Mycobacterium tuberculosis. Image courtesy of Centers for Disease Control and Prevention.

Protecting County Residents from Tuberculosis

Author: Public Health Department
Date: 3/23/2018 9:49 AM

The annual number of new TB cases in SLO County has remained in the single digits for many years—yet it's a serious illness that gets serious attention from the County Public Health Department.

Tuberculosis (TB) is one of the world's deadliest diseases. It is less common in the U.S. than in many parts of the world, and less common today than it was in the past. Yet it still poses a threat. What does that mean in SLO County?

Rates are low—and the Public Health Department works to keep it that way.

The annual number of new TB cases in SLO County has remained in the single digits for many years—yet it's a serious illness that gets serious attention from the County Public Health Department.

TB spreads through the air when a person who has active TB disease coughs, speaks, laughs or sings. People nearby can breathe in the bacteria and become infected. That infection may stay latent for years (or a lifetime) or may develop into active TB disease. Patients with active TB develop symptoms —such as a severe cough and night sweats—and are referred to the Public Health Department by their doctor or  hospital.

"When someone comes to us with active TB, they are usually very sick," said Christine Gaiger, communicable disease program manager. "It's rough for them because they're feeling bad and this is when they need to stay isolated so they don't spread the disease."

Only people with active TB in their lungs or throat can pass the disease to others, and only through the air—not by touching surfaces. People with latent infection or TB in other parts of the body (it can develop in the eyes or spine, for example) cannot spread the disease. TB spreads among people who spend extended time together, not by passing someone on the street or having a short conversation.

"Six hours sitting next to someone on an airplane—that's the level of contact it generally takes to spread TB," said Gaiger.

Nurses personally deliver treatment every day.

When patients come to the Public Health Department with active TB, they begin an intense treatment regimen that continues for months. This treatment is so critical that a Public Health nurse must personally observe patients taking their medicine five days a week to ensure they fully complete the treatment.

"Every pill—we need to make sure they don't miss a dose," said Gaiger.

In the initial weeks when patients need to stay isolated, a nurse visits every day to deliver medicine and observe the patient taking it. After two weeks, the illness is no longer contagious. For the next few months, patients work with nurses to figure out a schedule that works for them: they may visit a Public Health clinic or a nurse may bring them medicine at home or at a meeting place.

Why this tremendous commitment?

It helps ensure not only that the patient fully recovers, but also that TB does not spread to more people.

Investigation prevents more people from becoming sick and spreading TB.

As patients begin treatment, the Public Health team begins investigating. They start by connecting with family  members and close daily contacts, then gradually broaden the scope to contact friends, colleagues, classmates and people who belong to a club or congregation together.

People in these groups are offered a TB test, a chest X-ray and , if needed, treatment for TB infection. If they have been infected with TB, treatment can prevent the latent infection from growing into active TB disease.

What you can do: know the risk and follow through.

When it comes to protecting yourself and the community from TB, simple precautions go a long way.

First, Gaiger says, it's important to be aware of the disease and take it seriously. If you've spent more than a month in a country where TB is prevalent, tell your doctor and get tested. If you're screened for TB and a test is recommended, follow up and get the test. If the test shows you've been exposed to TB, follow through on the recommended treatment, even if you feel fine.

"It's important to know your risk factors," said Gaiger. "It's still a disease that's out there, and it can kill you if you don’t get treatment. The good news is that treatment is available and can prevent many people from ever getting sick."

Recognizing World TB Day on March 24.

Across California and worldwide, public health leaders recognize World TB Day on March 24, the day in 1882 that Dr. Robert Koch announced his discovery of the bacteria that causes TB. At the time of his discovery, TB killed one in every seven people living in the U.S. and Europe.

Through daily work and careful attention to every patient, Public Health workers in SLO County, like their peers across the world, continue building on this legacy to limit the spread of TB.

Learn more about TB at