Fortunately, in developed countries like the United States, tuberculosis (TB) is rare. According to the CDC, there were just under 8,000 reported cases in the U.S. last year. But this lung infection spreads quickly and can be deadly if left untreated. This means TB testing is an important tool to prevent large outbreaks and protect public health. Many people who have TB don&#;t show any symptoms. An estimated 25% of the world&#;s population has what&#;s known as latent tuberculosis infection. Although these individuals don&#;t feel sick and can&#;t spread the disease, it can turn into an active infection&#;especially in people with a weak immune system.
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Luckily, if a latent TB infection is caught with a test, you can be treated early to prevent an active infection. Since March 24th is World Tuberculosis Day, now is a great time to review what a TB test is, what you should expect, and who needs one.
A TB test checks to see if you&#;ve been infected with the bacteria responsible for causing tuberculosis. The most common type is a skin test that&#;s also called a Mantoux test or tuberculin skin test. Depending on why you need to be tested, you can also get a TB blood test. Either test can show if you&#;ve been infected with the bacteria that causes TB. But they can&#;t tell the difference between a latent or active infection. So if you have a positive skin or blood TB test, you&#;ll need additional testing to confirm which type you have. For now, let&#;s look at the two most common types of TB tests more closely.
A TB skin test works by injecting a small amount of protein under your skin to test your immune system&#;s response. Remember, this isn&#;t the actual bacteria that causes TB, just a protein from it. You can&#;t get sick from a TB skin test. But if you&#;ve been exposed to TB in the past, your skin will react to the protein. You&#;ll notice a firm, red bump at the injection site. A TB skin test requires multiple visits to your healthcare provider. During the first visit, they&#;ll use a small needle to inject the protein just under the skin of your inner forearm. This will leave a small bump or &#;bubble&#; that normally disappears within a few hours. You then need to wait 48-72 hours before returning for the provider to look at your arm and determine if the test is positive or negative. In some cases, such as for those working in healthcare, you may need to repeat this process a second time. The two-step TB test process helps prevent false negatives and better detects TB infections in people who were exposed less recently.
The blood test for TB is more convenient than the skin test since you only have to come to one appointment. It&#;s also more accurate than the skin test. Of course, many people dislike having their blood drawn so the skin test is still popular. During a TB blood test, a healthcare provider will insert a needle into a vein in your hand or arm and take a small blood sample. This usually only takes a few minutes and consists of a small pinch as the needle goes in. The provider will send your blood to the laboratory for testing and your results usually come back in 24-48 hours.
Most people don&#;t need a TB test. However, there are some exceptions. Most importantly, anyone having symptoms of an active TB infection should get tested. This includes symptoms like:
Some employers also require a TB test for employment. If you work in healthcare, childcare, or a school, you may need to be tested. Those at higher risk for getting TB may also want to be tested. This includes those who live or work in homeless shelters, nursing homes, or prisons, where TB is more common. You should also be tested if you travel outside the U.S. to an area where TB is common. For more information on who should be tested, refer to the CDC&#;s guidelines here.
If you need a TB test and don&#;t want to wait forever, urgent care is a great choice. At most clinics, you can simply walk in when it&#;s convenient and get your test done. Remember, if you have a TB skin test, you&#;ll need to come back to the same location a few days later.
Visiting urgent care for a TB test is usually faster than trying to make an appointment with your primary care provider (PCP). And since urgent care centers perform many TB tests and have a streamlined process, you&#;ll be in and out quickly.
If you&#;re an employer who needs TB testing for your entire workforce, Velocity Urgent Care is here to help. Our occupational medicine program is dedicated to helping you keep your employees safe and healthy.
Our clinics offer TB skin tests as well as drug testing, employee physicals, and walk-in injury treatment for everyone on your team. We also offer DOT physicals at all of our locations. To learn more about Velocity Urgent Care&#;s occupational medicine offerings, please visit our information page.
If you need a fast TB test for work or because you&#;re feeling sick, Velocity Urgent care is here for you. Our clinics specialize in efficient care that&#;s built around your schedule. You can walk into any of our convenient locations and get your TB test done the same day.
You can also make an appointment with our convenient online registration portal to skip the waiting room and arrive when it&#;s your turn to be seen. We even offer text message updates so you can wait in the car (if you prefer) until it&#;s time for your appointment.
