Class 0

Individuals are placed in this class if they have had no exposure to tuberculosis and have a negative tuberculin test. This test determines if a person has already been infected with tuberculosis mycobacteria by measuring how sensitive a persons immune system is to proteins, called tuberculins, from the tuberculosis mycobacteria cultures. In a tuberculin skin test, the tuberculins are injected under the skin. After 48 to 72 hours the size of induration, or hardening of the skin, is evaluated.

Class 1
Individuals placed in class 1 have been exposed to tuberculosis, but did not have a positive tuberculin skin test. Treatment for latent tuberculosis infection should be initiated if the person is immune compromised and especially if they are HIV positive. A joint statement prepared by the American Thoracic Society and the Centers for Disease Control and Prevention recommends that persons with latent tuberculosis infection be treated daily with isoniazid for nine months. Other recommended alternative treatments include a two month daily regimen of rifampin and pyrazinamide or rifampin alone for four months.

Class 2
Individuals placed in class 2 have a positive tuberculin skin test, but no evidence of active tuberculosis. Some persons in class 2 may be treated for latent tuberculosis infection.

Class 3
Individuals placed in class 3 have active tuberculosis and exhibit symptoms of the disease. Patients with active tuberculosis may have abnormalities in the upper lung lobes that can be detected by a chest radiograph. Patients with past active tuberculosis may have nodules and fibrotic scars in the upper lung lobes. Individuals in class 3 will remain in class 3 until treatment of tuberculosis is completed. The American Thoracic Society, the Centers for Disease Control and Prevention and the Infectious Disease Society of America recommend all adults with active tuberculosis disease begin treatment with a two month initial phase of isoniazid, rifampin, purasinamide and ethambutol. At the end of two months patients are then treated either four months or seven months with isoniazid and rifampin depending on whether lesions were initially observed in the lungs and if bacterial cultures are positive after the initial treatment period.

Class 4
Individuals who do not have active tuberculosis disease, but have had a previous episode of tuberculosis and have a positive reaction to the tuberculin skin test are placed in class 4.

Class 5

Individuals placed in class 5 are suspected of having tuberculosis, but have a pending diagnosis. After a tuberculin skin test, mycobacterial culture and chest x-ray the person should be classified in one of the other preceding classes.
Types

Latent TB means that you have the TB bacteria in your body, but your body?s defenses (immune system) are keeping it from turning into active TB. This means that you don't have any symptoms of TB right now and can't spread the disease to others. If you have latent TB, it can become active TB. Active TB means that the TB bacteria are growing and causing symptoms. If your lungs are infected with active TB, it is easy to spread the disease to others.

How is TB spread to others? Pulmonary TB (in the lungs) is contagious. It spreads when a person who has active TB breathes out air that has the TB bacteria in it and then another person breathes in the bacteria from the air. An infected person releases even more bacteria when he or she does things like cough or laugh.

Who is most at risk for TB? Some people are more likely than others to get TB. This includes people who:

Have HIV or another illness that weakens the immune system. Have close contact with someone who has active TB, such as living in the same house as someone who is infected with TB. Care for a patient who has active TB, such as doctors or nurses. Live or work in crowded places, such as prisons, nursing homes, or homeless shelters, where other people may have active TB. Have poor access to health care, such as homeless people and migrant farm workers. Abuse drugs or alcohol.
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What Is Pulmonary Tuberculosis?

Pulmonary tuberculosis (TB) is bacteria that that attack your lungs. It is a potentially deadly disease, but it is curable if you get medical help right away and follow your doctors instructions. The bacterium (germ) that causes TB is called Mycobacterium tuberculosis. This germ can cause other kinds of TB, but pulmonary TB is the most common. You can get sick with TB if you inhale the droplets exhaled by a person who has the disease. Although TB is preventable and treatable, according to the World Health Organization, up to 66 percent of the people who get sick with TB will die if they do not get proper medical care. (WHO) If you believe you have pulmonary tuberculosis, see your doctor immediately. If you have been exposed to TB, ask for a TB test. TB is quite rare in the United States with the CDC reporting in 2010, a total of 11,181 tuberculosis (TB) cases. The disease has been in decline over the last decade and is at the lowest rate recorded since national reporting began in 1953.
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Types of TB: Latent TB vs. TB Disease

Just because you have been exposed to TB germs does not mean you will get sick from TByet. About one-third of the worlds population has been infected with the germs that cause TB. Most of these people do not get sick right away because their immune systems can fight the germs. In those people, the disease goes to sleep and is called latent TB. People with latent TB have no symptoms and cannot make other people sickbut they must still be tested and treated. People with latent TB can develop symptoms and become contagious at any time. Then, they are said to have TB disease.
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Who Is at Risk for TB Disease?

