Tuberculosis Elimination

Interactive Disease Data

Information for Individuals

Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis. TB most often affects the lungs, but the bacteria can also affect other parts of the body, including the kidneys, spine, and brain.

TB spreads through the air when a person with infectious TB disease in their lungs or throat coughs, speaks, or sings. When someone breathes in the TB bacteria, the bacteria can enter the lungs and begin to grow. TB in the lungs and throat can be infectious, while TB in other parts of the body is usually not.

Not everyone who is infected with TB bacteria becomes sick. Because of this, there are two TB-related conditions: TB infection (TBI) and TB disease. People with TB infection are not sick and cannot spread TB to others, but they may develop TB disease in the future. TB disease can be serious and may be fatal if not treated properly.

This section provides information to help you understand how TB spreads, what symptoms look like, and how testing and treatment can protect you and your community.

TB Disease

TB bacteria become active when the immune system is unable to stop them from growing. When the bacteria become active, they begin multiplying in the body and cause TB disease. Some people develop TB disease soon after infection, while others become sick later if their immune system becomes weakened.

Who Is at Higher Risk for TB Disease?

Some individuals are more likely to develop TB disease because they have weakened immune systems. This includes:

• Babies and young children
• People living with HIV, the virus that causes AIDS
• People with:
  • Substance use disorders
  • Diabetes mellitus
  • Silicosis
  • Cancers of the head or neck
  • Leukemia or Hodgkin’s disease
  • Severe kidney disease
  • Low body weight
• People receiving certain medical treatments, such as long-term steroid therapy or organ transplants

A weakened immune system makes it harder for the body to control TB bacteria, increasing the chance that TB infection will progress to TB disease.

Symptoms of TB Disease

Symptoms depend on where in the body the TB bacteria are growing. TB most often affects the lungs. Lung TB (pulmonary TB) may cause:

• A cough that lasts longer than two weeks
• Chest pain
• Coughing up blood or sputum (phlegm from deep in the lungs)

Other symptoms of TB disease can include:

• Weakness or fatigue
• Weight loss
• Loss of appetite
• Chills or fever
• Night sweats

If you have symptoms of TB disease, you should contact your health care provider or local health department as soon as possible.

To learn more about TB disease, visit the CDC Active TB Disease.

Testing for TB

Some people are at higher risk for tuberculosis (TB) infection and should be tested. TB testing helps identify infection early so individuals can receive treatment and prevent the spread of disease.

Who Should Be Tested for TB Infection?

People with a higher risk for TB infection include:

• Individuals who have spent time with someone who has TB disease
• People born in, or who frequently travel to, countries where TB is common (including most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia)
• People who live or work in high-risk settings such as correctional facilities, long-term care facilities or nursing homes, and homeless shelters
• Health care workers who care for individuals at increased risk for TB disease
• Infants, children, and adolescents who have been exposed to adults at increased risk for TB infection or TB disease

Risk Assessment Before Testing

Before testing, a health care provider will assess your risk for TB infection.

• If you are low risk, testing may not be necessary.
• If you are at high risk, your provider may recommend testing.

TB testing should be completed with the intention to treat TB infection if the test result is positive.

Types of TB Tests

There are two commonly used tests for TB infection:

• Interferon-gamma release assay (IGRA) – a blood test
• Mantoux tuberculin skin test (TST) – a skin test

A health care provider will help determine which test is best for you.

For more information about TB infection testing, visit: https://www.cdc.gov/tb/testing/. 

How is TB Disease Treated?

TB disease can almost always be cured with the right medicine. It is important to take all medicine exactly as prescribed by your health care provider to ensure the treatment works.

Medicines Used to Treat TB Disease

People with TB disease need to take several medicines to kill all the TB bacteria and prevent drug resistance. The most common medicines include:

• Isoniazid (INH)
• Rifampin
• Pyrazinamide
• Ethambutol
• Streptomycin

Your health care provider will determine the right combination of medicines for your treatment.

Staying Home While Infectious

If you have TB disease in your lungs or throat, you may be infectious and able to spread TB bacteria to others. You may need to stay home from work, school, and public activities until you are no longer infectious. Most people are no longer infectious after taking TB medicine for several weeks.

Your doctor or nurse will tell you when it is safe to return to normal activities.

Living Your Life During Treatment

Having TB disease should not prevent you from living a normal life. Once you are no longer infectious and are feeling better, you can resume your usual daily activities. TB medicines do not normally affect your strength, sexual function, or ability to work.

