“If you can breathe, you can get TB”: RHHD takes on tuberculosis 

Sunday, March 24, is World TB Day. On World TB Day, public health workers commit to educating our communities about tuberculosis, an airborne bacterial infection that can lead to serious disease and death if it goes untreated.

At RHHD, we have a TB team committed to education and care! The team includes Public Health Nurses Rosalie Bieda and Kenneth Brown and Outreach Worker Mehrima Matrood. They work with TB screening, testing, and treatment across Richmond and Henrico.

With almost 48 combined years of experience at RHHD, Rosalie, Kenneth, and Mehrima have seen and heard it all when it comes to TB. Ahead of World TB Day, they share a few of the TB facts they wish more residents knew:

While there are clear risk factors for TB, anyone can get it.  

Some people are at higher risk for developing tuberculosis. Risk factors might include being exposed to someone who has active TB; spending time in a country where TB is common; or living or working in a congregant setting like a nursing home, a homeless shelter, or a prison.

TB risk assessments can help healthcare workers know if a TB test is a good idea. In Richmond and Henrico, TB experts work closely with RHHD’s refugee clinic to make sure that people coming from countries with a high TB burden are able to access the care they need easily.

While it’s important to make sure that populations most at risk for TB can receive testing and treatment, Rosalie wants people to know that TB is not just limited to one community or type of individual: “I’ve had patients from all backgrounds. I’ve had doctors with TB, teachers with TB, blue collar workers, anyone.” Recognizing this fact will lessen stigma around the illness, which can lead to a reluctance to get tested or treated.

“People often think [TB only impacts] poor people or people who are not from the U.S.,” Mehrima says. “But if you can breathe, you can get TB.”

TB actually shows up in two stages: latent and active.  

TB experts distinguish between a latent TB infection—which can cause no symptoms and will not show up on something like a chest X-ray—and active TB disease, which causes serious symptoms and is contagious.

Rosalie encourages people who test positive for latent TB to begin preventive treatment: “If you don’t treat, you have about a 10% chance of developing active TB disease and at that point, treatment is non-optional. It’s always easiest to treat the infection rather than the disease.”

Kenneth adds that treating latent TB is critical because we can’t always predict when our immune systems will face challenges: “Your immune system is what keeps TB latent, so I tell folks, ‘If you get a bad case of COVID, you’ll be dealing with COVID and an active case of tuberculosis. Whatever can compromise your immune system can cause TB to become active.’”

TB care doesn’t end with testing and diagnosis.  

Kenneth says that “TB is one of the more treatable diseases, unless it’s a drug resistant form. Once you get people on a therapy, they usually improve quickly.” Health departments are often the primary point of contact for tuberculosis cases because not all doctors have this specialty and because medications to treat active TB can be really expensive.

Community partners like Daily Planet Health ServicesCrossover Health Ministry, and The Healing Place now help treat latent TB for patients. When active TB disease is diagnosed, health departments like RHHD will get involved to lead contact tracing and to make sure that anyone exposed to active TB can be tested and offered treatment.

RHHD also works with clients to manage the long, necessary cycle of antibiotics. People on treatment for active TB participate in directly observed therapy, which means that someone is with you while you take your medication each day.

At RHHD, this person is Mehrima. As an outreach worker, she visits people at their homes and helps them navigate not only medication but also life challenges that might make staying on medication difficult. “Our job is to make sure people take their medicine, and in order for them to do that, they need food, they need housing,” Mehrima explains. VDH provides funding for social support for TB patients, and she connects clients to other services, too.

Mehrima often works with clients who may be unhoused or working complicated hours, so she adjusts her schedule to get to them daily. And because she sees patients for six months or a year at a time, she builds a lot of trust and connection: “I have clients who still talk to me 18 or 19 years later after a case finishes!”

The number one thing you can do? Learn the symptoms.  

Mehrima suspects that many people don’t get tested for TB because they mistake their symptoms for a respiratory illness: “People think, ‘I have a cold, I have pneumonia, I have the flu, but nobody thinks, ‘oh, I’m sick, I might have TB.’” If you’re experiencing symptoms like a lingering cough, night sweats, chest pain, or fatigue, you might want to ask your care provider if a TB risk assessment or test is a good next step.

Kenneth also cautions that TB isn’t just a disease of the lungs: “It can spread to other parts of your body. Someone might get a pain in their hip, their spine, their brain, and it doesn’t go away no matter what they try. In that case, you might need to check for TB.”

If you or a loved one are experiencing TB-related symptoms, or you have questions about travel or occupational risks, get in touch with RHHD’s TB team by calling 804-205-3501.