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III. What are the important facts that Healthcare Workers need to know about Tuberculosis? A. Background Tuberculosis is an infectious disease caused by bacteria, which is spread from person to person through the air. The infected person (source) exhales germs into the air and another person (host) inhales them, usually after close and prolonged contact. The risk of TB increases with age and underlying diseases such as Diabetes, AIDS, and other diseases that cause immunosuppression. TB is a curable disease. Health Care Workers are at risk when a patient with TB of the lung or larynx has not yet been identified and Infection Control Precautions are not in place. B. Tuberculosis 1. Most common symptoms Commonly seen symptoms include night sweats, weight loss, fever, fatigue, frequent coughing, and coughing up blood. 2. Diagnostic tests Tests commonly used to diagnose TB include PPD skin testing, Chest X rays, and cultures from sputum specimens 3. TB treatment Most people with TB must take anti TB medications for 6 to 12 months. They may need to take as many as 5 different anti TB drugs and some vitamins. The contagious period depends on the patients’ response to treatment. It may be as short as two weeks or may be longer based on the results of sputum tests, X rays, and decreasing symptoms. C. Prevention of transmission of TB 1. Patients identified with suspected or confirmed TB must be placed in a private room with negative pressure ventilation according to the requirements for Airborne Precautions. Doors and windows must be kept closed and visitors should be limited to immediate family members. D. Healthcare Worker Safety 1. Possibility of acquiring active TB If a HCW becomes infected after exposure to TB, he/she will develop a positive skin test result (PPD). This is identified as infection but is Not Active TB Disease. Preventive treatment may be recommended as a result of the positive skin test. Treatment decisions are made by a qualified physician and are based on the individual’s age, health status, and current recommendations for TB preventive therapy. Each individual is unique and treatment must be planned accordingly. The risk of developing active disease after PPD conversion is 1% in the first year and only 10% over a lifetime. E. TB Education 1. OSHA requires healthcare employers to provide TB education annually The education is to include the nature, extent and hazards of TB in that institution, job risks for exposure to TB, possibility of acquiring active TB, treatment of TB, engineering controls in place (masks, negative pressure), the selection, fitting, testing, and policies for TB masks, and the OSHA requirements. 2. Patient and family education Patients are taught techniques to control spread such as coughing into a tissue, wearing a snug fitting mask when out of the isolation room, taking medications exactly as instructed and for as long as instructed, reporting for checkups, and avoiding travel and crowds until declared noninfectious. IV. Conclusion In today’s complex health care world, it still remains essential to practice the simplest form of infection control: HAND WASHING. In addition, it is prudent to keep abreast of current literature regarding the scientific studies and recommendations for ways to prevent the transmission of infectious diseases. Learning, however, is just the beginning. We, as health care professionals need to apply our knowledge in daily practice.
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