People who are most at risk for developing TB disease are: the elderly

small children smokers people who already have an immune system problem, such as HIV people who do not regularly see a doctor, such as homeless people people who live in crowded conditions, such as prisons
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TB Around the World

At the turn of the 20th century, tuberculosis was the most common cause of death in the United States, but, according to the Centers for Disease Control and Prevention, the number of TB cases in the United States has been declining for 50 years. (CDC) TB most commonly occurs in developing countries because of overcrowding and limited access to medical care. In some countries where TB rates are dangerously high, a vaccine called Bacillus Calmette-Gurin (BCG) is used. Although BCG is somewhat helpful in preventing people from catching TB, it is not considered effective enough to justify wide use.
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How Does Someone Catch TB?

You can become infected with TB when you breathe in the tiny droplets of air exhaled by someone who has TB disease when they cough, sneeze, laugh, or sing. TB germs can float in the air for several hours, so it is possible to inhale them even when the sick person is not in the same room as you are. You cannot catch TB by shaking hands, sharing food or drink, or kissing.

What Are the Symptoms of Pulmonary TB?

People with latent TB have no symptoms, but they should still be treated. Symptoms of pulmonary TB include: coughing that continues for several days

coughing up blood fever, including low-grade, consistent fever excessive sweating chest pain unexplained weight loss fatigue Because these are signs of other diseases, too, you should see a doctor to find out their cause.
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How Is TB Diagnosed?
You should immediately see your doctor if you have symptoms of TB disease. Your doctor will conduct a physical exam, including checking to see if your lymph nodes are swollen, asking about your health history, and perhaps scheduling a chest X-ray. If your doctor thinks you might have TB, or if you have been exposed to someone who has TB disease, the next step is a medical test. There are two tests for TB: a skin test and a blood test. The skin test is the most common and less expensive, but it requires two visits to your doctor. If returning for a second visit might be a problem for you, you should ask your doctor if you can take the blood test.
Skin Test

Your doctor or nurse will inject a very small amount (not enough to make you sick) of the protein from TB under your skin. The location of the shot may itch a little, but it is important not to scratch it, as this could make the test result hard to read. You will be told to return to the doctors office in either two or three days. At that time, the doctor or nurse will look at the spot where the injection was made to see if it is swollen. A hardened swelling of five or more millimeters is an indication that you could be infected with TB. Five millimeters is about one-quarter of an inch. Redness at the location of the injection is normal and is not a sign of a TB infection.

Blood Test

Your doctor or nurse will take a sample of your blood that will then be exposed to TB in a laboratory. Blood test results are usually available within 24 hours.
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How Is TB Treated?
People with latent TB have no symptoms and cannot pass TB to another person. However, it is very important to be treated even if you have no symptoms because you could develop TB disease in the future. If you have latent TB, you may need to take just one TB drug. If you have TB disease, your doctor will prescribe several medicines, which you will need to take for six months or longer. The four most common TB medicines are: isoniazid rifampin (Rifadin, Rimactane) ethambutol (Myambutol) pyrazinamide Even if you feel better after starting your medicines, you must continue to take your medication exactly as your doctor prescribed. Stopping treatment or skipping doses can make TB resistant to medicines, leading to a very dangerous type of TB called multidrugresistant TB (MDR TB). To help you complete treatment, your doctor might recommend an approach called directly observed therapy (DOT). With DOT, a healthcare professional such as a nurse meets with you every day or several times a week to administer your medication so that you dont have to remember to take it on your own. If you are not on DOT, you should make a plan for taking your medicines so that you do not miss a dose. Some tips to help you remember to take your medicines are to: Take them at the same time every day.

Make a note on your calendar each day to show you have taken your medicines. Ask someone to remind you to take your medicines every day. Keep your medicines in a weekly pill organizer.