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 which patients have or may have TB. You also need to know how to prevent, recognize, and treat the condition.

Path to safety

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

Symptoms of TB include:

  • 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.

You also can reduce your risk of TB by keeping your immune system healthy. Be sure to eat healthy, get rest, and exercise regularly.

Health care workers should have a tuberculin skin test (TST) once or twice a year. This test shows if you carry the bacteria that cause TB. Workers in certain areas may need TSTs more often. 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 have caught 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 are not contagious unless you have active TB that hasn’t been treated.

Unfortunately, TB 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 yet. If the X-ray is negative, 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 is positive, the doctor will treat you for active TB. They may give you 3 or 4 medicines to take for 9 to 12 months. At this point, you are contagious. You’ll need to take precautions to avoid spreading the infection. The doctor will keep you out of work until the antibiotics kick in. This can take several weeks, depending on your overall health. It is very important to finish all of the medicine your doctor prescribes for you. Not following the entire treatment plan can mean the infection does not get fully treated. This can lead to a form of drug-resistant TB, which means that 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 to ask your doctor

  • In addition to protective gear and testing, is there anything else I should 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?