Basic Tuberculosis Facts and Prevention

1. Route of transmission
Tuberculosis (TB) is spread through the air from one person to another. The TB
bacteria are put into the air when a person with TB disease of the lungs or throat coughs,
sneezes, speaks, or sings. People nearby may breathe in these bacteria and become
infected. Not everyone infected with TB bacteria becomes sick. Clinical diseases develop
in about 10 percents of infected patients. TB bacteria become active if the immune system
can't stop them from growing, especially in elderly patients, chronic alcoholisms, patients
with diabetes, or patients with pneumoconiosis.

2. Open tuberculosis and non-open tuberculosis
Patients with “open tuberculosis” indicate that their sputum was acid-fast staining
positive, which usually refer to 40 to 100 thousands of tuberculosis bacilli in each ml of
their sputum. Those patients usually account for the minority of all patients with
tuberculosis. Besides, the transmission rates would decrease to the insignificant level in
95% of patients after two weeks of regular and proper anti-tuberculosis therapy. In the
contrary, although the transmission ability is lower in “non-open tuberculosis”, a noncompliant
patients with closed tuberculosis still can be converted into open TB.

3. Management of airway specimen
If your physician suspected the diagnosis of tuberculosis and ordered a sputum
examination, please send the first specimen in the early morning for examination. The
sputum may be collected in outdoor area or places with good ventilation. Gargling with tap
water would not affect the diagnostic rate of the examination except mouth rinse or tooth
paste. Before you expectorate the sputum, please take several times of deep breath.
About three to five ml of specimen is adequate. The specimen should be examined in
fresh status.

4. What to Do If You Have Been Exposed to TB
Please contacted with the local health administrative unit for the referral sheet of
follow-up. The chest X ray examination is the essential component of the follow-up. If you
already had cough, sputum examination is also necessary. For adults or patients without
history of BCG-vaccination, skin tuberculin test is also feasible.

5. Daily Prevention
a. Diet: Patients with active tuberculosis should consume healthy and balanced diet to
improve his/her immunity. There is no need for food and water isolation because this is
not the usual transmission route for tuberculosis.
b. Clothes: TB bacilli is relatively heat-sensitive. Thus, the linen and clothes of TB-infected
patients should be exposed to sunshine periodically to reduce the bacterial burden.
c. House: TB bacilli can live for several months in the most and dark area. Please keep the
house with good ventilation and sunshine whenever possible.
d. Environment: If you have to stay in closed public area such as the hospital or in the
public transportation facility, please wear proper mask.
e. Activity: Please keep regular daily activity and avoid unnecessary overnight activities,
tabacco, and alcohol.
f. Others: please bring the TB handbook during regular hospital visit for discounts.
If you are a patient with active tuberculosis and planning to start the treatment, we would
recommend the DOTS projects. Besides, patients should follow the regulations of the
disease-control before and during flight. The public health nursing staff and TB case
managers would visit the patients or contact with telephone intermittently.
g. Treatment completion: after the completion of the treatment, the patient should return to
hospital for follow-up every three to six months during the first year. After the second year,
a yearly follow-up is recommended. A proper life style modification for life-long is
recommended.