Health Care Workers and Tuberculosis

As part of their job, health care workers are exposed to many diseases. Tuberculosis, also known as TB, is one of these. It’s important to know if a patient has, or may have, TB. Health care workers also need to know how to prevent, recognize, and treat the condition.

Path to safety

People who have TB can have the following symptoms:

• Chronic cough that lasts 3 weeks or longer.
• Cough that brings up mucous or blood.
• Chest pain.
• Fever.
• Tiredness.
• Chills and night sweats.
• Loss of appetite and weight loss.

When people with TB cough, they release bacteria as droplets into the air. You can catch tuberculosis by breathing in these droplets. If you work around infected patients, wear a protective mask. Patients also should wear a mask to protect others. In a doctor’s office setting, remove infected patients from the waiting room. In a hospital, put them in isolation.

Overall, you also can reduce your risk of getting TB by keeping your immune system healthy. Eat healthy, get rest, and exercise regularly.

Testing for TB

If you work in health care or are at risk for getting TB, you also should have a tuberculin skin test (TST) once or twice a year. This test shows if you carry the bacteria that causes TB. Workers in certain areas may need TSTs more often. Ask your employer if you have questions. Talk to your doctor about any medicines you take or conditions you have.

A negative reaction to the test usually means you don’t have the bacteria. If you test positive, you likely have tuberculosis. However, the infection can be inactive or active. Inactive TB means that bacteria are present in your body but are dormant. Your body’s immune system can suppress TB for years. You aren’t contagious unless you have active TB that hasn’t been treated.

What if I have TB?

TB in your body can become active at any time. To prevent an active infection, you need treatment. First, your doctor will order a chest X-ray. This checks to see if the infection is active. If it’s not active, the doctor may prescribe an antituberculosis medicine for 6 to 9 months. This medicine helps prevent the infection from activating in the future.

If the X-ray shows the infection is active, your doctor will treat you for active TB. He or she may give you 3 or 4 medicines to take for 9 to 12 months. At this point, you’re contagious. You’ll need to take precautions to avoid spreading the infection. Your doctor will keep you out of work until the antibiotics kick in. This can take several weeks, depending on your overall health. It’s very important to finish all the medicine your doctor prescribes for you. Not following the entire treatment plan can mean the infection doesn’t get fully treated. This can lead to a form of drug-resistant TB, which means many medicines will no longer work to treat it.

Once you’ve had a positive TST, you don’t need to be retested. You can rely on symptoms to decide if you have active tuberculosis. If you have a lasting cough or other symptoms, contact your doctor. They will order a chest X-ray to diagnose active TB.

Things to consider

There are several strains of tuberculosis. If you’re infected, you still need to take precautions around patients with TB. This way, you don’t catch a different strain.

If you’ve had the Bacille Calmette-Guérin (BCG) vaccine, you can get TB. Therefore, you still should receive skin tests. This vaccine is not generally recommended for health care workers. It can cause a mild positive reaction to the skin test. Usually, the reaction becomes less severe over time. If your result worsens, you may have TB and will need treatment.

Questions for your doctor

• In addition to protective gear and testing, what else should I do if I’m caring for someone who has TB?
• If I’m infected with TB, will I always have it?
• What are the side effects of medicines used to treat TB?

Resources

United States Department of Labor, Occupational Safety and Health Administration:  Tuberculosis