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Tuberculosis (TB)








TB Guidance for Hurricane Workers and Evacuees						Español (Spanish)							Print
													Updated October 24, 2023
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										Going to a Public Disaster Shelter During the COVID-19 PandemicEmergency managers, shelter managers, and public health professionals are taking measures to reduce the possible spread of COVID-19 among people who seek safety in a disaster shelter during severe weather events.
Here are some tips to help you prepare and lower the risk of infection while staying safe in a shelter.**Identifying Persons in Your Evacuation Center Who May Have TB**In your evacuation center, you should actively assess two groups of persons:
Persons who were under treatment for tuberculosis (TB) before the storm
Persons who currently have symptoms of active TB diseaseTo assess these persons, you should ask the following questions.
Were you taking medicine for TB just before the hurricane? (If yes, go directly to **Management of Persons Who Were Under Treatment for TB Before the Storm**. If no, proceed with questions 2-6.)
Have you coughed up any blood in the last month? **OR**
Do you have a cough that has lasted for at least 3 weeks? **AND**
Have you felt feverish or had chills for more than one or two weeks? **AND**
Have you experienced extreme sweating (night sweats) for more than one or two weeks? **AND**
Have you lost a lot of weight recently without dieting? How much? Since when?
If the person answers “yes” to question 2 or answers “yes” to each of the questions 3, 4, 5, and 6) proceed to **Management of Persons with Symptoms of TB Disease.**)Management of Persons Who Were Under Treatment for TB Before the StormSuggested questions to ask persons who are identified as being treated for TB before the storm:
Did you **take any medicine** for your tuberculosis?
When did you start this medicine? When did you stop? Were you taking medicine when the hurricane came? Are you out of medicine?
Do you remember the names of the pills? *(If they can’t remember, try asking how many different types of pills they were taking for TB.)*
Who was giving you the medicine? (Did you go to the state or local TB program or pharmacy, or did someone come to you and give you each individual dose?)
**When** was this diagnosis made?
Do you remember if you had to cough up sputum (phlegm from deep inside your lungs) into a cup for your doctor/nurse to send to the lab? (This would be part of work-up for TB disease.)
**Who**prescribed your TB medicine?
**Very important: Try to get name/contact info for the state or local TB program or private provider who prescribed TB treatment (or at least get the county/parish in which person lived).**For persons whom you suspect as being under treatment for TB disease (not latent TB infection), immediate action is needed. This includes anyone in your evacuation center who was taking more than one medicine for TB or was receiving directly observed treatment for this disease. You should immediately notify the TB program in your jurisdiction.Management of Persons with Symptoms of TB DiseaseIf anyone in your evacuation center has symptoms of TB disease (that is, if the person answers “yes” to question 2 or answers “yes” to each of the questions 3, 4, and 5 above), contact the state or local TB programabout this person immediately.
If the state or local TB program determines that this person was potentially infectious while evacuating or staying in the evacuation center, a contact investigation will be needed. This is the process for identifying persons who may have been exposed to this infectious disease and providing any needed follow-up care. The contact investigation is done by the state or local TB program in cooperation with the evacuation center staff.Additional Measures You Can Take to Prevent the Spread of TBTB bacteria are spread when people with TB in their lungs coughs, speaks, or sings. Keep plenty of tissues on hand and offer them to clients and staff to cover their cough. **But most importantly, contact your state or local TB program if you suspect someone has TB disease.**Background Information on TB**What is TB?**
Tuberculosis (TB) is a disease caused by bacteria called *Mycobacterium tuberculosis*. The bacteria usually attack the lungs. But, TB bacteria can attack any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal. TB disease was once the leading cause of death in the United States.
TB bacteria are spread through the air from one person to another. The bacteria are put into the air when a person with TB disease of the lungs or throat coughs, speaks or sings. People nearby may breathe in these bacteria and become infected.
When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.
TB disease in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.
TB in other parts of the body, such as the kidney or spine, is usually not infectious.
However, not everyone infected with TB bacteria becomes sick. People who are not sick have what is called latent TB infection. People who have latent TB infection do not feel sick, do not have any symptoms, and cannot spread TB bacteria to others. But, some people with latent TB infection go on to get TB disease.
