Tuberculosis
Tuberculosis is a disease caused by bacteria. If you become ill with tuberculosis, you will need to take medication for at least six months. In Norway, tuberculosis examinations and treatment are free.
What is tuberculosis?
Tuberculosis (TB) is an infectious disease caused by bacteria. Tuberculosis is spread via tiny, invisible droplets that are expelled into the air when someone with infectious tuberculosis coughs, sneezes, speaks or laughs. When other people inhale this air, droplets containing tuberculosis bacteria can be drawn in with the air and enter their lungs.
Tuberculosis bacteria infections are not very contagious. Tuberculosis bacteria will cause illness if the body is unable to defend itself against the bacteria. It is most common to contract tuberculosis in the lungs, but it can also be contracted elsewhere in the body (such as in the lymph nodes, bones, brain, bone marrow, intestines, urinary tract, heart or adrenal glands).
Only tuberculosis in the lungs can be passed on to other people.
What is latent tuberculosis?
Being infected with tuberculosis without being ill is called latent tuberculosis infection. In other words, you have tuberculosis bacteria in your body even though you are not experiencing any symptoms. Your immune system will keep the bacteria under control, with the result that you do not become ill.
About a quarter of the world’s population is infected with the tuberculosis bacterium, but only a few of these become ill. It can take many years from becoming infected until a person becomes ill. Most people who are infected do not become ill.
If you become infected with the bacteria, but are not ill, the doctor at the hospital may still recommend that you take medication for a short period of time. This is a preventive tuberculosis treatment, which aims to reduce the risk of you becoming ill later.
You cannot be infected by people who have a latent tuberculosis infection.
Symptoms of tuberculosis
The symptoms of tuberculosis are also common symptoms of a number of other illnesses. To confirm that you have tuberculosis rather than something else, you must be examined.
The most common symptoms of tuberculosis are:
- persistent cough (for three weeks or more)
- persistent fever (feel very hot)
- loss of appetite and weight loss
- weakness and fatigue
- excessive sweating at night
- swelling or bump on your neck or groin or under your arms
Less common symptoms are:
- chest pain
- breathing difficulties
- coughing up mucus containing blood
You should see your GP if you have one or more of these symptoms.
Tuberculosis in organs other than the lungs can cause symptoms in the affected body parts.
Symptoms of tuberculosis in children
Children may experience different symptoms of tuberculosis compared with adults:
- excessive daytime sleepiness and lethargy
- loss of appetite
- slight weight gain
- excessive sweating at night
Children with tuberculosis rarely cough.
How do I find out whether I have tuberculosis?
If you suspect that you or someone you know may have tuberculosis, you should see your GP or a healthcare professional in your municipality, or go to the accident and emergency department at your local hospital.
Remember that the symptoms of tuberculosis are also common signs of other illnesses. To confirm that you have tuberculosis, you will need to be examined.
Who needs to be examined for tuberculosis?
You will need to be examined for tuberculosis if you:
- come from a country where tuberculosis is common and intend to stay in Norway for more than three months
- are arriving in Norway as a refugee or asylum seeker
- intend to work with children or the sick, and have spent at least three months in a country with a high incidence of tuberculosis during the last three years
- have been or suspect that you may have been exposed to tuberculosis infection
Infection tracking and testing for tuberculosis
Usually, only a few of those who have been in close contact with a person infected with tuberculosis actually become infected. It is most common to be infected by someone you live with.
If you have come into close contact with a sick person, you may be asked to come in for an examination by a healthcare professional who is responsible for infection control in the municipality where you live. It takes time for tuberculosis infection to become visible on samples. It is therefore common to wait for eight to ten weeks before the examination is performed.
Testing of high-risk groups
Some people are more likely to become infected or develop the disease (high-risk groups) and should be tested earlier:
- Children from 0 to 5 years of age who over time have been in close contact with someone who is ill with tuberculosis.
- People with an impaired immune system due to illness (e.g. diabetes, cancer or HIV/AIDS)
- People receiving treatment involving certain types of medications, including medications for chronic intestinal inflammation and gout conditions (TNF-alpha inhibiters, cancer medications or treatment with cortisone preparations).
If you belong to one of these high-risk groups or feel ill as a result of tuberculosis, you must contact a health professional in your municipality as soon as possible. They will consider whether you should be tested now or whether you can wait eight to ten weeks.
Evaluation and diagnosis
If you or your child are experiencing the symptoms of tuberculosis or belong to a high-risk group, contact your GP or healthcare provider in the municipality where you live.
To find out whether it could be tuberculosis, you will be referred from your municipality to the hospital for an X-ray of your lungs and/or IGRA blood test.
If the samples indicate that you need to undergo more tests and examinations or speak to a specialist, you will be referred by the municipality to the hospital again. Getting an appointment at the hospital can take anywhere from a few days to three months once you have been referred from the municipality.
At the hospital, a specialist will examine whether you are infected with tuberculosis or are ill and should be treated. The results of the examinations at hospital can take a long time. Most people can continue to live a normal life while they are waiting for a referral or results of medical tests and examinations.
Treating tuberculosis
Tuberculosis is a treatable disease and most people recover fully.
A tuberculosis coordinator (TB coordinator) (fhi.no, in Norwegian) will monitor your treatment and work with the doctor at the hospital and healthcare professionals in the municipality where you live.
Tuberculosis is treated with medications, usually tablets. Most people will need to take medication every day for six months, but the treatment sometimes takes longer.
It is important that you take your medication as instructed by your doctor. If you stop the treatment too early or forget to take your tablets, the bacteria may become resistant and the medication stop working.
What does the treatment involve?
If your tuberculosis is not infectious, you can stay at home and live normally.
If the doctor suspects that your tuberculosis is infectious, you will have to go into isolation at the hospital. You will have to stay there until your medication has stopped your tuberculosis from being infectious to other people, a process which normally takes two to three weeks. Once you have been discharged from hospital, you will no longer be able to infect other people.
It is important that you take your medication. It is common for a healthcare professional to come to your home with medication every day. This is called directly observed therapy (DOT). In some places, it is possible to meet the healthcare professional via a video link instead. A treatment programme will be set up that is individually tailored to each patient. You can contact your TB coordinator if you have any questions during your treatment.
Rights in connection with tuberculosis
All treatment for tuberculosis is free of charge in Norway. This also applies to medications and wound care equipment.
If you are an asylum seeker or do not have legal residence in Norway, you have the right to remain in Norway until your treatment for tuberculosis has been completed.
The healthcare professional you are in contact with is subject to a duty of confidentiality. You can find out more about confidentiality here.
You can apply for reimbursement for the cost of your travel by car, train or bus for examinations and treatment of your tuberculosis (in Norwegian). In the event of travel by taxi, the doctor will decide whether you are entitled to have your travel expenses covered. Patients without a Norwegian ID number, D number or bank account can have a payment form sent to them in the post.
Peer service for tuberculosis patients
Would you like to talk to someone who has already had tuberculosis? Former tuberculosis patients are available for telephone calls or meetings. These peers are subject to a duty of confidentiality. You can get in touch with a peer on LHL International’s website.