Introduction to

Tuberculosis
(TB)
This Slide Deck Covers the
Following Topics about
Tuberculosis (TB):
1. What is Tuberculosis (TB)?

2. How TB spreads

3. Latent TB Infection and TB Disease

4. Risk Factors

5. TB Testing

6. Treatment

7. TB Elimination
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What is Tuberculosis
(TB)?
Tuberculosis (TB)

• TB is spread from person to person through the air.

• TB is a disease caused by bacteria called Mycobacterium
tuberculosis. The bacteria, or TB germs, usually attack the
lungs. However, TB germs can attack any part of the body
such as the kidney, spine, or brain.
• Pulmonary TB is TB in the lungs.
• Extrapulmonary TB is TB in places other than the lungs, such as the
kidney, spine, or brain.

• Not everyone infected with TB germs becomes sick.

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TB is the World’s Top Cause of Death due
to Infectious Disease

• TB is not a disease of the past.

• Too many people in the United States still suffer from TB.
• In 2019, there were 8,976 cases of TB disease in the United
States, which is the lowest number on record.

• TB is a serious disease that can cause a person to become

very sick if not treated with medicine.

• Treatments are available to prevent and cure TB.

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Progress Toward TB Elimination,
United States, 1982-2019

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TB Impacts People From
All Over the United States

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Anyone Can Get TB

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How TB Spreads
TB Spreads
Through the Air
TB spreads from person
to person when someone
with contagious TB
coughs, speaks, or sings.

10
TB is NOT Spread by

Sharing Saliva from

toothbrushes kissing

Shaking Touching bed Sharing food,

someone’s hand linens or toilets drink, or utensils

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Latent TB Infection
and TB Disease
Two TB-Related Conditions

Latent TB Infection (LTBI)

• People with latent TB infection
• Do not feel sick, do not have symptoms, and cannot spread
TB germs to others.
• Can have latent TB infection for years.
• Have a small amount of TB germs in their bodies that are
alive but inactive.
• Latent TB infection can develop into TB disease.

TB Disease
• If TB germs become active and multiply, latent TB infection can
turn into TB disease.
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Not Everyone Who Is Infected with TB Becomes Sick

Person with Person with

Latent TB Infection TB Disease

Has a small amount of TB germs in Has a large amount of active TB

his/her body that are alive but inactive germs in his/her body

Cannot spread TB germs to others May spread TB germs to others

Does not feel sick, but may become sick if May feel sick and may have symptoms
the germs become active in his/her body  such as a cough, fever, and/or weight loss

Usually has a positive TB skin test or TB Usually has a positive TB skin test or TB
blood test result indicating TB infection blood test result indicating TB infection

Should consider treatment for latent TB

Needs treatment for TB disease
infection to prevent TB disease
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Untreated Latent TB Infection
Can Lead to TB Disease

• If the immune system can’t stop TB germs from growing,

they become active (multiplying in your body); this is called
TB disease. 
• Most people diagnosed with TB disease in the United States
become sick after living with latent TB infection for years.

• It is estimated that up to 13 million people in the United

States have latent TB infection.

• Latent TB infection treatment is 90% effective in preventing

the development of TB disease.

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Tuberculosis (TB) Disease: Only the Tip
of the Iceburg

There are two types of TB conditions: latent TB infection and TB disease.

People with TB disease are sick from active TB germs. They usually have
symptoms and may spread TB germs to others.
People with latent TB infection do not feel sick, do not have symptoms, and cannot
spread TB germs to others.
But, if their TB germs become active, they can develop TB disease.
Millions of people in the U.S. have latent TB infection Without treatment, they are
at risk for developing TB disease.

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Possible TB Disease Symptoms

Night Sweats Fever Chills

Weakness
Weight loss No appetite
or fatigue

Cough lasting Coughing up

Pain in blood or sputum
longer than
the chest (phlegm from inside
3 weeks the lungs)

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People with TB Disease Are Sick
and Can Spread TB Germs

• TB disease is a serious condition and can lead to death if

not treated.

• TB disease can almost always be treated and cured with medicine.

• A person with TB disease typically requires the following:

X-rays 180 days of medicine

Lab tests Follow up and testing of close contacts

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Public Health Workers are
Responsible for Finding TB Contacts

• A TB contact is persons exposed to someone with contagious

TB disease

• Contacts can include family members, roommates or

housemates, close friends, coworkers, classmates, and others

• People with TB disease can spread TB germs to those around

them

• The local health department will conduct a contact

investigation by following up and testing those who have been
close to someone with TB

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Risk Factors
Who Is at Higher Risk For Becoming
Infected with TB Germs?

