Bismarck Burleigh Public Health (BBPH) encourages all North Dakotans to observe Thursday, March 24, as World TB Day. World TB Day raises awareness about the enormous burden tuberculosis (TB) causes for individuals, families, communities and countries. TB is now the number one infectious killer in the world, with 1.5 million TB-associated deaths per year.

Tuberculosis is caused by bacteria (Mycobacterium tuberculosis) that most often affect the lungs. The bacteria is spread through the air from person to person. If a person has TB bacteria but has no symptoms, they are considered to be “TB-infected,” but are not contagious. Once a person with infection becomes ill, they are considered to have TB disease and they are contagious. With appropriate antibiotic therapy, people can be treated and cured of TB. Early screening helps identify TB infection before it becomes infectious, and this is the best time to treat it.

Although overall TB case numbers have declined over the last century, the United States is seeing an increase in TB disease for the first time in 23 years, including both adults and children. In 2015, nine cases of TB disease were reported in North Dakota. In 2016, seven cases have already been reported in the state. Between 300 and 500 TB-infected persons (who do not have the disease and are not contagious) are identified in North Dakota each year.

Because TB is prevalent in many areas of the world, many cases reported in the U.S., including North Dakota, are identified as foreign-born persons who have emigrated within the past five years from areas that have high TB incidence. However, TB also occurs in U.S. residents. The highest risk of contracting TB occurs for residents and employees of high-risk congregate settings such as prisons, nursing homes, homeless shelters, health care facilities, and drug treatment facilities. Anyone with close contact to contagious cases of TB are also considered high-risk. The risk of TB is also greater for people suffering from conditions that impair the immune system, such as HIV, rheumatoid arthritis, diabetes, substance abuse, or in people taking TNF-alpha inhibitors, or women who are pregnant.

When people who have TB disease cough, sneeze or spit, TB bacteria can be propelled through the air and inhaled by someone who is not infected. TB bacteria most commonly grow in the lungs, and can cause symptoms such as:
• A bad cough that lasts 3 weeks or longer
• Pain in the chest
• Coughing up blood or sputum (mucus from deep inside the lungs)
• Weakness or fatigue
• Weight loss
• No appetite
• Chills
• Fever
• Sweating at night

Anyone who experiences the symptoms listed and believes they may have had contact with a person with TB disease should see their medical provider.