2. Why do we test? 1.We want to prevent an outbreak of Tuberculosis in our campus community 2.We want to find those that are affected and get them treated so you are able to continue to participate in your schooling.

3. Tuberculosis What is it? Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with TB can die if they do not get treatment. About 10-20% of the international students that we screen each semester will be positive for a tuberculosis infection and will need further work up!

4. Tuberculosis Continued How is it spread? TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection. http://www.cdc.gov/tb/

5. Active versus Latent Disease The Difference between Latent TB Infection and TB Disease A Person with Latent TB Infection A Person with TB Disease Has no symptoms Has symptoms that may include: - a bad cough that lasts 3 weeks or longer - pain in the chest - coughing up blood or sputum - weakness or fatigue - weight loss - no appetite - chills - fever - sweating at night Does not feel sick Usually feels sick Cannot spread TB bacteria to others May spread TB bacteria to others Usually has a skin test or blood test result indicating TB infection Usually has a skin test or blood test result indicating TB infection Has a normal chest x-ray and a negative sputum smear May have an abnormal chest x-ray, or positive sputum smear or culture Needs treatment for latent TB infection to prevent active TB disease Needs treatment to treat active TB disease

6. QFT What is it? The QuantiFERON ® -TB Gold test (QFT-G) is a whole- blood test for use as an aid in diagnosing Mycobacterium tuberculosis infection, including latent tuberculosis infection (LTBI) and tuberculosis (TB) disease. This test was approved by the U.S. Food and Drug Administration (FDA) in 2005.

7. QFT A positive result suggests that M. tuberculosis infection is likely; a negative result suggests that infection is unlikely

8. Positive Test Results You will see the provider at Student Health Sent to the hospital to have a Chest x-ray You will then come back to Student Health for results and evaluation.

9. Treatment Options Active TB cases will be sent to an infectious disease physician to manage Latent TB cases (the majority): Take the treatment Rifampin daily treatment for 4 months. You will have blood taken before treatment and the 1 st, 2 nd, and 3 rd month of treatment You will come into student health for monthly visits to identify signs or symptoms of adverse drug effects and for medication refills.

10. Treatment Options You have to decide the risk and benefits of treatment versus the latent infection becoming active. You may decide not to take treatment If so, you will be asked to come in every 6 months and review signs and symptoms of active disease at Student Health. You should be aware of your chances of getting active tuberculosis

11. Adherence Important that once you start treatment that you adhere to the medication regime. If we need to stop the treatment because of side effects we will discuss options from there. Drug resistant Tuberculosis has been associated with the incomplete treatment of Latent Tuberculosis.

12. We are here for you We want to keep you healthy and also keep the campus community healthy. The goal is to keep you in class so that you are able to complete your degree and move on to your professional life. It is important that you review this information and then we can answer questions as they arise.

13. References Center for Disease Control and Prevention, Tuberculosis, http://www.cdc.gov/tb/ http://www.cdc.gov/tb/ ACHA guidelines: Tuberculosis screening and targeted testing of college and university students (2012). http://www.acha.org/Publications/docs/ACHA_Tubercu losis_Screening_Apr2012.pdf