Is tuberculosis contagious?

Written by Xiong Hong Hai
Infectious Disease
Updated on April 05, 2025
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Tuberculosis (TB) is only infectious in some patients who have a large amount of tubercle bacilli in their sputum. In fact, many patients with active pulmonary tuberculosis are not infectious. For more patients with active pulmonary tuberculosis, tubercle bacilli cannot be found in their sputum, so the actual situation must be considered. In fact, to determine if pulmonary tuberculosis is infectious, it is simple: look for acid-fast bacilli in the sputum. If the sputum acid-fast staining is positive, it indicates infectiousness. Infectious pulmonary tuberculosis requires systematic and standardized anti-tuberculosis treatment.

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Does the BCG vaccine prevent tuberculosis?

The BCG vaccine primarily prevents infection by the tuberculosis bacillus, so it can prevent pulmonary tuberculosis. The protective effect of the BCG vaccine is mainly achieved through inducing a cell-mediated immune response. After vaccination, a primary infection is formed, which is processed by macrophages that transmit the antigen information to immune-active cells, leading to the differentiation and proliferation of T cells and the formation of sensitized lymphocytes. When the body is re-infected with the tuberculosis bacillus, the macrophages and sensitized lymphocytes are activated, causing a specific immune response in the body, thereby resisting the infection by the tuberculosis bacillus. Therefore, the BCG vaccine mainly prevents pulmonary tuberculosis.

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What is tuberculosis?

Tuberculosis is a disease where the bacterium Mycobacterium tuberculosis infects the lungs. It is a persistent bacterium that grows slowly. Tuberculosis is an infectious disease and quite common historically, often referred to as consumption in the past, as mentioned in the novels of Lu Xun. In modern times, tuberculosis is relatively manageable if the infection has not developed resistance to drugs. Proper anti-tuberculosis treatment can result in a cure rate exceeding 90% on the first attempt. However, if the treatment is not adhered to correctly—if the patient stops taking the medication prematurely or does not follow the prescribed regimen—the bacteria may develop resistance, reducing the effectiveness of the treatment. This is particularly problematic in elderly patients, who might also experience adverse reactions to tuberculosis medications, making treatment difficult. Thus, while tuberculosis is generally treatable, infections with drug-resistant strains can be fatal if not managed properly.

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Does tuberculosis cause headaches in its initial stage?

Tuberculosis is a highly contagious respiratory disease caused by the infection of Mycobacterium tuberculosis in the lungs, generally transmitted through respiratory droplets or direct contact. When infected with tuberculosis, symptoms that often appear include low-grade fever in the afternoons, coughing, expectoration, hemoptysis, chest pain, chest tightness, and shortness of breath. Some may experience weight loss, fatigue, and night sweats. Therefore, when patients with pulmonary tuberculosis exhibit an afternoon low-grade fever, it often leads to the occurrence of headaches. Therefore, it is very common for patients in the early stages of pulmonary tuberculosis to exhibit various symptoms, primarily due to the rise in body temperature.

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What department should tuberculosis patients visit?

For tuberculosis, you can visit the Department of Infectious Diseases. Infectious diseases or respiratory medicine are suitable options, and if a hospital doesn't have these specialized departments, you can consider visiting the Center for Disease Control. In smaller hospitals, below the secondary level, where such specific departments may not be available, you might also consider seeing the Department of General Internal Medicine. General Internal Medicine or typical internal medicine departments can also handle this. However, our first recommendation would still be the Respiratory Medicine Department. Some hospitals combine Infectious Diseases with other related departments, making them the preferred choice for tuberculosis patients as these departments likely have the most experience in treating such diseases.

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Can people with tuberculosis drink alcohol?

Whether patients with tuberculosis can drink alcohol, first of all, it is important to know that tuberculosis is a chronic infectious disease and a consumptive disease that consumes the body's calories. Drinking alcohol can affect the body's absorption of energy. Moreover, most patients with tuberculosis need to take anti-tuberculosis medication, most of which are metabolized through the liver and can cause varying degrees of liver damage. Drinking alcohol can exacerbate liver damage and reduce the effectiveness of the medication. Additionally, since there are many types of anti-tuberculosis medications for tuberculosis patients, some medications may cause adverse reactions when drinking alcohol. Therefore, all tuberculosis patients must strictly abstain from drinking alcohol during treatment.