Our public health staff work closely with the State of Alaska to investigate and respond to infectious disease outbreaks. We provide testing and treatment for both latent and active tuberculosis.
Our clinic is located on the first floor. Call 343-4799 to make an appointment for your TB clearance card assessment or if you have any questions or concerns.
TB bacteria are 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, speaks, or sings. People nearby may breathe in these bacteria and become infected.
TB is NOT spread by:
- shaking someone's hand
- sharing food or drink
- touching bed linens or toilet seats
- sharing toothbrushes
- kissing
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. TB in other parts of the body, such as the kidney or spine, is usually not infectious. 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 Risk Factors
Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later, when their immune system becomes weak for another reason. Overall, about 5 to 10% of infected persons who do not receive treatment for latent TB infection will develop TB disease at some time in their lives. For persons whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for persons with normal immune systems.
Generally, persons at high risk for developing TB disease fall into two categories:
- Persons who have been recently infected with TB bacteria
- Persons with medical conditions that weaken the immune system
Persons who have been Recently Infected with TB Bacteria
This includes:
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Close contacts of a person with infectious TB disease
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Persons who have immigrated from areas of the world with high rates of TB
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Children less than 5 years of age who have a positive TB test
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Groups with high rates of TB transmission, such as homeless persons, injection drug users, and persons with HIV infection
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Persons who work or reside with people who are at high risk for TB in facilities or institutions such as hospitals, homeless shelters, correctional facilities, nursing homes, and residential homes for those with HIV
Persons with Medical Conditions that Weaken the Immune System
Babies and young children often have weak immune systems. Other people can have weak immune systems, too, especially people with any of these conditions:
- HIV infection (the virus that causes AIDS)
- Substance abuse
- Silicosis
- Diabetes mellitus
- Severe kidney disease
- Low body weight
- Organ transplants
- Head and neck cancer
- Medical treatments such as corticosteroids or organ transplant
- Specialized treatment for rheumatoid arthritis or Crohn’s disease
How to get a Tuberculosis Clearance Card
Persons with a prior negative skin test or have never had a skin test, must receive a skin test. Please obtain the test during our Immunization Clinic hours.
Persons with a prior positive skin test should arrange for a TB assessment appointment. Please bring any documents showing test results, chest x-ray (if done already) and any medical provider notes or card related to prior assessments.
The TB clearance card is valid for one year.
TB Clearance related to Immigration, Refugee, or Asylum Status
Services include a review of medical history, chest x-ray, TB skin test, and necessary laboratory work. Please bring any documents and x-rays related to these items you may already have.
We cooperate with the State Refugee Coordinator and Catholic Social Services' Refugee Assistance & Immigration Services (RAIS) program in helping immigrants and refugees obtain needed TB clearance. More information about Catholic Social Services' RAIS program can be found here.
Latent TB Infection and TB Disease
Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.
Latent TB Infection
TB bacteria can live in the body without making you sick. This is called latent TB infection. In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection:
- Have no symptoms
- Don’t feel sick
- Can’t spread TB bacteria to others
- Usually have a positive TB skin test reaction or positive TB blood test
- May develop TB disease if they do not receive treatment for latent TB infection
Many people who have latent TB infection never develop TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have a weak immune system, the bacteria become active, multiply, and cause TB disease.
TB Disease
TB bacteria become active if the immune system can't stop them from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. People with TB disease are sick. They may also be able to spread the bacteria to people they spend time with every day.
Many people who have latent TB infection never develop TB disease. Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Other people may get sick years later when their immune system becomes weak for another reason.
For people whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for people with normal immune systems.
The Difference between Latent TB Infection (LTBI) and TB Disease
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A Person with Latent TB Infection
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A Person with TB Disease
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- 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
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- Cannot spread TB bacteria to others
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- May spread TB bacteria to others
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- Usually has a skin test or blood test result indicating TB infection
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- Usually has a skin test or blood test result indicating TB infection
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- Has a normal chest x-ray and a negative sputum smear
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- May have an abnormal chest x-ray, or positive sputum smear or culture
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- Needs treatment for latent TB infection to prevent TB disease
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- Needs treatment to treat TB disease
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Providers referring clients for TB evaluation and/or treatment
Main Phone number: (907) 343-4799
Call and ask to speak to or leave a message with a TB Nurse. The DHHS should be called regarding any patients needing immediate referral to us for suspected or lab confirmed TB disease so we can start working with you and the patient immediately.
Additionally, notify the State of Alaska, Section of Epidemiology at (907) 269-8000 (Monday-Friday 8:00am-4:30pm) with the required information to comply with state regulations on reporting communicable diseases.
We will need the following information:
- Patient's name, date of birth, and demographics to include good phone number (if a child, please include parent(s) first and last name).
- TST and/or IGRA results with dates.
- Chest x-ray result as well as the actual film or CD.
- Laboratory tests such as LFTs, HIV, Hepatitis panel, sputum collection dates and results; culture and smears results for any other body fluids or tissues done for TB bacteria.
- Medical notes related to TB assessment and diagnosis or referral.
- Prescription for drug treatment if diagnosis of Latent TB infection is already made and you are not requesting us to provide the medication(s). PLEASE DO NOT GIVE THE SCRIPT TO THE CLIENT. If you do prefer the client hand carry the script to us, we recommend writing on it - "To be filled only at the MOA Health Dept."
- Prescriptions for drug treatment if diagnosis of TB disease (or suspected disease) is already made.
- Orders for any other treatments such as repeating LFTs, sputum or other body fluid collections. If not, we will follow our usual protocols for these items.
Items above can be faxed to us at (907) 343-7992; ATTN: TB RN