Health Care Workers and Tuberculosis

Health Care Workers and Tuberculosis
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How can I protect myself from tuberculosis infection?

It’s important to know which patients might have tuberculosis (also known as “TB”). You could catch this disease by breathing in droplets that get into the air when infected people cough. Infected patients may have symptoms such as a chronic cough (lasting for weeks and bringing up mucus or blood), weight loss, fever or night sweats. If you work around any infected patients, wear a protective mask. Have the patients wear a mask and isolate them from other patients. For example, remove them from the waiting room in an office setting, or put them in isolation in the hospital setting.

You can also reduce the risk of contracting tuberculosis by eating healthy, getting enough sleep and exercising regularly, all of which keep your immune system healthy.

How will I know if I have contracted tuberculosis?

As a health care worker, you should have a tuberculosis skin test once or twice a year. The test determines whether you have been infected by the bacteria that causes tuberculosis, but it won’t tell you whether you have an active infection. If you have any illnesses or take certain medicines, you may need to have additional skin tests to get accurate results.

What does a positive tuberculosis skin test mean?

If you have a positive reaction to the tuberculosis skin test, it usually means that you have been infected by tuberculosis bacteria. However, there is a more than 90% chance that your body’s immune system has suppressed the infection. When the immune system does its job, TB often stays dormant for years. Unfortunately, it can eventually change into an active infection that can damage your health and body organs such as the lungs.

To prevent an active infection, you will need to be treated. After a positive skin test, you will most likely have a chest X-ray to make sure that you don’t have an active tuberculosis infection. If your X-ray is negative and your skin test reaction is recent, you may be given an antituberculous medicine for 6 to 9 months. This medicine is used to prevent any activation of the infection in the future. You are not infectious to others unless you have active tuberculosis that has not yet been treated.

A negative skin test means that you have not picked up the bacteria (unless you are HIV positive or otherwise immunosuppressed).

What does it mean to have active tuberculosis?

If you have a positive skin test and an abnormal chest radiograph or symptoms of tuberculosis, you’ll be treated for active tuberculosis. When you’re diagnosed with active TB, you’re infectious to others. You may be treated with 3 or 4 medicines for 9 to 12 months. You’ll need to take precautions with your family and other people you are in close contact with. You’ll also be kept out of work until you’re no longer infectious, which usually takes a few weeks. Active tuberculosis is much less common than a tuberculosis infection, which your immune system can suppress on its own.

If I had bacille Calmette-Guérin (BCG) vaccine, do I need to have a skin test?

Yes, you should still have a skin test. The BCG vaccine is not 100% protective, so you could still get tuberculosis. This vaccine is not generally recommended for most health care workers. The vaccine can cause a mild positive reaction to the tuberculosis skin test. Usually, this reaction becomes less severe over time. If your result becomes more severe, you may have been infected with tuberculosis and will need to be treated.

What should I do if I learn that a patient I cared for had active tuberculosis?

If you are exposed to a patient who has active tuberculosis, you should have a baseline tuberculosis skin test (unless you recently had your yearly tuberculosis test). This is especially important if the disease wasn’t recognized, the infected patient was not isolated or masks were not used. A follow-up test in 3 months will show if the exposure resulted in infection.

If I have a positive skin test, should I continue to be tested?

Once you have had a positive skin test, you shouldn’t continue to have skin tests. It’s necessary to rely on symptoms to determine if you have active tuberculosis. You should get a chest X-ray if you have a cough lasting for 2 to 3 weeks, if you are bringing up mucus with blood in it, if you have fever or weight loss. Routine yearly chest X-rays are not usually necessary.

If I have a positive tuberculosis skin test, should I continue to use precautions?

Some people think that once they’ve been infected with the bacteria that causes tuberculosis, they don’t need to take precautions or wear a mask when dealing with tuberculosis patients. However, there have been a few instances of people being reinfected with a new tuberculosis strain, so you should continue to take precautions.