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Tuberculosis Control


Tuberculosis (TB) is a bacterial infection that is common worldwide. It is primarily a respiratory illness. TB is transmitted person to person from someone who has active tuberculosis disease to others by exposure through the air.  Transmission of TB usually requires prolonged contact with someone who has active disease. TB infection can be treated with medicine and takes months to fully treat. Once someone with active TB has been started on adequate treatment they are no longer contagious during the remaining time until their treatment is completed.
Latent Tuberculosis Infection (LTBI)

Most often when someone is infected by tuberculosis their immune system isolates the bacteria and they do not develop active disease. This is called latent tuberculosis infection (LTBI) and is not contagious to others. Only about 10% of healthy individuals who are infected with TB, and have LTBI, will develop active TB disease in their lifetime. To help prevent someone with LTBI from going on to develop active TB disease they are treated with medicine to eliminate any TB bacteria they may still have in their body.

Testing for TB
Screening for tuberculosis can be done by a skin test or a blood test, and may require a chest x-ray, depending on an individual’s circumstance and risk for TB. Regular screening is not recommended for our general population. High risk groups, including any contacts of someone with active tuberculosis disease are tested when indicated. Refugees entering the U.S. as well as other groups are screened for TB disease before their arrival in the U.S. Upon arrival to our community refugees are again screened for tuberculosis.

Vaccination for TB
BCG is a vaccine for tuberculosis that is used in countries with a high prevalence of TB. Many foreign-born individuals have been vaccinated with BCG. However, BCG is not recommended for use in the U.S. because of the low risk for tuberculosis infection and the variable effectiveness of the vaccine as well as its potential to interfere with the tuberculin skin test.   

TB in our community
North Dakota is a low incidence state for tuberculosis.  Fargo Cass Public health provides services to individuals who reside in Cass County with active TB disease and those who have been exposed to the disease but do not have active tuberculosis, including those with LTBI.
 
A public health nurse (RN) provides:

•      Case management and directly observed therapy for active TB patients
•      Contact investigation and follow up for infected contacts.
•      TB medication provision for treatment of LTBI and regular evaluation for side effects
•      TB education for high risk groups or the general public

Medication for treatment of active TB disease and latent TB infection is available at no cost to individuals with these conditions.  Medication can be obtained through Fargo Cass Public Health with a referral from the ordering physician.

Fargo Cass Public Health also offers TB testing. We currently offer a blood test (T SPOT) for those over age 5 and a TST (TB skin test) for those under 5. There is a charge for this testing.  Routine TB testing is not necessary or recommended. Groups who may need TB testing are contacts of an active case, and certain individuals of whom it may be required for school or employment. 

Current and factual information about TB can be obtained at http://www.cdc.gov/tb

For more information concerning services at Fargo Cass Public Health call Anne at 241-1378