Matthew Whitson, RN, MSN
Tuberculosis Team Leader
7430 Louis Pasteur Drive
San Antonio, TX 78229
The mission of the Tuberculosis Elimination Program is to prevent the spread of tuberculosis in Health Service Region 8 through:
Clinical management of persons suspected of having or confirmed to have tuberculosis
Identification, screening and treatment of contacts to cases
Education about tuberculosis
HSR 8 provides directly observed therapy (DOT) to all individuals confirmed with or suspected of having TB and all children on preventive therapy for Latent Tuberculosis Infection (LTBI).
Infected individuals who have been identified as part of a contact investigation or a DSHS-sponsored screening program will be offered LTBI therapy. Other people with LTBI are referred to their family doctor for treatment.
TB Reporting Guidelines
State law requires health care professionals to report confirmed or suspected cases of TB at the time within 1 working day. To report confirmed or suspected TB cases, call 210-949-2166 or 210-949-2196.
Court Ordered Management
Court ordered management of non-compliant TB cases is determined by the local health authority or the Regional Medical Director for patients who are unable or unwilling to adhere to treatment in accordance with Chapter 8a, Subchapter G of the Texas Health and Safety code (beginning with Section 81.151). It is based on any combination of the following:
Medical evaluation of a patient who has demonstrated failure of improvement with outpatient therapy
Failure to comply with the health authority’s medical control order for any reason
Continued threat to self or the public due to either of the above
Tuberculosis – General Information
What is TB?
Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys or the spine. A person with TB can die if they do not get treatment.
What are the Symptoms of TB?
The general symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected.
How is TB spread?
TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection.
What is the difference Between Latent TB Infection and TB Disease?
People with latent TB infection (LTBI) have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease.
People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease. People with TB disease of the lungs or throat are capable of spreading germs to others. They are prescribed drugs that can treat TB disease.
What should I do if I have spent time with someone with Latent TB Infection?
A person with latent TB infection cannot spread germs to other people. You do not need to be tested if you have spent time with someone with latent TB infection. However, if you have spent time with someone with TB disease or someone with symptoms of TB, you should be tested.
What Should I Do if I Have Been Exposed to Someone with TB Disease?
People with TB disease are most likely to spread the germs to people they spend time with every day, such as family members or coworkers. If you have been around someone who has TB disease, you should go to your doctor or your local health department for tests.
How Do You Get Tested for TB?
There are two tests that can be used to help detect TB infection: a skin test or a special TB blood test. The Mantoux tuberculin skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm. The special TB blood test measures how the patient’s immune system reacts to the germs that cause TB.
What Does a Positive Test for TB Infection Mean?
A positive test for TB infection only tells that a person has been infected with TB germs. It does not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.
What is Bacille Calmette-Guérin (BCG)?
BCG is a vaccine for TB disease. BCG is used in many countries, but it is not generally recommended in the United States. BCG vaccination does not completely prevent people from getting TB. It may also cause a false positive tuberculin skin test. However, persons who have been vaccinated with BCG can be given a tuberculin skin test or special TB blood test.
Why is Latent TB Infection Treated?
If you have latent TB infection but not TB disease, your doctor may want you to take a drug to kill the TB germs and prevent you from developing TB disease. The decision about taking treatment for latent infection will be based on your chances of developing TB disease. Some people are more likely than others to develop TB disease once they have TB infection. This includes people with HIV infection, people who were recently exposed to someone with TB disease, and people with certain medical conditions.
How is TB Disease Treated?
TB disease can be treated by taking several drugs for 6 to 12 months. It is very important that people who have TB disease finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy (DOT). DOT helps the patient complete treatment in the least amount of time.