Tuberculosis (TB)

TB is a bacterial infection that usually affects the lungs. It’s caused by a bacterium called Mycobacterium tuberculosis.

TB is spread by breathing in bacteria that are coughed out by people with TB in their lungs.

The number of people with TB in the UK is low. And the good news is TB can be prevented and cured with the right treatment.

There are some countries where TB is more common, and the risk of infection is higher, such as Bangladesh, China, India, Indonesia, Moldova, Nepal, Nigeria, Pakistan, Philippines, Russia, Ukraine, and South Africa.

Latent TB

Latent TB is when you have TB bacteria in your body, but you have no symptoms. People with latent TB cannot spread the TB infection to other people.  

When most people breathe in TB bacteria, the body’s immune system controls the bacteria and stops it from growing. The bacteria are still in your body but do not make you feel unwell.    

In some people, the bacteria can become active in later life leading to symptoms. This is known as ‘active TB’.

Latent TB can be treated with antibiotics.

Active TB

If you have TB and you have symptoms this is called active TB. Only 5 to 10% of people who breathe in TB bacteria develop symptoms. Active TB can be spread to other people.

People may become ill weeks, months, or even years after breathing in TB bacteria.  

Active TB happens when the body’s immune system can’t control the TB bacteria and causes an infection. Active TB usually affects the lungs but can affect other parts of the body.

Active TB can be serious but can be cured with the right treatment.

Anyone can get TB. However, the people most at risk are those who have lived outside of the UK where TB rates are high. 3 in 4 TB cases in the UK come from people who have lived outside the UK.

You’re also at higher risk if:    

• you're live or spend a lot of time with someone diagnosed with active TB
• you have a weak immune system, for example people with HIV
• you have diabetes 
• you don’t eat enough (malnourished)
• you regularly smoke, drink alcohol or take drugs
• you live in overcrowded or unhealthy conditions, for example people who are homeless.

Children under five are also at risk because their immune system has not fully developed.

TB normally affects the lungs, but it can affect different parts of the body too, including the bones, brain, lymph glands, kidneys, spine, skin, and stomach.      

If you have active TB in your lungs the most common symptoms are:    

• a cough that lasts more than three weeks 
• coughing up phlegm (sputum)
• chest pain
• losing weight without meaning to
• not feeling hungry
• a high temperature or night sweats 
• extreme tiredness.

If you have TB in other parts of your body, you may have symptoms such as:  

• swollen glands 
• body ache 
• swollen joints
• tummy ache
• dark pee 
• headaches 
• being sick 
• feeling confused 
• a stiff neck 
• a rash.

If you have active TB, you may have tests including:  

• a chest X-ray
• echocardiogram 
• ultrasound 
• CT scan
• phlegm (sputum) sample tests
• a bronchoscopy (camera test going into the lungs)
• a biopsy 
• other tests depending on where the infection is in the body e.g., urine tests.

If you have no symptoms but you are at risk of latent TB, you may need a blood test or a Mantoux skin test. The Mantoux skin test is where a small amount of liquid is injected under your skin. If you have TB, the liquid will react with your skin.  

It can be difficult to diagnose TB in children. This is because there are far less TB bacteria in children than in adults. It’s also harder for children to cough up phlegm. This means it’s difficult to find the bacteria in phlegm (sputum) samples. 

TB is curable. It is treated with a combination of antibiotics to fight the bacteria.

Treating active TB

For active TB, you will take a combination of antibiotics for at least six months. If the TB is affecting your brain or spinal cord, the treatment will last for 12 months.

Treating latent TB

You will be prescribed antibiotics to prevent the TB becoming active. Treatment will usually last 3-6 months.

Treating TB in other parts of the body

If your TB has spread to the brain, spinal cord, or area around your heart, you may be prescribed steroids.

Side effects

TB medicine side effects will be different depending on the medicines you take. The most common side effects for antibiotics are:  

• feeling sick or dizzy
• skin rashes 
• pins and needles
• flu-like symptoms.

We have more information about the side effects of steroids.

If your side effects are severe, your treatment will normally be stopped until the side effects go away. But if your TB is severe, you may have to continue your treatment and be monitored at the same time. Do not stop taking your medicines without talking to your healthcare professional.

Getting a diagnosis and getting treated for TB as early as possible is the best way to prevent the spread of TB.

Most people won’t spread TB after taking medication for two weeks. However, if you have been diagnosed with active TB, you can also reduce the risk of spreading TB to others by:  

• covering your mouth with a tissue when you cough and throwing the tissue in a bin 
• regularly washing your hands 
• staying at home and asking people not to visit you
• making sure the people you live with are tested for TB to see if they need treatment too.

The BCG vaccination

There is a vaccine for TB called the BCG vaccine. The BCG vaccine helps protect you from TB. The BCG vaccine should be offered to:

• newborn babies who:
  o    are born in areas where TB rates are high 
  o    have a parent or grandparent who was born in a country where TB rates are high 
  o    are born into a family where someone has had TB in the last five years
• children under 15 who weren’t vaccinated as babies and who may be at high risk of TB
• people under 35 who: 
  o    have been in close contact with someone with TB 
  o    have come to live in the UK from an area where TB rates are high
  o    work with animals that can get TB, for example cows 
  o    work with people from countries where TB rates are high, for example hostels for refugees 
  o    plan to live or work for more than three months in a country where TB rates are high.