Tuberculosis (TB)

What is tuberculosis?

Tuberculosis (TB) is a bacterial infection that most commonly affects the lungs, but can also affect the lymph nodes, bones, joints and kidneys. It can cause meningitis.

In New Zealand, there are approximately 300 cases of TB diagnosed each year. While life-threatening complications such as haemorrhage from the lungs are now rare, TB can still be a very serious disease, particularly for older people.

Tuberculosis is spread through coughing, sneezing or spitting. The bacteria are carried into the air and people nearby can breathe them in through their mouths and noses. You need to live or work closely with an infected person to catch the disease.

Tuberculosis can stay sleeping (latent) in someone’s body for many years before it develops. Even though you feel well and healthy, the doctor may still advise treatment to make sure you do not develop TB disease.

TB can be treated with antibiotics. It’s very important to finish the treatment or the disease will get worse again.

Tuberculosis vaccinations are normally only given to:

• babies at risk of catching TB from someone living in their house
• babies who are going to live in a country with a high rate of TB
• babies whose parents, household member or carer have in the last 6 months lived in a country with a high rate of TB.

Signs and symptoms

People with tuberculosis don’t always show symptoms. If you’re healthy, your body can usually stop the TB bacteria from growing.

• a cough lasting 3 weeks or more, often with thick phlegm
• tiredness
• night sweats
• weight loss
• swollen glands (usually in your neck).

Coughing up blood is a widely known symptom of TB, but if this occurs, it will happen a long time after someone is infected.

If you think you may have TB, it’s important to see your doctor. They can arrange tests to see if you’re infected. If you do have the disease, people you have regular contact with will need to be tested too.

Treatment

TB is treated with a combination of antibiotics, which need to be taken for at least 6 months. Sometimes longer courses are needed, such as for TB meningitis.

People usually begin to feel better 2–4 weeks after starting treatment.

You can’t catch TB from a person who has been taking the antibiotics for 2 weeks or more.

It’s very important to finish the course of antibiotics, or the disease will get worse again.

Prevention Immunisation for babies

Babies at risk of catching tuberculosis can be given the BCG (Bacille Calmette-Guérin) immunisation when they’re born.

• Will your baby be living in a house with a person who has TB or has a history of TB?
• During their first 5 years, will your baby be living for 3 months or longer in a country with a high TB rate?
• Within the last 5 years, has a parent or carer or the baby, or household member, lived for 6 months or longer in a country with a high TB rate?

If the answer to any of these questions is yes, your baby is eligible for the BCG immunisation.

Which countries have a high TB rate?

• most of Africa
• much of South America
• Russia and the former Soviet states
• Indian subcontinent
• China, including Hong Kong
• South East Asia (except Singapore)
• some Pacific nations (except Cook Islands, Niue, Samoa, Tokelau and Tonga).

Immunisation for other people

• Children under 5 years of age who are at risk of TB exposure are also eligible for BCG vaccine.
• In some circumstances the local Medical Officer of Health may also recommend BCG vaccination for specific populations.

Making a decision about immunisation

Most people who are vaccinated against TB develop a small blister around the injection site. Within 3 months this should heal and form a scar.

Risks associated with tuberculosis:

TB can be a very serious disease, sometimes resulting in:

• major haemorrhage from the lungs (now rare)
• death (now rare, more likely in elderly people)
• 387 out of 1 million infants may develop enlarged lymph nodes and a local abscess (very rare)

Source: Ministry of Health – Manatū Hauora