Tuberculosis – Risk of continued transmission in healthcare workers

Abstract

IntroductionControl of tuberculosis (TB) in healthcare workers requires an early recognition of contacts, the adoption of efficient protective measures and screening for cases of latent tuberculosis (TL) and recent TL. AimsSystematic screening for TB and TL in healthcare workers with contact with patients or other workers with TB and risk of contagion. Material and methodsIn a hospital with approximately 5400 workers 13 screenings were performed September 2007– December 2008 due to risk of continued TB. These consisted of clinical observation, tuberculin skin test (PT), Quantiferon®-TB Gold (QTF) test if PT ≥10mm and <15mm and chest X-ray. The diagnoses were performed according to the recommendations of the Portuguese Pulmonolgy Society (SPP). Results792 workers (563 ♂; 229 ♀) were included in the 13 screenings. Of these, 75 presented symptoms and 31 had radiology abnormalities. PT was performed in 490 workers, with results <10mm in 250, ≥10 and <15mm in 175 (QTF positive in 36) and ≥15mm in 65. Of the screened workers, 280 had a previous PT ≥15mm, and therefore it was not repeated. 1 case of active TB was diagnosed in a worker, as well as 408 cases of TL (51.5%) and 42 cases of recent TL (5.3%). ConclusionsTB is considered an occupational disease in healthcare workers. The screening of contacts and TL cases is an important tool for an early diagnosis of active disease and for identifying the cases with higher risk of future disease.