Who Is at Higher Risk for Tuberculosis

Anyone can get tuberculosis (TB), but some people are at higher risk. They fall into two groups:

• people more likely to be exposed to TB germs; and
• people more likely to develop active TB disease once infected.

If you have recently spent time with someone who has active TB disease, you may be at risk — talk to a health care provider about testing.

Conditions that raise the risk of active disease

Some people with weakened immune systems are at very high risk of developing active TB disease after infection, so it is very important that they get treatment for inactive TB to prevent it. Medicines and conditions that can weaken the immune system include:

• HIV infection;
• substance use, such as injection drug use;
• specialized treatment for rheumatoid arthritis or Crohn's disease;
• organ transplants;
• severe kidney disease;
• head and neck cancer;
• diabetes;
• medical treatments such as corticosteroids;
• silicosis;
• low body weight.

Babies and young children often have weak immune systems, and children — especially those under five — are more likely to develop TB disease once infected.

Places and situations that raise the risk of exposure

You're more likely to be exposed to TB germs if you:

• were born in, or often travel to, countries where TB is common, including some in Asia, Africa and Latin America;
• live or used to live in large group settings where TB is more common, such as homeless shelters, prisons or jails;
• work where TB is more likely to spread, such as hospitals, homeless shelters, correctional facilities and nursing homes.

The TB vaccine doesn't rule TB out

Bacille Calmette-Guérin (BCG) is a vaccine against TB disease. It isn't generally used in the United States but is often given to infants and young children in countries where TB is common, where it protects against severe forms such as TB meningitis. You can still get TB after BCG.

Tell your provider if you've had BCG, especially before a TB test: it can cause a false-positive skin test. TB blood tests are preferred for people who have had BCG.

Prevention and equity

TB is preventable and curable. If you're at risk, talking with a provider is the first step to protecting yourself, your family and your community from this highly contagious disease. In the United States, TB falls hardest on groups that have historically faced greater obstacles to health.

Sources

• Centers for Disease Control and Prevention: "Tuberculosis Risk Factors."