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Tuberculosis

Tuberculosis (TB) is a serious disease caused by breathing in a bacteria called Mycobacterium tuberculosis. TB usually infects the lungs. TB can also infect other parts of the body, including the kidneys, spine and brain.

People can have TB and not be sick, this is called latent TB. Latent TB is when a person has the TB bacteria in their body but it is not growing. The latent TB can become active TB at any time and make you very sick. If you have inactive TB infection you need to get treatment to cure your TB infection. 

TB is contagious. People who are sick with active TB disease spread TB germs through the air. It's important for people with TB to get treatment right away. TB treatments can cure TB and prevent it from spreading to others. 

Symptoms of tuberculosis

  • A cough that lasts two weeks or more, especially if you cough up fluid or blood comes from your lungs when you cough
  • Fever
  • Weight loss
  • Night sweats
  • Loss of appetite

Many of these symptoms can be confused with other illnesses. If you have these symptoms, or if you think you might have TB, see you doctor.

Diagnosing tuberculosis

TB testing is done through a skin test that will show if you have been infected with TB. The skin test cannot tell when you were infected with TB nor can it tell if you have active or inactive TB. 
If the skin test shows that the TB germ is in your body, your healthcare provider will more order tests to see if you have active TB disease.

You may get:

  • A chest X-ray, to see if there is any damage to your lungs.
  • A test of the fluid that comes from your lungs when you cough. This will show if you have active TB disease in your lungs.

Treatments for tuberculosis

If you are infected with TB, the doctor or nurse will get you the TB medicines you need. TB medicines are free for most people in Canada. Medicine can cure TB. In Canada, they can't change your immigration status based on the fact that you have a TB infection.

Treatment for inactive TB infection

If you have inactive TB infection, there are TB bacteria in your body, but you do not have any symptoms. Inactive TB must be cured to kill the TB bacteria before it becomes active TB and makes you very sick. 
Inactive TB is often treated with a medicine called isoniazid (INH). Most people are prescribed this medication daily for 9 months.  Inactive TB is also treated with the medicine isoniazid (INH) for 6 months and 3 months with INH and rifampin (PMP) for 3-4 months.  
It’s very important to take your TB medicine exactly as your doctor or nurse says, for as long as they say. If you stop taking your TB medicine or skip doses, these things could happen:

  • Your TB infection could come back.
  • Your TB infection could turn into active TB disease. With active TB, you will have symptoms and feel sick and you can pass TB on to your friends and family. 
  • You could accidentally make the TB germ even stronger, so your TB infection is harder to treat. This is called drug-resistant TB and it is very dangerous and it can be deadly. 

Treatments for active TB infection

If you have active TB, your doctor will prescribe medicine to cure you.
To get TB medicine, you need a prescription. TB medicine and treatment are free for most people in Canada.
Some antibiotic medicines (antibiotics) can cure TB. They kill the tuberculosis germs. It usually takes two or more TB medicines to cure active TB disease.
These are the most common medicines to cure TB:

  • Isoniazid (INH), also called Dom-Isoniazid®, Isotamine®, or PMS-Isoniazid®. It comes as pills or syrup.
  • Rifampin (RMP), also called Rifadin® or Rofact®. It comes as pills.
  • Pyrazinamide (PZA), also called PMS-Pyrazinamide® or Tebrazid®. It comes as pills.
  • Ethambutol (EMB), also called Etibi®. It comes as pills.

Your doctor may put you on all four medications at first. Your doctor will decide which medicines are best for you, and how long you must take them to be cured. TB germs are hard to kill. That's why it's very important that you take all your medicine. 
After you take TB medicine for a few weeks you will start to feel better and your doctor or nurse will let you know when:

  • You are no longer contagious.
  • You are able to return to school/work

In order to cure TB, you will need to take medicine for as long as your doctor tells you, even if you don’t feel sick.
If you stop taking you TB medicine early, these things could happen:

  • You could make the TB bacteria even stronger, so your TB infection becomes very hard to treat and it could be deadly. This is called drug-resistant TB. If you have drug resistant TB, you will need to take more medicines that are expensive and have more side effects.
  • Your active TB infection could come back.
  • Your TB infection could get worse. The TB germ could spread to other parts of your body.
  • You could spread TB to other people. 

What you should know about taking TB medicines

  • Take your TB medicines exactly as your doctor or nurse says, for as long as they say. Take them even if you're feeling better.
  • Ask your doctor or pharmacist to explain the side effects of TB medicine. Ask them what to do if you forget to take a pill.
  • Do not take the pain medicine acetaminophen (Tylenol® or another brand).
  • Do not drink alcohol.
    • TB medicine puts stress on your liver. So do alcohol and acetaminophen. If you take TB medicines and alcohol or acetaminophen, your liver could get sick.
  • Tell your doctor about any other medicine you may be taking.
  • If you get pregnant while you’re taking your TB medicine, tell your doctor. Your doctor may change your medicine.
  • If you plan to become pregnant, talk with your doctor.
  • Take your medicine at the same time every day. Write a note or set an alarm to remind yourself to take it.
  • Keep your medicine in a place where you see it often.

The DOT program 

DOT stands for Directly Observed Treatment. It’s a program that can help you take your TB medicine regularly and get cured more quickly. If you are part of a DOT program, you will meet with a nurse or other health-care provider every day or a few times a week. They will watch you to take your medicine, look out for side effects and answer your questions. 

Preventing tuberculosis

There is a vaccine to prevent TB called Bacille Calmette-Guerin (BCG). BCG is mainly used to protect babies and young children against TB if they are living in an area with a lot of TB.  
In Canada, very few people get the BCG vaccine. Babies in First Nations and Inuit communities with high rates of TB are the only ones who routinely get the BCG vaccine. 

Smoking tobacco and TB

Smoking tobacco puts you at a higher risk for TB. If you have TB and smoke, it can have dangerous side effects including making it much harder for your body to get rid of TB and making your TB last longer, as smoking causes TB mediation to be less effective. You can quit smoking, there are many programs out there to help you quit. Learn more about how you can quit smoking