Completing your full course of treatment is the best way to ensure all TB bacteria are killed and to prevent getting sick again.

TB Infection

Not everyone infected with TB bacteria becomes sick. Because of this, there are two TB-related conditions: TB infection and TB disease.

What is TB Infection?

TB infection occurs when TB bacteria are present in the body but are not causing illness. In most people who breathe in TB bacteria, the immune system is able to stop the bacteria from growing.

People with TB infection:

• Have no symptoms
• Do not feel sick
• Cannot spread TB bacteria to others
• Usually have a positive TB skin test or positive TB blood test
• May develop TB disease in the future if they do not receive treatment

Why Treat TB Infection?

Many people with TB infection never develop TB disease. The bacteria can remain inactive for a lifetime without causing harm.

However, in some people—especially those with weakened immune systems—TB bacteria can become active, multiply, and cause TB disease. Treating TB infection greatly reduces the chance of developing TB disease later in life.

TB Infection Treatment

Treating TB infection is the best way to prevent TB disease. While many people with TB infection never become sick, some individuals are at higher risk of progressing to TB disease if they do not receive treatment.

Who Is at Higher Risk for Developing TB Disease?

People at higher risk include:

• Individuals with HIV infection
• People infected with TB bacteria within the last two years
• Babies and young children
• People who inject drugs
• Individuals with medical conditions that weaken the immune system
• Older adults
• People who were not treated correctly for TB disease in the past

Why Treat TB Infection?

If you have TB infection, taking medicine can stop you from developing TB disease in the future. This is called treatment for TB infection (also known as latent TB infection treatment).

There are several treatment options available. You and your health care provider will work together to decide which treatment is best for you.

During Treatment

It is important to take all medication exactly as prescribed to ensure treatment is effective.
During treatment, you will see your doctor or nurse regularly so they can check your progress and make sure you are responding well to the medicine.

If You Do Not Receive Treatment

People with TB infection who do not receive treatment should know the symptoms of TB disease. If symptoms develop later—such as a cough lasting more than two weeks, chest pain, fever, night sweats, or weight loss—they should contact a health care provider right away.

TB Program Contact Information

Use the list below to find contact information for local and regional TB Control and Elimination Programs across Tennessee. If you need testing, treatment, or more information about TB, please contact the office nearest to you.

TB Program Contacts

Chattanooga / Hamilton County TB Control
921 E. 3rd Street, Chattanooga, TN 37403
Phone: 423-209-8030
Program website: https://health.hamiltontn.org/en-us/services/tuberculosiscontrol.aspx

Jackson / Madison County TB Program
804 N. Parkway, Jackson, TN 38305
Phone: 731-423-3020
Program website: https://www.madisoncountytn.gov/190/Tuberculosis-Services

Memphis / Shelby County TB Control and Elimination Program
814 Jefferson Avenue, Room 111, Memphis, TN 38105
Phone: 901-222-9664
Program website: https://www.shelbytnhealth.com/188/Tuberculosis-Control-Elimination-Program

Nashville / Davidson County TB Elimination Program
2500 Charlotte Avenue, Suite 100, Nashville, TN 37209
Phone: 615-340-5650
Program website: https://www.nashville.gov/departments/health/clinical-health-services/tuberculosis-elimination-program

Information for Health Care Professionals (HCPs)

This section provides clinical guidance and resources for health care professionals involved in diagnosing, reporting, and managing tuberculosis in Tennessee, including reporting requirements, laboratory information, program contacts, and screening recommendations.

Reporting Requirements

Health care professionals in Tennessee are required to report both tuberculosis (TB) infection (“latent TB infection”) and suspected or confirmed active TB disease to the Tennessee Department of Health. Timely reporting helps ensure rapid public health response, appropriate treatment, and effective contact investigation.

Reporting timeframes include:

• Suspected or confirmed active TB disease
  • Must be reported by telephone within one business day
  • A completed PH-1600 form must be submitted within one week
• TB infection (latent TB infection)
  • A completed PH-1600 form must be submitted within one week

How to Report

Health care professionals can report TB cases using the resources provided by the Tennessee Department of Health. Instructions, required forms, and reporting methods are available online.

Reporting Resources:

• Tennessee Reportable Diseases Website

• How to Report for Health Care Providers (PDF) (2020)

These resources provide step-by-step instructions and required information for submitting TB reports in Tennessee.

Laboratory

This section provides laboratory guidance and technical resources to support testing, diagnosis, and management of tuberculosis (TB) and other mycobacterial infections in Tennessee.

