According to the CDC, “transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers (HCWs) in healthcare settings.” Transmission is most likely to occur from patients who have unrecognized TB or have received ineffective treatment. When other people breathe in these droplets, they can become infected. This ability of the TB disease to pass through the air makes preventing the spread of TB in the healthcare environment a critical concern for healthcare workers.

What is TB? The CDC defines TB as a contagious and potentially life-threatening infectious disease caused by a bacterium called Mycobacterium tuberculosis. People with TB disease of the lungs or larynx release the bacteria into the surrounding area when they cough, sneeze, talk or otherwise expel air, dispersing droplets that contain M. tuberculosis.

Usually a cough suggests a cold, flu or bronchitis, but tuberculosis shares this common symptom and should not be overlooked. Over the past decade, tuberculosis has again become a disease of great concern. According to a Newsweek article, “…the threat [of tuberculosis] is evolving – not only in the developing world, but also inside the United States, where the Centers for Disease Control and Prevention recorded nearly 10,000 cases of TB last year. Tuberculosis germs are tough, and if a patient’s course of treatment is interrupted, drug-resistant strains can develop and infect other individuals.”

“Drug-resistant tuberculosis is on the rise,” writes Polly J. Price in an op-ed piece for The New York Times. “The World Health Organization reports around 500,000 new drug-resistant cases each year. Fewer than half of patients with extensively drug-resistant tuberculosis will be cured, even with the best medical care.”

The CDC has issued specific work practices designed to help prevent transmission of the TB:

Administrative Measures should be used to limit the number of HCWs exposed to M. tuberculosis. These measures include conducting TB risk assessments, developing and instituting a TB infection-control plan, screening and testing healthcare workers for TB, and training healthcare personnel regarding TB.

Environmental Controls should be used toreduce the concentration of infectious droplets in the air. Facilities should use local exhaust ventilation, dilute and remove contaminated air by using general ventilation, and clean the air by using high-efficiency particulate air filtration.

Respiratory protective equipment should be used in situations that pose a high risk for exposure. Use of respiratory protection can help protect healthcare workers from droplets that have been expelled into the air by an infected patient.

Many facilities require TB testing for their commercial visitors. Facilities in California, Texas, New York, and Florida collectively reported almost half of all the TB cases in the United States in 2013. Since they are 50% more likely to encounter TB than facilities in the rest of U.S., facilities in these states should especially monitor their populations including staff, visitors, volunteers, students and healthcare representatives. TB credential requirements include testing and training and can be customized both by your facility’s risk level and category of visitor. Third-party credentialing can make sure everyone is doing their part to fulfill your facility’s policies and prevent the

spread of TB.
For vendor representatives: If one or more of your facilities require training on TB or you are interested in learning more about the disease, consider taking our TB Prevention for the Healthcare Worker training course. Available through Reptrax UniversityTM, the class material is designed to teach you about the impact of tuberculosis. It includes a history of the disease, its causes and symptoms, guidance on how to safely treat patients and information on how to prevent the spread of the disease.

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