Medical Center Occupational Health Basics-Tuberculosis Handouts

Tuberculosis Handouts
Pdf Summary
In this document, Dr. Wendy Thanassi provides a comprehensive guide to TB (tuberculosis) testing in healthcare workers (HCWs). TB is a disease that has two conditions: latent TB infection and TB disease. People with TB disease are sick and can spread TB germs, while those with latent TB infection do not feel sick and cannot spread the germs. However, if the infection becomes active, it can develop into TB disease. Many people in the US have latent TB infection and are at risk of developing TB disease without treatment.<br /><br />TB disease can cause symptoms such as night sweats, fever, chills, weakness or fatigue, weight loss, loss of appetite, cough lasting longer than 3 weeks, pain in the chest, and coughing up blood or phlegm from the lungs.<br /><br />Latent TB infection can become active TB disease in people who have recently been infected with TB germs or have medical conditions that weaken the immune system. These conditions include HIV infection, substance abuse, certain treatments for rheumatoid arthritis or Crohn's disease, organ transplants, severe kidney disease, head or neck cancer, diabetes, corticosteroids use, silicosis, and low body weight.<br /><br />The document also provides information on the incidence of TB in different countries and the number of TB cases in healthcare workers. It highlights that healthcare workers have a low risk of TB compared to the general public, with a small percentage of TB cases occurring among them.<br /><br />The guide discusses the different tests used for TB screening, including the tuberculin skin test (TST) and interferon gamma release assays (IGRAs) such as QuantiFERON (QFT). It explains the limitations of the TST, including its inaccuracy, subjectivity, and poor patient compliance, and emphasizes the advantages of IGRAs.<br /><br />The document also discusses the use of IGRAs in serial testing and their role in identifying TB reversion. It highlights the importance of not routinely testing healthcare workers for TB unless there is known exposure or evidence of ongoing transmission.<br /><br />The guide provides information on LTBI (latent TB infection) treatment options, including the use of a 3HP regimen (isoniazid and rifapentine) as a preventive therapy for TB.<br /><br />Finally, the document emphasizes that there is a low prevalence of TB in the US, with the majority of cases occurring among the foreign-born population. It encourages healthcare workers to consider LTBI treatment to prevent the reactivation of TB and make the world safer.<br /><br />Overall, this guide provides valuable information on TB testing in healthcare workers and highlights the importance of identifying and treating latent TB infection to prevent the development of TB disease.
Keywords
TB testing
healthcare workers
latent TB infection
TB disease
symptoms
incidence of TB
tuberculin skin test
interferon gamma release assays
IGRAs
LTBI treatment