People with active TB disease can be treated and cured if they seek medical help. Even better, people with latent TB infection can take medicine so that they will not develop active TB disease.The Difference Between Latent TB Infection and Active TB DiseaseThe Difference Between Latent TB Infection and Active TB Disease
A Person with Latent TB Infection (LTBI)
A Person with Active TB DiseaseHas no symptoms
Does not feel sick
Cannot spread TB bacteria to others
Usually has a positive skin test or blood test result indicating TB infection
Has a normal chest x-ray and a negative sputum smearMay be taking medication to treat this condition (either self-administered isoniazid [INH] for 6-9 months, self-administered rifampin for 4 months, or isoniazid and rifapentine for 3 months under directly observed therapy [DOT] by a state or local TB program worker)
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
Usually feels sick
May spread TB bacteria to others
Usually has a positive skin test or blood test result indicating TB infection
May have an abnormal chest x-ray, or positive sputum smear or cultureUsually treated with four medicines (isoniazid, rifampin, pyrazinamide, and ethambutol) for at least 2 months, then isoniazid and rifampin for at least another 4 months—these doses are typically administered under directly observed therapy (DOT) by a state or local TB program workerFor more information, visit www.cdc.gov/tb,
Or call CDC at 800-CDC-Info (English and Spanish) or 888-232-6348 (TTY).
							
					
							Last Reviewed:  October 3, 2017						Source: 	Division of Tuberculosis Elimination, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention
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        Syndicate homeTuberculosisBasic TB Factsplus iconHow TB SpreadsLatent TB Infection and TB DiseaseSigns & SymptomsTB Risk FactorsExposure to TBTB PreventionVaccinesTB & HIV CoinfectionTB and DiabetesTB TermsPersonal StoriesTesting & Diagnosisplus iconWho Should be TestedTesting for TB InfectionTesting in BCG-Vaccinated PersonsTB Screening and Testing of Health Care PersonnelTesting During PregnancyDiagnosing latent TB infection and TB diseaseTreatmentplus iconDeciding When to Treat Latent TB InfectionTreatment Regimens for Latent TB Infection (LTBI)Treatment for TB DiseaseAdverse EventsTB Treatment of Persons Living with HIVTB Treatment and PregnancyTB Treatment for ChildrenFrequently Asked QuestionsDrug-Resistant TBResearchplus iconTB Epidemiologic Studies Consortiumplus iconResearch ProjectsPublicationsTB Trials Consortiumplus iconStudy DescriptionsBackgroundBehavioral & Social Science ResearchHealth Care Settingsplus iconTB Infection Control in Health Care SettingsResources for TB Screening and Testing of Health Care Personnelplus iconFrequently Asked QuestionsTB in Specific Populationsplus iconHealth DisparitiesAsian PersonsBlack or African American PersonsHispanic or Latino PersonsChildrenPregnancyCorrectional FacilitiesPeople Experiencing HomelessnessInternational TravelersLaboratory Informationplus iconDrug Susceptibility TestingFalse-Positive Investigation ToolkitInterim Laboratory Biosafety Guidance for XDR  tuberculosis strainsModel Performance Evaluation Program (MPEP)Rapid Molecular Testing to Detect Drug-Resistant TB in the USplus iconExecutive SummaryIntroductionBackground on Tests for Molecular Detection of DRGeneral Considerations and Principles for a Molecular DR Testing ServicePossible Scenarios and Scope of Testing for a Molecular DR Testing ServiceResearch NeedsGeneral Recommendations of the Expert PanelCommunication Plan for the ReportRecommendationsReferencesPanel Members and CDC ParticipantsAppendix 1Appendix 2Appendix 3The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TBplus iconGeneral ConsiderationsGeneral Recommendations of the Expert PanelRecommendations