)
pyrazinamide (PZA)

Regimens for treating TB disease have an initial phase of 2 months, followed by a choice of several options for the continuation phase of either 4 or 7 months (total of 6 to 9 months for treatment). Learn more about the continuation phase of treatment.

It is very important that people who have TB disease to finish the medicine, taking the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat (CDC).

School Exclusion and Reportable to Public Health

In the extremely rare case of a student infected with TB, the infection should be immediately reported to Ventura County Public Health and the child would be excluded from school until released by their doctor and a public health officer.

Other TB Resources

For more information about tuberculosis, please visit the Centers for Disease Control and Prevention.

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