Laboratory Resources

External links and accessibility notice:
Some of the resources listed below link to external websites not managed by the Tennessee Department of Health (TDH). TDH is not responsible for the content, accessibility, or privacy practices of these external sites.

CDC: TB Laboratory Guidance

Acid-Fast Bacilli (AFB) & Mycobacterium Guidance (PDF) (2020)

Mycobacterium Isolation Procedures Guidance (PDF) (2021)

Mycobacterium tuberculosis Culture Guidance (PDF) (2021)

Mycobacterium leprae Laboratory Guidance (PDF) (2020)

NTCA/APHL Consensus Statement on GeneXpert Testing for TB (PDF)

TB Program Contact Information

Use the list below to find contact information for local and regional TB Control and Elimination Programs across Tennessee. If you need testing, treatment, or more information about TB, please contact the office nearest to you.

TB Program Contacts

Chattanooga / Hamilton County TB Control
921 E. 3rd Street, Chattanooga, TN 37403
Phone: 423-209-8030
Program website: https://health.hamiltontn.org/en-us/services/tuberculosiscontrol.aspx

Jackson / Madison County TB Program
804 N. Parkway, Jackson, TN 38305
Phone: 731-423-3020
Program website: https://www.madisoncountytn.gov/190/Tuberculosis-Services

Memphis / Shelby County TB Control and Elimination Program
814 Jefferson Avenue, Room 111, Memphis, TN 38105
Phone: 901-222-9664
Program website: https://www.shelbytnhealth.com/188/Tuberculosis-Control-Elimination-Program

Nashville / Davidson County TB Elimination Program
2500 Charlotte Avenue, Suite 100, Nashville, TN 37209
Phone: 615-340-5650
Program website: https://www.nashville.gov/departments/health/clinical-health-services/tuberculosis-elimination-program

Screening Recommendations

Targeted TB screening helps identify individuals at higher risk for tuberculosis (TB) infection or TB disease. Health care professionals should assess risk, use appropriate testing methods, and partner with public health agencies to ensure timely evaluation and treatment.

Screening in Correctional Facilities

Correctional facilities are high-risk settings for TB transmission. Effective TB prevention and control in these environments includes:

• Early identification of people with TB disease through screening at entry and during routine follow-up
• Successful treatment of TB disease and latent TB infection (LTBI)
• Appropriate airborne precautions, including airborne infection isolation, environmental controls, and respiratory protection
• Comprehensive discharge planning to ensure continuity of care when individuals leave the facility
• Thorough and efficient contact investigations when a TB case is identified

These activities should be carried out in close collaboration with local and state health department TB programs and other key partners. Ongoing education for incarcerated individuals, detainees, and correctional facility staff is essential to support cooperation and adherence to TB prevention practices. Regular program evaluation should be conducted to ensure TB control measures remain effective.

Long Term Care Facilities

Effective TB prevention and control measures in nursing homes:

• Early identification of persons with TB disease through entry and periodic follow-up screening;
• Successful treatment of TB disease and latent TB infection;
• Appropriate use of airborne precautions (e.g., airborne infection isolation, environmental controls, and respiratory protection);
• Comprehensive discharge planning; and
• Thorough and efficient contact investigations when a TB case has been identified.

These measures should be instituted in close collaboration with local or state health department TB-control programs and other key partners. To ensure TB prevention and control measures are effective, periodic program evaluation should be conducted.

Prevention and Control of Tuberculosis in Facilities Providing Long-Term Care to the Elderly Recommendations of the Advisory Committee for Elimination of Tuberculosis

Screening for Tuberculosis and Tuberculosis Infection in High-Risk Populations Recommendations of the Advisory Council for the Elimination of Tuberculosis

Correctional Facility TB Resources

External links and accessibility notice:
Some of the resources listed below link to external websites not managed by the Tennessee Department of Health (TDH). TDH is not responsible for the content, accessibility, or privacy practices of these external sites.

National Tuberculosis Controllers Association – CorrectTB

Southeastern National Tuberculosis Center – Corrections Resources

CDC: Prevention and Control of Tuberculosis in Correctional and Detention Facilities

Glossary

Review definitions of key terms, abbreviations, and acronyms related to tuberculosis and public health. This glossary is designed to make TB information easy to understand for all readers.

