What is tuberculosis?

Tuberculosis (TB) is an infectious disease that most often damages your lungs, but can affect any part of your body. It can cause serious illness and death if it’s not treated. TB is caused by the bacterium mycobacterium tuberculosis.

It’s very uncommon to catch TB in Australia. However, TB is common in some other countries. Many Australians born overseas have TB.

There are 2 types of TB:

• Latent TB infection — this is when someone is infected with TB but does not get sick, because their immune system is able to control the infection.
• Active TB disease — this is when the TB bacteria multiply and the immune system is not able to control them. Active TB causes symptoms.

Most people with latent TB never become unwell from it, but about 1 in 10 will develop active TB. This could happen shortly after becoming infected, or many years later. Young children, older people, and people with a weakened immune system are more likely to become unwell.

What are the symptoms of tuberculosis?

People with TB may:

• feel tired
• lose weight without trying to
• have a fever
• sweat in bed at night
• lose their appetite

If you have pulmonary (lung) TB, you might have:

• a cough that lasts at least 3 weeks
• sputum (phlegm) containing blood
• chest pain

TB in other parts of your body can cause pain or swelling in that area. Lymph node TB can cause swollen glands.

How is tuberculosis spread?

TB is spread through the air when a person with active TB in their lungs or throat coughs, sneezes, speaks, laughs or sings. If other people nearby breathe in the bacteria, they can catch TB.

People with active TB in other parts of their body are not infectious. Latent TB is also not infectious.

You are most at risk of catching TB if you:

• have had close contact with someone with active TB — the longer, more often or more closely you were in contact, the higher your risk
• live in a country where TB is common
• have a weakened immune system

When should I see my doctor?

See your doctor if you have symptoms of TB, or if you have been exposed to someone infectious. Your doctor can refer you for testing.

If you are a refugee, see a doctor and have a TB test soon after you arrive in Australia.

You may also need a TB test if you:

• have moved to Australia from a country where TB is common
• are starting a medicine that weakens your immune system
• live in crowded surroundings
• work with people who may have TB
• are starting a new job
• use injected drugs

How is tuberculosis diagnosed?

Your doctor may order a tuberculin skin test, also called a Mantoux test. A small amount of liquid is injected just under the skin of your forearm. A healthcare worker will check the site 48 – 72 hours later. If there is a red lump, it means you have been infected with TB.

Sometimes a blood test is used to detect TB.

These tests can’t tell you if you have active or latent TB. If the test is positive, you may have a chest x-ray, a physical examination or a sputum culture to see if you have active TB. If TB outside the lungs is suspected, you may need a different test, such as a biopsy.

Active TB is a notifiable disease.

How is tuberculosis treated?

For latent TB, your doctor can prescribe antibiotics to reduce the risk of you developing active TB. You will need to take them for at least 6 months. Not everyone with latent TB needs to be treated — some people are monitored over time.

For active TB, you will be prescribed a combination of antibiotics, which you must take for at least 6 months. You will need to stay home from school or work until you are no longer infectious. Your close contacts should be tested.

You may need treatment through a hospital clinic, but some people are treated by their general practitioner (GP). If you complete the full treatment, you have an excellent chance of being cured of TB disease.

It’s important to take all your medicines according to your doctor’s instructions. Don’t stop taking your medicines early. If you don’t complete treatment, you could develop drug-resistant TB, where the infection does not respond to the usual antibiotics. This is harder to treat and requires different medicines for up to 2 years.

Can tuberculosis be prevented?

The vaccine for tuberculosis ­is called the bacille Calmette–Guérin (BCG) vaccine. It does not prevent you from becoming infected with TB, but it helps prevent severe or life-threatening TB disease, especially in young children.

Most Australian children do not need the BCG vaccine, as TB is very uncommon in Australia. The vaccine is not part of the National Immunisation Program schedule.

The vaccine is recommended for:

• Aboriginal and/or Torres Strait Islander children living in some parts of Australia
• children who are travelling to areas where TB is common
• babies whose parents or carers have TB
• young children who are exposed to leprosy at home
• some babies born to parents from countries where TB is common
• some healthcare workers

The BCG vaccine, which is registered for use in Australia, is not always readily available. Ask your doctor, or contact your state or territory immunisation health service, to find out how to get the BCG vaccine. Other BCG vaccines may be available through special prescribing arrangements.

Everyone who may have been exposed to TB in the past should have a skin test before they are vaccinated.

Tuberculosis vaccine

Vaccination is your best protection against the severe effects of TB. This table explains how the vaccine is given, who should get it, and whether it is on the National Immunisation Program Schedule. Some diseases can be prevented with different vaccines, so talk to your doctor about which one is appropriate for you.

Complications of tuberculosis

TB can cause damage to your lungs or other organs.

It can also cause very serious illnesses, such as:

• miliary TB — affecting the whole body
• brain TB

Resources and support

Find out more if you are a parent considering TB vaccination for your child.

If you prefer a language other than English, you can find information about TB in many other languages from the New South Wales Multicultural Health Communication Service.

If you have lung disease, visit Lung Foundation Australia for information and support services.