Tuberculin skin test results positive

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New Hampshire Department of Health and Human Services Division of Public Health Services

Tuberculin Skin Test or Blood Assay ---Results: Positive

1. What does a positive tuberculosis (TB) test mean? A positive reaction means that the person has TB germs somewhere in the body. The person may have latent TB infection, but not necessarily the disease.

2. How can a person be infected and not have TB disease? After TB germs enter the body, in most cases, body defenses control the germs by building a wall around them. The germs can stay alive inside these walls for years in an "inactive" (latent) state. While TB germs are inactive, they can't harm the person and they can't spread to other people. The person is infected but not sick.

3. What is TB disease? Tuberculosis (TB) is a serious illness caused by active TB germs. It is possible to get TB disease shortly after the germs enter the body if body defenses are weak. It is also possible, even after many years, for inactive TB germs to become active when body defenses are weakened. This may be due to aging, a serious illness, drug or alcohol abuse, or HIV infection (the virus that causes AIDS). When defenses are weakened and inactive TB germs become active, the germs can then break out of the walls, begin to multiply and damage the lungs or other body organs. This causes symptoms that may include a lasting cough, fatigue, coughing up blood, fever, loss of appetite and weight loss. There may be chest pain and night sweats. Sometimes, TB disease can be spread to other people.

4. How are TB germs spread? TB can be spread by people with active disease who release the bacteria (germs) into the air by coughing, sneezing, laughing, singing or speaking forcefully. The tiny, invisible moisture droplets travel through the air and are breathed in by another person. TB is most commonly spread to people in confined, poorly ventilated spaces. It usually takes a prolonged or multiple exposures for the germ to spread.

5. What's next? How does a person know if they have infection or disease? A chest x-ray is necessary to see if the germs have started to damage the lungs. A medical evaluation is also necessary to assess for TB outside of the lungs. If the x-ray is normal and there are no symptoms, the TB germs are probably inactive and TB disease is not present. If the x-ray is abnormal or symptoms are present, additional tests will be needed.

In order to protect an infected person from getting TB disease, the medical provider may give the person medicine to take for a period of time.

This is latent TB infection treatment. Medicine is given depending on the risk of developing active disease and the risk of side effects from the treatment.

NH DHHS, Division of Public Health Services TB Test: Positive Results September 2006

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6. Tell me more about the risk factors used to determine treatment recommendations. Isoniazid (INH) is the antibiotic proven to reduce the risk of TB infection progressing to TB disease in the future. It means taking one pill per day, taken consistently for nine months. Generally, INH is recommended for anyone who tests positive for TB with risk factors for developing disease.

7. Why is treatment important? Although only about one person in ten with a positive skin test or blood assay ever develops TB disease, the risk continues throughout the rest of your life. The symptoms of TB are common to many other illnesses. Without INH treatment, any cold or cough that lasts longer than usual could be a sign of TB disease. It may be weeks or months before a person sees their medical provider and TB is diagnosed. In the meantime, they may infect those with whom they live and work. Small children are especially likely to develop serious TB disease. TB treatment can prevent you from getting sick with TB disease. It is important for your health and for the health of your friends, family and colleagues.

8. How does INH attack TB germs? INH fights TB germs in two ways: It

? Stops TB germs from growing ? Reduces the number of TB germs.

9. When should a person with a positive test have another test? There is no need to ever have another test done. Once you have a positive result, you will generally always have a positive result. INH treatment will not change the result to negative.

10. What about chest x-rays for those with a positive TB test result? X-rays are recommended for the initial evaluation and when persistent cough-illness occurs. You should contact your health-care provider if the following symptoms occur: persistent cough, bloody sputum, night sweats, fever, or unexplained weight loss.

Remember: If you have a positive TB test

"ALWAYS THINK TB" Notify your health-care provider if you develop a cough-illness

New Hampshire Department of Health and Human Services Tuberculosis Program 603-271-4469

revised 906

NH DHHS, Division of Public Health Services TB Test: Positive Results September 2006

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