Most important in TB prevention is for people with infectious TB to take their medicine as prescribed. If you are taking medication, you need regular check-ups and possibly additional chest X-rays or sputum tests to show whether the medicine is working, and whether you are still infectious. If the tests show that you still have the bacteria in your sputum even after a few months of treatment, you may need to take some extra drugs, or change the drugs you are taking.
Detection of early cases and prompt treatment are crucial in controlling the spread of TB. The local health department may need to test people who have spent time with you for TB infection.
If you are sick enough to go to hospital, you may be put in a special room with air vents that keep TB bacteria from spreading. People working in these rooms wear face masks to protect themselves from bacteria. You must stay in the room to prevent spreading bacteria.
If you are infectious while at home, protect yourself and others as follows:
- Wash your hands after sneezing, coughing or holding your hands near your mouth or nose.
- Cover your mouth with a tissue when you cough, sneeze or laugh. Discard used tissues in a plastic bag, then seal and throw it away.
- Do not attend work or school.
- Avoid close contact with others.
- Sleep in a room away from other family members.
- Ventilate your room regularly. TB spreads in small closed spaces. Put a fan in your window to blow out air that may contain bacteria.
TB Vaccine (BCG)
The TB vaccine, BCG, is often given to babies and children in countries where TB is common, although its protective value is debatable. However, it is thought that BCG does offer increased protection against developing TB in parts of the body apart from the lungs (i.e. extra-pulmonary TB). The vaccine's efficacy varies throughout the world from 0 to 80%, but it is only effective in children, not adults. In South Africa efficacy is about 60% against pulmonary TB.
In some countries, BCG is no longer given routinely, since the incidence of TB in those countries is very low. In other parts of the world where there is a high prevalence of TB, BCG is given to children at birth as part of the routine vaccine schedule. It may also be given at three months, on entering school, and on leaving high school. BCG must not be given to a person with active TB. If you were vaccinated with BCG, you may have a positive reaction to a TB skin test, due to the BCG vaccine itself or to a real TB infection.
A positive reaction probably means that you have TB infection if:
- Your skin test reaction is large
- You were vaccinated many years before (the BCG reaction lessens over time)
- You have ever spent time with someone with infectious TB
- Someone in your family has had TB
- You are from a country where TB disease is common such as South Africa
BCG vaccination should not be given to tuberculin-positive individuals, patients on corticosteroid or immunosuppressive therapy, and other causes of immune deficiency.
Adverse effects are rare. However, the vaccine may cause a local reaction in sensitive people, lasting about three days.
Children visiting areas with a high risk of TB infection should be offered tuberculin skin testing, and BCG vaccination if the test is negative.
Reviewed by Dr AW Dreyer, Pathologist and Clinical Microbiologist, Centre for Tuberculosis, National Institute for Communicable Diseases February 2015.
Previously reviewed by Joanna Evans, PhD, Molecular Mycobacteriology Research Unit, Division of Medical Microbiology Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, February 2011.