OSF HealthCare Newsroom

Tuberculosis: Symptoms, Spread and Safety Tips

Mon, 10 Feb 2025 08:00:00 -0600

A Tuberculosis (TB) outbreak in Kansas City, Kansas, has people on edge, with not much public knowledge about the disease or how to prevent it.

The Kansas Department of Health & Environment reported as of January 31, 67 people were infected in the latest outbreak. Two people died and roughly half have finished treatment and are considered cured.

What is Tuberculosis?

“TB is referred to as ‘the great mimicker,’ says Sharjeel Ahmad, MD, a staff physician of infectious disease with OSF HealthCare, meaning the signs and symptoms are like many other viruses and bacterial infections people get.

“Tuberculosis is a very contagious bacterial infection,” Dr. Ahmad says. “It’s caused by a bacterium called Mycobacterium tuberculosis. It is spread when people cough, sneeze or spit. So, if you cough, spit or sneeze, you generate tiny particles. When someone else inhales that, you can get infected by TB.”

While active TB disease cases are rare, Dr. Ahmad says it's likely that one in four people worldwide have been exposed to this bacterium. In Peoria, Illinois, OSF HealthCare Saint Francis Medical Center treated six TB patients in 2024. The bacteria can be transmitted easily, with the infectious dose being a single live bacterium sufficient to infect people. The infection is transmitted airborne, through droplets and aerosol.

Tuberculosis signs and symptoms

“Warning signs include, but are not limited to, unexplained fever, night sweats and unintentional weight loss,” Dr. Ahmad says. “The infection is spread through inhaling, so the lungs are the primary site for infection”

Lung symptoms include a chronic cough that doesn’t go away, along with vague chest aches and pains. You may have phlegm, which could sometimes have blood in it.

“The Vampire Effect”

Dr Ahmad says, "Before the Industrial Revolution, folklore often associated tuberculosis with vampires. When one member of a family died from the disease, the other infected members would lose their health slowly. People believed this was caused by the original person with TB draining the life from the other family members".

"It can be deadly if it's left untreated. It was colloquially referred to as 'the consumption,' way back when because it consumes the body, and the body can get overwhelmed by it."

Why do most people not get the TB vaccine?

There is a vaccine for TB, and 2021 marked 100 years it has been around. It's made from a weakened strain of bacteria, Dr. Ahmad says. It's called Bacille Calmette-Guérin (BCG). The rates of protection against tuberculosis infection vary widely.

"It offers protection from getting TB of the brain/meningitis, especially in kids. It also has some protection against TB outside the lungs," Dr. Ahmad says. "There are some factors like genetics and where the patient is, which means it is not 100% protective. Estimates of protective effect vary between 20-70% for protection against TB disease.”

The TB vaccine can also interfere with a particular skin screening test for TB if the vaccination was given recently.

“Since the disease is so rare” Dr. Ahmad adds. We've opted over the years to not mess up our ability to detect known cases," he says.

Who is most at risk?

The youngest and oldest populations are both at high-risk for TB, along with those who have been around an infected person.

"This is a disease of overcrowding and poor hygiene," Dr. Ahmad says. "It's been around in humans forever. It's transmitted from person to person via the respiratory route."

People with a weakened immune system are also at risk of developing the disease if they are exposed to it. This could include people with diabetes or HIV. Patients who take medications that suppress the immune system – including patients with autoimmune diseases, transplants, and cancer patients are also more at risk. Patients with prior history of lung disease/damage are also at risk.

Dr. Ahmad adds that homeless shelters, correctional facilities and those with substance use disorder are also at-risk for becoming infected with TB.

How TB is treated in the hospital

Dr. Ahmad says care teams use "airborne precautions," including rooms with special ventilation systems in the hospital. TB patients are kept in these "negative pressure rooms" away from others to prevent the spread of infection. The entire care team wears personal protective equipment, including gowns, gloves and N95 masks, while in the room with the patient.

The medication regimen for TB patients is intense. Traditionally, four different antibiotics will be used for the first two months. "Once we have the antibiotic susceptibility results, and everything looks good, we can drop the patient down to just two antibiotics until we reach six months’ duration of treatment for lung TB," Dr. Ahmad says. If TB spreads outside the lungs, treatment can be even longer.

While therapy can be initiated at the hospital, the patient does not have to stay in the hospital for the whole duration of treatment. Once a care plan has been formulated, it is coordinated with the local health department to ensure there are no gaps in care during the transition, the patient continues to have access to the medication, and they do not pose a public health risk to others. The aim is to limit the patient's interaction with others inside and outside the hospital until they are deemed non-infectious, meaning they cannot transmit the infection. The hospital infection control/prevention team and county health department also remain vigilant, ensuring any potential exposures are traced and screened.

