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** Evaluate for active TB disease with a chest x-ray, symptom screen, and if indicated, sputum AFB smears, cultures and nucleic acid amplification testing. A negative TST or IGRA does not rule out active TB disease.
Persons with TB disease are most likely to spread the bacteria to other people they spend time with every day, such as family members or coworkers. Anyone who has been around someone who has TB disease should go to the doctor or local health department for TB tests.
Persons with Medical Conditions that Weaken the Immune System HIV infection (the virus that causes AIDS) Substance abuse. Silicosis. Diabetes mellitus. Severe kidney disease. Low body weight. Organ transplants. Head and neck cancer.
The droplets containing the bacteria must be inhaled for the infection to spread from one person to another. This means that being near someone with TB disease when they cough, sneeze, or even talk close to your face for an extended period of time puts you at risk for infection.
Between 20 to 30% of people exposed to a person with active TB become infected. For that reason, doctors usually distinguish between infection (or a positive TB test) and an active infection. After you are infected, your immune system will attack the bacteria.
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In a person who is newly infected, the skin test usually becomes positive within 4 to 10 weeks after exposure to the person who is ill with TB. (See Tuberculosis infection (latent tuberculosis) in adults: Approach to diagnosis (screening).)
What to Do If You Have Been Exposed To TB. If you think you have been exposed to someone with TB disease, you should contact your doctor or local health department about getting a TB skin test or a special TB blood test. Be sure to tell the doctor or nurse when you spent time with the person who has TB disease.

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