to ACET, CDC, DTBEData & Statisticsplus iconTB Incidence in the United StatesReported TB in the US, 2022 Surveillance Reportplus iconNational DataReporting Area DataRisk FactorsDemographicsTB Treatment and Case OutcomesDrug-Resistant TBMolecular SurveillanceTuberculosis in the United States, 2022 (Slide Set)Archived Surveillance Reports and Slide Sets2021 State and City ReportArchived State and City ReportsProfessional Resources & Toolsplus iconTools for Healthcare ProvidersResources for TB Programsplus iconStrengthening Civil Surgeons’ Capacity to Improve LTBI Surveillance and Outcomes Among Status AdjustersNotice of Funding Opportunity (NOFO)Program EvaluationTB Centers of ExcellenceTB Elimination AllianceTB Genotypingplus iconConventional TB GenotypingWhole Genome SequencingTB GIMSAnalytic ToolsLatent Tuberculosis Infection ResourcesPublications & Productsplus iconPatient and Public MaterialsFact SheetsGuidelinesplus iconControl & EliminationDrug-Resistant TBInfection Control & PreventionLaboratory & GenotypingTB & HIVTB in Specific PopulationsTesting & DiagnosisTreatmentVaccines & ImmunizationsArchived TB GuidelinesGuides & Toolkitsplus iconAggregate ReportsCDC TB Surveillance TrainingCore CurriculumEffective TB Interviewing for Contact InvestigationEthnographic GuidesFalse-Positive Investigation ToolkitForging Partnerships to Eliminate TuberculosisGuide to Application of GenotypingLTBI: A Guide for Primary Health Care ProvidersMantoux Tuberculin Skin Testing ProductsReport of Verified Case of Tuberculosis (RVCT)Self-Study ModulesTB Contact Investigation Interviewing Skills CourseTB eDOT ToolkitUnderstanding the TB Cohort Review ProcessNewslettersplus iconTB Notes, No. 4, 2023TB Notes, No. 3, 2023TB Notes. No. 2, 2023TB Notes. No. 1, 2023TB Notes, No. 4, 2022TB Notes, No. 3, 2022TB Notes, No. 2, 2022TB Notes, No. 1, 2022TB Notes, No. 4, 2021TB Notes, No. 3, 2021TB Notes, No. 2, 2021TB Notes, No. 1, 2021Pamphlets, Brochures, Bookletsplus iconQuestions and AnswersPatient Education SeriesTuberculosis - Get the FactsTuberculosis - The Connection between TB and HIV12-Dose Regimen for Latent TB Infection-Patient Education BrochurePostersplus iconMantoux Tuberculin Skin Test Wall ChartWorld TB DayThink TBStop TBTake on TBReports & Articlesplus iconDTBE Authored Journal ArticlesTuberculosis Laboratory Aggregate ReportsSlide Setsplus iconIntroduction to TuberculosisEpidemiology of Tuberculosis Among Non-U.S.​–Born Persons in the United States, 1993–2016Self-Study Modules on Tuberculosis, 1-5 Slide SetsThe Tuberculosis (TB) in Correctional Settingsplus iconFacilitator GuideIntroduction to TB GenotypingEpidemiology of Tuberculosis in Correctional Facilities, United States, 1993-2017Prevention and Control of Tuberculosis in Correctional and Detention FacilitiesGuidelines for Preventing the Transmission of M. TB in Health care SettingsInvestigation of Contacts of Persons with Infectious TBEpidemiology of Pediatric Tuberculosis in the United StatesTargeted Tuberculosis Testing and Treatment of Latent Tuberculosis InfectionElectronic Tools & ResourcesWeb-Based Courses & Webinarsplus iconTB 101 for Health Care WorkersContent SyndicationInfographicsplus iconSocial Media GraphicsCustomizable Take on TB Infographic with InstructionsEventsWorld TB Dayplus iconU.S. TB ChampionsHistoryFeaturesplus iconTB Risk FactorsTreating Latent TB Infection with Short-Course RegimensWorld Tuberculosis (TB) Day 2021World Tuberculosis (TB) Day 2020Linksplus iconState TB Control OfficesAbout Usplus iconMission Statement and Activitiesplus iconDTBE Strategic PlanNational TB Program ObjectivesOrganization ChartAdvisory Groupsplus iconFederal TB Task Force To receive email updates about this page, enter your email address: Email Address			What's this?				Submit


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