Q: I am a 28 years old male suffering from mild tuberculosis (fibrosis of lungs). I am searching for a job right now and unable to clear the medical tests due to TB. I am undergoing proper treatment and can work for 12 hours at a stretch. I do not feel weakness anymore. Do companies reject candidates out rightly on such medical grounds or do they consider the treatment progress? For how long will my chest X-ray show the signs of TB? How long will I take to get treated completely?

A:Tuberculosis is a treatable infectious disease, which is curable with appropriate medications when they are taken regularly for the full treatment duration. The response to treatment depends upon the site of affection (lungs or other organs), the stage of the disease at diagnosis and at initiation of treatment, the immunity of the affected person, and most importantly on the adherence to treatment recommendations from a qualified chest physician. Failure to adhere to treatment recommendations or non-compliance may lead to poor response to treatment, development of complications from the disease, and drug resistant tuberculosis. The duration of treatment depends on the site of the body affected, and may have to be prolonged depending on clinical response and adherence to anti-tuberculosis medications. In most cases of drug sensitive pulmonary tuberculosis, without any complications or underlying defect in the immunity (from other infections such as HIV or due to other treatment or disease related causes) a minimum of 6 months of treatment is required.

There is a need to monitor the response to the treatment through regular clinical examination by doctors, reviewing adherence to medications, monitoring for side effects arising from anti-tuberculosis therapy, and relevant laboratory investigations. The occupational health implications of a positive tuberculosis (TB) diagnosis are significant since the disease can lead to diminished performance/productivity, increase sickness related absenteeism from work, besides creating a danger by being a potential source of infection to other staff, clients, and visitors. However with appropriate therapy most individuals become non-infectious within a couple of weeks of therapy. However, every case must be judged within the context of their unique work environment and needs of the specific job. For instance, the occupational health recommendations for a health care worker (doctor or nurse) with TB is quite different compared to that involving a lone worker in an IT company, or a labourer involved in heavy physical work. The radiological changes seen on chest X-ray or CT scan may persist for a variable period of time depending on the initial degree of involvement, presence of complications (for example lung abscess or cavity development), immunity of the affected person, drug sensitivity or resistance of the TB bacteria causing the infection. I suggest you consult an appropriate chest physician for specific queries related to your problems. You may also wish to seek advice from relevant occupational health doctors (if available) for advice regarding employment rights (sick leave, pay, infection control), work restrictions, and eligibility for other jobs. The suitability for a specific job is generally judged not just by persistence of chest X ray changes but the overall clinical picture which would include state of general health, clinical examinations findings, relevant laboratory tests (such a sputum examination). I wish you all the best for a speedy recovery and future employment opportunities.