Tuberculosis Epidemic Among Hospital Personnel

Haley, Charles E.; McDonald, Robert C.; Rossi, Lois; Jones, Wilbur Devereux; Haley, Robert W.; Luby, James P.

doi:10.1086/646003

Cited by 104 publications

(31 citation statements)

References 16 publications

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“…In addition, numerous hospital outbreaks (Blumberg et al 1996;Fischl et al 1992;Haley et al 1989;Iseman 2000;McElnay et al 2004) of TB and nosocomial transmission to health care workers were reported. However, these studies were all retrospective.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, the risk of TB was found to be 2.3-fold higher in nurses in Japan (Nakasone 1999). In the United States, the resurgence of TB was also companied by numerous hospital outbreaks of TB and nosocomial transmission to the health workers (Blumberg et al 1996;Fischl et al 1992;Haley et al 1989;Iseman 2000). Therefore, control of M. tuberculosis transmission, especially in hospitals, remains a very important issue of public health in Taiwan and worldwide.…”

Section: Introductionmentioning

confidence: 99%

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Concentration Profiles of AirborneMycobacterium tuberculosisin a Hospital

Chen

2008

Aerosol Science and Technology

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Pulmonary tuberculosis remains one of the major public health issues worldwide. However, concentration profiles of airborne Mycobacterium tuberculosis in hospitals and other medical facilities have not been well characterized. Therefore, the aim of the present study was to measure concentration profiles of airborne M. tuberculosis in a hospital including TB-patient related areas (TB-areas), and non-TB-patient related areas (non-TB-areas). A total of 58 airborne samples were collected by a filter and quantified by real-time qPCR system. It was found that the airborne M. tuberculosis concentrations in TB-areas were significantly higher than those in non-TB-areas. In regard to the profiles in the investigated hospital, the airborne M. tuberculosis concentrations from high to low were found in the waiting rooms and consulting rooms of medical department, emergency department, medical wards, main registry area, waiting rooms of ophthalmology department, and dining hall, respectively. In the medical wards area, it was found that the airborne M. tuberculosis concentrations in the room of a suspected TB patient were even higher than those found in negative pressure isolation rooms with TB patient. This suspected TB patient was, in fact, diagnosed as a TB patient a month later. In conclusion, concentration profiles of airborne M. tuberculosis in hospital environments were successfully characterized in our present study. In addition, it was strongly demonstrated that TB-areas do have higher airborne M. tuberculosis concentrations than non-TB-areas and implicate higher risks for nosocomial TB infection. Moreover, environmental monitoring of airborne M. tuberculosis might provide an early indicator for identification of TB patient.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Concentration Profiles of AirborneMycobacterium tuberculosisin a Hospital

Chen

2008

Aerosol Science and Technology

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“…Studies have demonstrated apparently high levels of infection from very short exposures to highly infectious cases. 44,179,180 This potential confounding variable does not affect results from institutional outbreaks arising from a point source exposure (i.e. a single infectious source case), but may affect results from community-based studies where different contacts have been exposed to different infectious source cases, unless the infectiousness of each source case has been individually assessed and incorporated into the calculation of amount of TB exposure.…”

Section: Use Of An Appropriate Reference Testmentioning

confidence: 99%

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Dinnes¹,

Deeks²,

Kunst³

et al. 2007

Health Technol Assess

531

361

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“…There has been a documented outbreak of TB in ED personnel with a single exposure to an active case. 19 The transmission of TB in health care facilities is an important issue for all health care staff and patients. 20,21 Federal agencies such as the CDC and the Occupational Safety and Health Administration (OSHA) have proposed rules and recommendations to reduce the risk of transmission of TB in health care facilities.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of an Emergency Department‐based Tuberculosis Counseling and Screening Program

Kirsch

Chanmugam

Keyl

et al. 1999

Academic Emergency Medicine

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Abstract. Objective: To assess the feasibility and effectiveness of an ED-based tuberculosis (TB) screening program. Methods: A TB screening program of adult ED patients was conducted at a university hospital ED with 46,000 annual visits that serves a poor urban community. Patients were screened on weekdays during business hours. ED patients were counseled about the disease and the screening procedure and, after consent, purified protein derivative (PPD) tests were placed. Patients returned in 48 -72 hours for reaction reading and posttest counseling. PPD-positive patients received a physical examination, chest x-ray, and HIV testing and were referred to a city TB clinic for possible treatment. Results: Overall, 873 patients were counseled, 630 were eligible for screening, and 374 (59.4%) consented to PPD testing. Of the 203 (54.1%) who returned, 32 (15.8%) were PPD-positive. No active case was detected, but 26 patients were referred to the health department. Eighteen kept their appointments and all 13 who were started on therapy completed treatment. Targeted screening of groups aged 55 years or more, nonwhite groups, and those with other high-risk factors would detect 84% of PPD-positive cases while testing only 48% of eligible patients. Conclusion: An ED-based TB screening program is feasible and can identify many patients requiring treatment. Targeted screening of high-risk groups could reduce the program cost, but would miss some cases.

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Tuberculosis Epidemic Among Hospital Personnel

Cited by 104 publications

References 16 publications

Concentration Profiles of AirborneMycobacterium tuberculosisin a Hospital

Concentration Profiles of AirborneMycobacterium tuberculosisin a Hospital

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Feasibility of an Emergency Department‐based Tuberculosis Counseling and Screening Program

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