Velocity Urgent Care is an in-network provider for most major insurance plans, meaning you can be seen for the cost of your co-pay and deductible.
All our locations also accept Medicare, Medicaid, and Tricare. Veterans Administration beneficiaries are also welcome.
To learn more about our services, locations, hours, and more, visit www.velocityuc.com.
The results of different tuberculosis tests can help determine if you have a latent infection or active disease that needs treatment. Testing can also play a role in determining the type of treatment you should have and in assessing how well that treatment is working.
Sometimes multiple tests may need to be conducted either at the same time or in a specific sequence, and your doctor may wait until all the results are available before reviewing them with you. In most cases, your doctor will explain what the results mean during an in-person appointment or over the . Test reports may also be available through an online health portal or by mail.
When your test results become available depends on the type of testing that is being performed. It is common for test results to come back within a few business days, but some types of tests can take a few weeks before results are ready.
People who have been diagnosed with tuberculosis and have received treatment usually need ongoing testing as a way of monitoring their health condition, including whether treatment has been effective against the infection.
After being initially diagnosed with tuberculosis, a patient may have additional tests in order to understand the extent of the disease and to identify the type of treatment that is most likely to work against the strain of tuberculosis bacteria causing the infection.
Tests to diagnose or rule out active infection for TB are frequently performed if screening tests find a latent TB infection. Diagnostic testing may also be recommended in people that have symptoms that could be explained by active TB. Potential symptoms of active tuberculosis include:
Screening tests may also be recommended in people who are at greater risk of reactivation of a latent TB infection, including:
People who do not have any symptoms of TB may have screening tests to detect a latent TB infection. This type of testing is most frequently recommended in people who have a known or likely exposure to TB, including:
Tuberculosis testing can be appropriate in many situations. The type of test and when it should be performed depends on the purpose of testing.
Another role of tuberculosis testing is to support public health programs. Because tuberculosis is a contagious disease, most national, state, and local health departments have protocols for reporting and tracking cases of TB. These programs are designed to reduce the spread of TB in the population, decrease the prevalence of drug-resistant TB, and identify people at high risk of TB who may benefit from testing.
Monitoring is how health care providers track a patient&#;s condition over time. For tuberculosis, monitoring tests can be used to see if treatment is helping to fight the infection. Tests may also be used to check for side effects from medications used to treat TB.
Treatment planning is how doctors decide the best way to treat tuberculosis in a specific patient. There are strains of tuberculosis bacteria that have become resistant to antibiotic medications. Testing allows the laboratory to see whether a patient&#;s TB infection is drug-resistant and test which medicines are most likely to be effective.
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Diagnosis is testing to determine whether a person has a specific condition. Diagnostic tests for tuberculosis are used to see if a person has an active TB infection that requires treatment. The diagnostic process can also include evaluating the severity of the infection and determining if there is disseminated disease.
Screening is testing that looks for a health problem in people who do not have any symptoms. For tuberculosis, screening tests can look for a latent tuberculosis infection. Some tests can check whether a person&#;s immune system has ever reacted to the bacteria that causes tuberculosis. Detecting latent TB enables treatment that can reduce the chances of developing active TB.
There are many kinds of tuberculosis tests that can be used for several different purposes. In general, tuberculosis tests are performed for screening, diagnosis, treatment planning, and monitoring.
There are many different types of tuberculosis tests. Each test provides information that can be valuable in certain situations. For example, the tests prescribed for screening for a latent TB infection are distinct from tests that diagnose active TB. Testing is tailored to each individual&#;s situation, and the doctor providing care can explain the role of each test.
The following sections provide more detail about several of the tests that are most commonly used for tuberculosis screening, diagnosis, treatment planning, and monitoring.
A first step in evaluating people for a possible TB infection is a combination of a health review and physical exam.
During a health review, also known as a health history, the doctor can ask about any symptoms you have, possible exposure to TB, and any coexisting health issues that may affect your risk of tuberculosis.
During a physical exam, the doctor can check for disrupted lung function, swollen lymph nodes, or other signs of infection that could be tied to tuberculosis.
Your health care provider can use information from these assessments to determine whether additional tests are needed.