TB disease – an illness in which TB bacteria are multiplying and attacking a part of the body, usually the lungs. The symptoms of TB disease include weakness, weight loss, fever, no appetite, chills, and sweating at night. Other symptoms of TB disease depend on where in the body the bacteria are growing. If TB disease is in the lungs (pulmonary TB), the symptoms may include a bad cough, pain in the chest, or coughing up blood. A person with TB disease may be infectious and spread TB bacteria to others.

BCG – a vaccine for TB named after the French scientists who developed it, Calmette and Guérin. BCG is rarely used in the United States, but it is often given to infants and small children in other countries where TB is common.

Chest X-ray – a picture of the inside of your chest. A chest X-ray is made by exposing a film to X-rays that pass through the chest. A doctor can look at this film to see whether TB bacteria have damaged the lungs.

Contact – a person who has spent time with a person with infectious TB.

Culture – a test to see whether there are TB bacteria in your phlegm or other body fluids. This test can take 2 to 4 weeks in most laboratories.

Directly observed therapy (DOT) – a way of helping patients take their medicine for TB. If you get DOT, you will meet with a health care worker every day or several times a week. You will meet at a place you both agree on. This can be the TB clinic, your home, work, or any other convenient location. You will take your medicine while the health care worker watches.

Extensively drug-resistant TB (XDR TB) - XDR TB is a rare type of TB disease that is resistant to nearly all medicines used to treat TB.

Extrapulmonary TB – TB disease in any part of the body other than the lungs (for example, the kidney, spine, brain, or lymph nodes).

HIV infection – infection with the human immunodeficiency virus, the virus that causes AIDS (acquired immunodeficiency syndrome). A person with both latent TB infection and HIV infection is at a very high risk for developing TB disease.

Isoniazid (INH) – a medicine used to prevent TB disease in people who have latent TB infection. INH is also one of the four medicines often used to treat TB disease.

TB infection (also known as Latent TB Infection) – a condition in which TB bacteria are alive, but inactive in the body. People with TB infection have no symptoms, don't feel sick, can't spread TB to others, and usually have a positive TB skin test or positive TB blood test reaction. But they may develop TB disease if they do not receive treatment for latent TB infection.

Multidrug-resistant TB (MDR TB) – TB disease caused by bacteria resistant to two of the most important medicines: INH and RIF.

Mycobacterium tuberculosis – bacteria that cause latent TB infection and TB disease.

Negative – usually refers to a test result. If you have a negative TB skin test reaction or a negative TB blood test reaction, you probably do not have TB infection.

Positive – usually refers to a test result. If you have a positive TB skin test reaction or a positive TB blood test reaction, you probably have TB infection.

Pulmonary TB – TB disease that occurs in the lungs, usually producing a cough that lasts 3 weeks or longer. Most TB disease is pulmonary.

Resistant bacteria – bacteria that can no longer be killed by a certain medicine.

Rifampin (RIF) – one of the four medicines often used to treat TB disease. It is considered a first-line drug.

Rifapentine (RPT) – one of two medicines used to treat latent TB infection.

Smear – a test to see whether there are TB bacteria in your phlegm. To do this test, lab workers smear the phlegm on a glass slide, stain the slide with a special stain, and look for any TB bacteria on the slide. This test usually takes 1 day to get the results.

Sputum – phlegm coughed up from deep inside the lungs. Sputum is examined for TB bacteria using a smear; part of the sputum can also be used to do a culture.

TB blood test – a test that uses a blood sample to find out if you are infected with TB bacteria. The test measures the response to TB proteins when they are mixed with a small amount of blood. Examples of these TB blood tests include QuantiFERON®-TB Gold In-tube (QFT-GIT) and T-Spot®.TB test.

TB disease – an illness in which TB bacteria are multiplying and attacking a part of the body, usually the lungs. The symptoms of TB disease include weakness, weight loss, fever, no appetite, chills, and sweating at night. Other symptoms of TB disease depend on where in the body the bacteria are growing. If TB disease is in the lungs (pulmonary TB), the symptoms may include a bad cough, pain in the chest, and coughing up blood. A person with TB disease may be infectious and spread TB bacteria to others.

TB skin test – a test that is often used to find out if you are infected with TB bacteria. A liquid called tuberculin is injected under the skin on the lower part of your arm. If you have a positive reaction to this test, you probably have TB infection. Other tests will be needed to find out if you have latent TB infection or TB disease.

Tuberculin or PPD – a liquid that is injected under the skin on the lower part of your arm during a TB skin test. If you have latent TB infection, you will probably have a positive reaction to the tuberculin.

Tuberculosis Cases and Rates by Public Health Region and County

Each year's data is released the following March 24th