Each year, World TB Day is observed on March 24.  This annual event commemorates the date in 1882 when German bacteriologist Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB).  World TB Day provides an opportunity to raise awareness about TB-related problems and solutions, and to support worldwide TB control efforts. For the second year, CDC joins the global Stop TB Partnership in adopting the World TB Day slogan, "Stop TB in My Lifetime”.

It is important that people are aware that tuberculosis still threatens many people’s lives. As CDC Director Thomas Frieden, a TB expert, said, “We're all connected by the air we breathe.” The world now faces a situation in which approximately 160 persons die of TB each hour (1.45 million died in 2009).  A quarter of all deaths in persons with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (PWHA) are caused by TB.

The evolution of the bacteria has outpaced the evolution of its treatment to such an extent that some forms of TB are now untreatable.  TB has been treatable for decades with a cocktail of drugs.  However, shoddy medical practices world-wide have enabled the bacteria to mutate and, in some cases, become all but untreatable.

Today, Multi Drug Resistant (MDR) and the more dangerous Extensive drug Resistant (XDR) strains of TB threaten to reverse previous medical gains against tuberculosis.  Drug-resistant TB can be fatal, and the average cost of treatment in the US is about $140,000.  More recently, renewed attention has been given to reducing the global burden of TB, but much remains to be done. Although we continue to make progress, we still have a long way to go to achieve complete eradication.

A review of Guam’s reported TB cases showed a high rate of 78.7 cases per 100,000 population in 1996.  With the implementation of the Directly Observed Program (DOT) we have seen a steady decline in the number of reported TB cases to a low of 42.4 cases per 100,000 population in 2012.  Although we are seeing a steady decline, Guam’s rate of active TB cases is still 5 times higher than Hawaii and 13 times higher than the United States as a whole, indicating that much more is needed to be done in the control and surveillance of the disease.

Inadequate /inappropriate treatment of TB leads to the emergence of drug resistance, Multidrug Resistant TB (MDR-TB), Extremely Drug Resistant TB (XDR-TB), or even Totally Drug Resistant TB (TDR-TB).

Treatment for Active TB is done at the Department of Public Health and Social Services, under the Directly Observed Therapy Program (DOT) which involves direct observation and close monitoring to ensure adherence and completion of treatment.  The World Health Organization (WHO) has promoted DOT as the most effective means available to stop the global threat of TB.

Tuberculosis Global Statistics

  • TB is one of the world’s deadliest diseases. One third of the world’s population is infected with TB bacteria.
  • In 2011, nearly 9 million people around the world became sick with TB.

    • And, there were around 1.4 million TB-related deaths worldwide.
  • TB is a leading killer of people who are HIV infected.         

Background on Tuberculosis

  • TB is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack and damage any part of the body such as the kidney, spine, and brain. If not treated properly, TB disease can be fatal.
  • 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.
  • TB is not spread by shaking someone’s hand, sharing food or drink, touching bed linens or toilet seats, sharing toothbrushes, or kissing.
  • There are two forms of TB: latent TB infection and TB disease. People with latent TB infection don’t feel sick, don’t have symptoms, and can’t spread TB bacteria to others. People with latent TB infection can go on to develop TB disease if they don’t take preventive therapy.
  • People with TB disease feel sick, have signs and symptoms, and may spread TB bacteria to others.
  • People who think they were exposed to someone with TB disease should contact their health care provider or the local health department to see if testing is needed.
  • It is important to know that a person who is exposed to TB bacteria is not able to spread the bacteria to other people right away. Only people with TB disease can spread TB bacteria to others. Before you would be able to spread TB to others, you would have to breathe in TB bacteria and become infected. Then the active bacteria would have to multiply in your body and cause TB disease. At this point, you could possibly spread TB bacteria to others.
  • Symptoms of TB disease may include:

    • a bad cough that lasts 3 weeks or longer
    • coughing up blood or sputum
    • weakness or fatigue
    • weight loss
    • no appetite
    • chills
    • fever
    • sweating at night

For more detailed information on TB, please contact Cecilia Teresa T. Arciaga, TB Program Manager, at 735-3602/7145/7157 (fax 735-7318), or visit the TB Program located at the Department of Public Health and Social Services, Room 118, in Mangilao.

More information about TB is available via CDC’s TB website at .

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