A tuberculosis skin test determines whether your immune system has reacted to the bacteria that causes tuberculosis in the past. It is commonly used to screen for latent TB infection and may provide useful information when trying to diagnose active TB.
To take the test, a small shot with inactivated tuberculosis bacteria, called a pure protein derivative (PPD), is injected under the skin. Normally this injection is done around the forearm. Two to three days later, you return to the doctor to see if there has been an immune reaction in the skin.
While a TB skin test can tell if you have come in contact with tuberculosis, it cannot determine whether an infection is latent or active. In addition, a skin test may not detect TB exposure until up to 10 weeks after a primary infection.
In order to improve the accuracy of skin testing, you may be required to have two consecutive negative TB skin tests. People with ongoing exposure to TB may have periodic TB skin testing. In contrast, once a person has had one TB skin test with a positive result, they never need to have the test again because it will always be positive.
Like the TB skin test, an interferon-gamma release assay (IGRA) blood test is frequently used to screen for latent TB infection. An IGRA test can determine if you have been exposed to tuberculosis before, but it cannot distinguish between an active and past infection.
For an IGRA test, a blood sample is usually taken from a vein in the arm. A laboratory then exposes the blood to synthetic tuberculosis bacteria proteins and checks for substances that the immune system produces if a person has ever been infected by TB.
Bacteria detection tests use different laboratory methods to check for the presence of Mycobacterium tuberculosis in a sample taken from the body. These tests are central to the diagnosis of tuberculosis and also enable drug susceptibility testing for planning treatment.
Methods of identifying bacteria in a sample include microscopic analysis, culture, and molecular tests. In many cases, more than one of these methods is used on the same sample.
Microscopic analysis is looking at a test sample with a microscope to see what type of cells are present. Chemicals, called stains, are applied to the sample to help recognize certain types of bacteria. For tuberculosis, a stain called the acid-fast stain is commonly used to better identify the Mycobacterium tuberculosis bacteria. While microscopic analysis can be performed quickly, it is less precise than other methods. As a result, results usually must be confirmed by other bacterial detection tests.
Culture is a type of testing that uses a sample from the body to grow bacteria in a dish in a laboratory. The bacteria that grow in the dish provide evidence about the type of bacteria in the body. Culture tests may take several weeks to provide results since the bacteria need time to grow, but the test is considered highly accurate. If tuberculosis bacteria are found, the lab can conduct further tests to see which types of drugs kill the bacteria most effectively.
Molecular tests look for traces of the genetic material of Mycobacterium tuberculosis in a sample. This type of testing can provide results within a few days, making it useful for the initial diagnosis of TB. Molecular tests can also provide information about the genetic makeup of the strain of bacteria in a person&#;s body, which can help guide treatment.
Many different kinds of tissues or fluids from the body can be tested to look for signs of the bacteria that causes TB. The kind of sample needed and the way it is obtained depends on where the doctors believe an active TB infection is affecting the body. These samples can include:
People with HIV may have weakened immune systems and are at an increased risk of developing active TB disease. Studies have found that some test methods, such as microscopic analysis, can fail to detect tuberculosis in people with HIV and delay the start of treatment.
In people with HIV, another type of bacterial detection test, known as a urine antigen test, may be used. This test looks for a substance called lipoarabinomannan (LAM), which makes up part of the cell structure of the tuberculosis bacteria. A urine LAM test can be conducted rapidly but needs confirmation with culture or molecular tests.
Tests that provide a picture of the inside of the body are frequently used in the diagnosis of tuberculosis. For patients with symptoms of TB or who have tested positive for a latent TB infection, imaging tests of the lungs can reveal signs of active TB that help determine whether further testing is necessary.
A frequently used imaging test is an x-ray of the chest. Less often, doctors may recommend a CT scan of the chest, which involves multiple x-ray images taken at different angles that are then combined by a computer. Imaging tests of other parts of the body and/or other types of imaging tests, such as PET scans and MRIs, are only used in more specific and limited circumstances.
After a person is diagnosed with tuberculosis, doctors may recommend several tests to check for other health conditions that are more common in people with TB. This often involves a blood test for HIV infection and may include tests for hepatitis B and hepatitis C.
Doctors may prescribe other tests to assess your overall health, and these tests may be performed over time to help monitor for side effects from medications. These tests can include evaluations of liver function, kidney health, and vision.
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