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You coughed up what?

Mon, 06 Jan 2025 13:00:00 -0600

Fall and winter could be renamed “coughing season” with seasonal illnesses in the air. But there’s more to coughing than the brief but annoying impact on your day.

Some coughing is normal. But you should see a health care provider quickly when you cough up things you shouldn’t.

The basics: Why do you cough?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, says coughing is one way your body protects your lungs and airways from irritants. You expel the bad stuff out of our system, she says.

Some everyday things that can make you cough: breathing in smoke, allergies and mucus dripping down to your throat and irritating it. Or, you may just wake up in the morning and cough a few times to lighten your chest. These shouldn’t alarm you, Dr. Ogun says.

“We have cough receptors in our airways and lungs,” Dr. Ogun explains. “If we have mucus or an irritant, there’s a signal sent to our brain. The brain activates those receptors to have the cough action happen. So that’s why you clear your throat or cough in the morning. You’re trying to clear out your airways.”

If your cough is associated with an illness (like a cold, flu, RSV, COVID, bronchitis or pertussis, also called whooping cough) or a chronic condition (like asthma or COPD), you should be seeing a provider as often as needed to learn how to manage things.

Coughing up things you shouldn’t

Watch for signs that your cough may be linked to a more serious problem, Dr. Ogun says.

Mucus: Our airways produce mucus to trap irritants, Dr. Ogun says. So it’s not out of the ordinary to cough up mucus from time to time. But if the mucus is thick or a different color (green or yellow), it could be a sign of pneumonia or bronchitis.

“When it’s persistent [cough with mucus] and it’s affecting your breathing, you definitely want to be seen [by a provider,]” Dr. Ogun says.
Vomit: Dr. Ogun says sometimes, you just cough hard enough to bring up some vomit. If it’s a “one-off,” as she calls it, you should still see a provider, but it may not be cause for great concern. But persistent vomiting while coughing could be a sign of whooping cough, acid reflux or aspiration (when food or drink gets into the lungs).
Blood: Coughing blood brings a high level of concern, Dr. Ogun says.

“Sometimes you have the common cold, you’re coughing for a long period and you irritated your airways. Maybe you nick the capillary artery [leading to coughing blood.] That’s fine,” Dr. Ogun says. “But more serious conditions would be a blood clot in the lung or tuberculosis.”

Heart failure, lung cancer or infections are also associated with coughing up blood.

Diagnosis and treatment

When you see a provider for an abnormal cough, they’ll ask about your health history, specifically about your cough. How long have you been coughing? Did something trigger it? What are you coughing up? Do you have other symptoms, like a fever?

“Then the provider could do a physical examination. They look at the back of your throat. They listen to your lungs to see if they hear anything concerning. Depending on what they find, they could order a chest X-ray or a CT scan to see what’s going on inside your chest,” Dr. Ogun says.

Treatment will depend on what the provider finds. For example, acid reflux can be tamped down by an antacid or a proton pump inhibitor (PPI). For an infection like pneumonia, you’ll get an antibiotic. If it is just an irritating tickle in your throat, you may get a steroid like Flonase.

What you can do

Some advice from Dr. Ogun to ensure coughs don’t derail your health:

Parents should keep a close eye on kids and their coughing.
No matter the age, don’t shake off one instance of a bad cough and assume things will go back to normal. See a provider right away.
While vaccines don’t prevent coughing, Dr. Ogun says they are critically important to stomp out the illnesses associated with coughing. Talk to your health care provider about when you’re due for flu, COVID, RSV, pneumonia and Tdap (tetanus, diphtheria and pertussis) vaccines.

“Pertussis is dangerous in immunocompromised people and kids,” Dr. Ogun warns. “RSV is highly contagious, as well. It’s life-threating in infants and older adults.

“What vaccines do is help prevent getting to the very severe stage [of an illness,]” she adds. “You’re trying to prevent ending up in the hospital. You’re also reducing the risk of infection. And you’re protecting people around you who may be sicker than you.”
Daily hygiene habits also go a long way. Sneeze or cough into your elbow or a tissue. Wash your hands often. Stay home and away from others when sick. Again, these don’t prevent coughs. But they can help prevent the spread of illness that brings those rough coughing fits.

OSF HealthCare Newsroom

Tuberculosis: Symptoms, Spread and Safety Tips

Video Interview Clips

You coughed up what?

Interview clips