Anyone can get TB

Some people have a higher risk of getting infected

with TB:
• People who have contact with someone who has infectious TB disease

• People who were born in or who frequently travel to countries where TB

disease is common, including Mexico, the Philippines, Vietnam, India,
China, Haiti, Guatemala, and other countries with high rates of TB

• Health care workers and others who work or live in places at high risk
for TB transmission, such as homeless shelters, jails, and nursing
homes
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 Since 2010, the Majority of U.S. TB Cases Occur in

Persons Born Outside of the United States*

*Percentages are rounded; data from 2019 22

 Countries of Birth Among Non-U.S.-born
Persons with TB, United States 2019*

*Percentages are rounded 23

 Reported TB Cases by Race/Ethnicity,*
United States, 2019 (N=8,868) †

* All races are non-Hispanic; multiple race indicates two or more races reported for a person but does not include persons of Hispanic/Latino origin.
†
Excludes unknown/missing values 24
Who Is at Risk for Developing TB Disease?

People at high risk for developing TB disease generally fall into two categories:
• Those who have been recently infected with TB germs
• Those with medical conditions that weaken the immune system, such as:

HIV infection Substance abuse Specialized treatment for rheumatoid Organ transplants Severe kidney
arthritis or Crohn’s disease disease

Head or neck cancer Diabetes Medical treatments such Silicosis Low body weight
as corticosteroids
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TB Testing
Two Types of Tests Can Be Used
to Diagnose TB Infection

• TB blood test or
• TB skin test
OR

If either test is positive, • Medical examination

further tests are done to
confirm a diagnosis of
TB disease: • Chest x-ray

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TB Blood Test

Blood is drawn and sent to a lab for analysis.

•
Positive blood test: A person likely has been infected with
TB germs. Additional tests are needed to determine if the
person has latent TB infection or TB disease.

•
Negative blood test: A person’s blood did not react to the
test and latent TB infection or TB disease is not likely.

The TB blood test is also known as an Interferon-Gamma Release

Assay (IGRA).
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TB Skin Test

The TB skin test, also called the Mantoux tuberculin skin test
(TST), requires two visits with a healthcare provider.

On the first visit, a test is placed. On the second visit, the test is read.

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People Vaccinated with BCG
Can Still Get TB Disease

Bacille Calmette-Guérin (BCG)

• Is a vaccine for TB disease.
• Is often given to infants and small children in countries
where TB is more common.
• Protects against severe forms of TB in children.

The TB vaccine is not widely used in the United States.

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TB Blood Tests Are Preferred for People
Who have Received the TB Vaccine (BCG)

• The TB vaccine (BCG) may make a TB skin test hard

to interpret.
• The TB vaccine does not affect TB blood tests results.
• TB blood tests give more accurate results in people
who have received the TB vaccine.

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Treatment
Treatment for Latent TB Infection Can
Prevent the Development of TB Disease

• TB germs in the body of someone with latent TB infection

are inactive, so they will not feel sick.
• As long as TB germs remain in the body, they can become active,
multiply, and make someone sick with TB disease.

• People with latent TB infection

• Should take medicine to prevent the development of TB disease,
even though they don’t feel sick.

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Treatment for Latent TB Infection

Compared to treatment for TB disease, latent TB infection treatment

Is shorter.

Is less costly.

Has fewer side effects.

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Treating TB Disease Protects Your Health and
the Health of Others

• People with TB disease can pass TB germs to their family,

friends, and others around them if they don’t take TB
medicine the right way.
• People with TB disease need to take several medicines when
they start treatment.
• After taking TB medicine for several weeks, a doctor will be
able to tell TB patients when they are no longer able to spread
TB germs to others.
• Most people take TB medicine for at least 6 months to
be cured.

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TB Elimination
 Together We Can Work Toward
TB Elimination in the United States

1. Strengthen current TB programs to

diagnose and treat TB disease.

2. Increase efforts to identify and treat latent

TB infection.

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Health Care Providers and Communities Need
to “Think TB!”

Protect the health and well-being of community members

at higher risk for TB:
• Know who is most at risk for TB
• Recognize the signs and symptoms of TB
• Test and treat patients who are at high risk for TB
• Be aware of latest TB research and shortest treatment
options
• Encourage conversations about TB and how it affects the
community to reduce stigma

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Key Partners
in TB Elimination
• Health care workers in doctors’
offices and hospitals, community
health centers, and academic
institutions
• State and local health
departments
• Communities at higher risk for TB

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 Resources

CDC TB website:
www.cdc.gov/tb/
State & Local TB Control Offices:
www.cdc.gov/tb/links/tboffices.htm
Find TB Resources:
https://findtbresources.cdc.gov

Facebook:
www.facebook.com/CDCTB/
Twitter:
www.twitter.com/cdc_tb
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. 40