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Tuberculosis
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Description
of the Disease
Tuberculosis (TB),
is a disease caused by a mycobacterium that typically attacks the lungs, but can
also affect the kidneys, bones, joints, lymph nodes and other body
systems. Most
people who become infected have what is called a latent TB
infection, or LTBI. Those with LTBI have a positive skin reaction to
a PPD (TB skin test), have no pulmonary damage, are asymptomatic and are not contagious to
other people; however, they may develop active TB disease later on
if they do not receive the recommended treatment.
TB
was once the leading cause of death in the United States. In the
1940’s, scientists discovered the first of several drugs that are
now used to treat TB. As a result, TB slowly began to disappear in
the United States; however, the number of TB cases increased by 20% from 1985 to
1992. Although the overall number of cases has declined since
1993, TB is still being reported to the Center for Disease Control (CDC)
from all 50 states, as well as the District of Columbia.
In 2000,
more than 16,000 new cases were reported in the United States.
Washington State reported 258 cases of tuberculosis for a case rate
of 4.4 per 100,000 persons. Twenty-five of Washington’s 39
counties had at least one new case of TB that year. The five highest incidence
rates were in Franklin, King, Cowlitz, Pierce and Yakima counties.
The
Cowlitz County Health Department is mandated by Washington State law
to perform public health functions related to surveillance, case
finding, epidemiological analysis and contact tracing for active
and latent tuberculosis cases.
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Related
Health Department Web Links
Related
Outside Websites
Washington
State Dept of Health web links
Center
for Disease Control web links
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What
services are provided by Health Department professionals for Cowlitz County?
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Investigation of all
notifiable diseases including the source of infections, potential
for spread and treatment option for tuberculosis.
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Linkage between
health care providers, Washington State Office Epidemiology and
Communicable Disease.
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Consultation with
public health nurses regarding treatment and prevention of
latent and active TB diseases.
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Referrals for
treatment of TB clients to private health care providers or specialists.
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Classroom
instruction of
the signs, symptoms and prevention of TB.
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Language
Interpretation services for high risk populations about the
disease.
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Outbreak control
investigation and related follow up for all phases of reportable
disease including education about the prevention of tuberculosis.
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TB Skin Testing
Click
HERE for a list of TB
Skin Test providers in Longview. |
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Transmission
TB
bacteria enter the air column when a person with active TB disease of the
lungs or throat coughs or sneezes.
Persons nearby may breathe in these bacteria and become
infected.
Prolonged
exposure to airborne bacteria is usually necessary for a healthy
person to become infected.
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Populations
At Risk
High-risk
groups include injection drug users, persons exposed to an
individual with active TB disease, babies and young children, and
individuals with compromised immune systems (such as those with HIV/AIDS,
hepatitis, diabetes, cancer, or severe kidney disease). You are
considered to be at risk if you have recently immigrated from a country where TB is common, or have spent time in
jails, migrant camps or homeless shelters.
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Symptoms
Symptoms of active TB
disease include: chronic fatigue, a bad
cough that lasts longer than 2 weeks, chest pain, coughing up blood, increased
sputum production, loss of weight, loss of appetite, chills, fever and night sweats.
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Prevention
Treatment of Latent TB Infection (LTBI) is
essential to controlling and eliminating TB in the United States.
Treatment of LTBI substantially reduces the risk that TB infection
will progress to disease. If you are a health care provider,
educator or public health safety worker in Washington state, an
annual TB test is required.
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Diagnosis
Diagnosis of active TB includes a positive PPD
skin test, a positive sputum test and an abnormal chest x-ray or a
positive tissue biopsy (when considering extrapulmonary TB). If the
PPD test is positive, the chest x-ray is normal, and the
person exhibits no clinical symptoms, then that person has Latent
Tuberculosis Infection (LTBI). In addition to doing a TB skin test,
clients are asked to fill out a health questionnaire to determine
their risk factors to exposure
to infectious tuberculosis.
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Treatment
Treatment for 9 to 12 months with Ioniazid (INH) is strongly recommended.
If the PPD is positive and
the chest X-ray is abnormal, then the person may have active TB and
is immediately quarantined and started on a four-drug regime until
sputum samples can be obtained and a culture and sensitivity test
can be performed.
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