Tuberculosis (TB)
The Issue
For most Canadians, the risk of developing tuberculosis (TB) is very low. However, there are approximately 1,600 new cases of TB reported in Canada each year, so it is important to know the symptoms and how to minimize your risks.
Background
Tuberculosis has existed for centuries, and used to be called "consumption". It is a serious disease that usually attacks the lungs, but can also affect other parts of the body, including the brain, the lymph nodes, and bones. Even though TB is completely curable with antibiotics, it continues to be a major health problem and kills almost two million people worldwide every year.
How TB is Spread
TB is not as contagious as many other diseases, including the flu and chickenpox. To become infected, a person usually has to have frequent exposure to someone with active TB. For example, spending several hours a day for a few months with a person with active TB would put you at risk of infection. You cannot become infected with TB by handshakes, sitting on toilet seats, or by sharing dishes with someone who has TB. Tuberculosis bacteria, called Mycobacterium tuberculosis, is spread through the air from person to person, when someone with infectious TB disease coughs or sneezes.
Tuberculosis Infection and TB Disease
Most people who are exposed to TB bacteria do not develop TB disease. In some cases, the person's immune system is able to kill the TB germs. When this doesn't happen, the bacteria can remain alive but inactive in the body, and this is called TB infection. A person with TB infection has no symptoms, is not sick, and poses no risk of spreading the bacteria.
TB infection may become TB disease if the infected person's immune system cannot stop the TB bacteria from growing. The risk of developing TB disease is highest in the first two years after someone is infected. About 10% of infected adults will develop TB disease at some point in their lives.
Risk Factors for Developing TB Disease
Anyone with a weakened immune system is at greater risk of developing TB disease. Conditions that weaken the immune system include HIV infection, end stage kidney disease, diabetes, cancer, organ transplants, silicosis, abuse of alcohol or drugs, and low body weight.
Babies, pre-school children, and the elderly are also at greater risk because their immune systems are weaker than those of healthy adults.
Also, certain population groups in Canada have an increased risk of TB infection. These groups include people born in or traveling to countries where TB is widespread, Aboriginal peoples, homeless people, and people who live in long-term care or correctional facilities. People who work with any of these groups (such as health care workers) are also at greater risk.
The Symptoms of TB Disease
The symptoms of TB disease in the lungs can include a bad cough that lasts longer than two weeks, pain in the chest, coughing up blood or phlegm, weakness or feeling very tired, weight loss, lack of appetite, chills, fever, and night sweats.
Minimizing Your Risks
If you belong to one of the groups at higher risk, and suspect you may have been exposed to TB bacteria, or if you are experiencing any of the symptoms of TB, you should see your doctor.
A skin test can determine whether you have TB infection. If you do, it is important to protect your immune system from becoming weak. Treating TB infection with antibiotics will help your immune system fight the TB bacteria and prevent the development of TB disease.
You may also need additional tests or chest x-rays to determine whether you have TB disease. Anyone with TB disease must take antibiotics for at least six months to kill all of the TB bacteria.
People who do not finish a full course of antibiotic treatment are at greater risk for developing a strain of TB that is drug resistant and harder to cure. They also pose a greater risk of spreading TB to others.
The Government of Canada's Role
Health Canada collects and analyzes data on all reported cases of TB in order to enhance national TB prevention and control. In addition, Health Canada conducts national surveillance of TB drug resistance, works on targeted research projects with provincial and territorial partners, and sponsors the Canadian Tuberculosis Committee (CTC). One of the CTC's key activities is "The National Strategy for TB Elimination."
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