Campus Tuberculosis Prevention: Key Facts You Should Know

Tuberculosis (TB) is caused by an aerobic, acid-fast bacterium known as Mycobacterium tuberculosis. It is a global chronic infectious disease and is particularly prevalent in developing countries. In Taiwan, TB cases occur year-round. The incidence rate is higher in males than in females, and higher in older adults than in younger individuals.

TB is transmitted through droplets and airborne particles. Infectious TB patients can generate droplets containing TB bacteria when they spit, cough, speak,sing, or laugh. If these droplet nuclei remain suspended in the air and are inhaled by others, infection may occur. TB is not transmitted through clothing or eating utensils.

Transmission most commonly occurs among household members living in the same space as the patient or among people with close contact. The duration of exposure to an infectious patient and whether the shared environment is well ventilated are key factors influencing TB transmission. After infection, most healthy individuals do not develop disease immediately. When TB becomes active, common symptoms include coughing for more than two weeks, weight loss, and fever. Effective anti-tuberculosis medications are available. As long as patients follow the physician’s prescribed treatment regimen, TB is a curable disease.

If a person is infected with TB bacteria but has not developed active disease,they are not contagious. This condition is known as Latent Tuberculosis Infection (LTBI). TB bacteria can remain dormant in the body for a long time and may reactivate later. In general, about 5–10% of infected individuals will develop active TB at some point in their lifetime, with the highest risk occurring within the first two years after infection. In addition to close contacts, individuals with other

risk factors for developing TB—such as diabetes (especially with poor blood glucose control), advanced age, immunodeficiency, or end-stage renal disease—are considered high-risk groups. If LTBI is treated promptly with anti-tuberculosis medications, the risk of future disease can be significantly reduced. Current LTBI treatment regimens, prescribed after physician evaluation, include 1HP, 3HP, 3HR, 4R, 6H, and 9H. When combined with directly observed therapy (DOT) public health support, these treatments can substantially lower the risk of developing active TB in the future.

Q&A

Q1:Who is more likely to develop tuberculosis?

People of any age, gender, or race can develop TB. Anyone infected with TB bacteria may develop the disease when their immune system is weakened. herefore,household members of infectious TB patients, older adults, individuals with diabetes, silicosis, those receiving dialysis, people on long-term corticosteroid therapy, individuals with alcohol dependence, and those with compromised immune systems are more likely to develop TB after infection.

Q2:What are the symptoms of tuberculosis?

Symptoms vary depending on an individual’s physical condition and immune status and may not be obvious in the early stages. When symptoms become more apparent, they may include persistent cough, sputum production, coughing up blood, night sweats, poor appetite, weight loss, prolonged fatigue or malaise, fever, chest tightness, or chest pain. If a person has been diagnosed with latent TB infection but has not received treatment and develops these symptoms, they should wear a mask and seek medical evaluation promptly.

Q3:Can tuberculosis be cured?

Yes.TB can be cured with proper treatment. If patients cooperate with physicians and public health authorities by taking medications regularly and attending follow-up visits, they can usually continue working as usual. The standard treatment duration is approximately six months, though physicians may extend treatment depending on the patient’s condition to ensure complete cure. For patients with infectious TB, it is recommended to rest at home as much as possible during the first two weeks of treatment, enroll in directly observed therapy, wear a mask, and avoid crowded public places. After two weeks of regular medication or once sputum tests become negative, normal daily activities can be resumed.

Q4:Which contacts need to undergo examination?

After a TB patient is diagnosed, public health personnel will conduct an assessment.Individuals meeting the following criteria should be examined:

• Those living in the same household as the TB patient.
• Those who had contact with the TB patient during the infectious period for 8 hours or more in one day, or a cumulative total of 40 hours or more.

Q5:What is latent tuberculosis infection?

After TB bacteria enter the body, they may become encapsulated by granulomatous tissue in the lungs. When the immune system is strong enough, the bacteria are controlled and do not cause disease. This balanced state is called latent tuberculosis infection. LTBI has no symptoms and is not contagious. However, if the immune system becomes weakened, LTBI may progress to active TB and lead to transmission.

Q6:Do TB contacts have to undergo LTBI testing?

For the health of TB contacts and in accordance with the Communicable Disease Control Act, TB contacts should undergo relevant examinations as arranged by public health authorities. Current evaluations for TB contacts include chest X-ray examination and LTBI testing, depending on the level of exposure risk. In principle, all contacts should receive a chest X-ray. Contacts of infectious TB cases will be informed by health authorities if LTBI testing is required.

Q7:Will people with latent TB infection immediately become TB patients?

Individuals with latent TB infection have about a 5–10% lifetime risk of developing active TB, with higher risk closer to the time of initial infection. Whether disease develops depends on factors such as overall health and immune status.Therefore, it is essential to follow public health arrangements and undergo examinations at scheduled times to enable early diagnosis and early treatment.

Q8:Can a person continue working or attending school after being diagnosed with TB?

According to Article 12 of the Communicable Disease Control Act, government agencies,private organizations, enterprises, or individuals may not refuse schooling,employment, care, residence, or impose other unfair treatment on individuals with communicable diseases, unless restrictions are imposed by competent authorities for disease control purposes. Therefore, individuals diagnosed with TB may continue working or attending school. However, for those with infectious TB, it is recommended—for the health of both the patient and the public—to rest at home as much as possible during the first two weeks of treatment, participate in directly observed therapy, and avoid crowded public places.After two weeks of regular treatment or once sputum tests become negative, normal routines may be resumed.

Q9:Can people refuse to interact with TB patients?

Once TB patients begin treatment, their infectiousness decreases rapidly. There is no need for excessive fear or discrimination against TB patients. According to Article 12 of the Communicable Disease Control Act, no unfair treatment may be imposed on individuals with communicable diseases, unless restrictions are required by competent authorities for disease control. Only when public health authorities determine that a patient requires long-term isolation to interrupt transmission will restrictions on personal freedom be imposed for TB treatment purposes.

Source: Centers for Disease Control, Taiwan – https://www.cdc.gov.tw/Disease/SubIndex/j5_xY8JbRq3IzXAqxbnAvQ