How easy is it to get TB?? Help!

Nurses General Nursing

Published

Hello! :jester: I was wondering how easy it is to get TB?? I have read up on it a little bit. I had a pat. the other day who was coughing around me. I tried to turn my head away. This pat. needed a lot of care, and I was in there most of the day.

Tonight, we got word that the pat. is most likely TB postive and was moved swiftly away to the reverse isolation room. Great. :grn: Have you ever experienced this?? What are the odds I was exposed?? I was in there a lot the previous day with this pat. in a regular old room with NO TB precautions.... :eek:

Up Vote Up Vote ×

It's actually not that easy. Think of all the ED nurses who get exposed all the time who aren't positive.

I've had several patients over the years who have been positive for TB, but with whom we didn't find out right away. One patient I cared for for three nights in a row, and he even had a sitter at the bedside 24 hours a day. Went home, came back two weeks later with worsening symptoms and they diagnosed TB then. About half our floor was exposed, and none of us ended up positive.

Your facility will test all of you now and then in several weeks/months.

Up Vote Up Vote ×
Specializes in Case Management.

Exposure to TB and taking care of a TB patient are 2 different things, IMO. Exposure would be evident with a positive TB test. Not everyone who cares for the patient will go on to have a positive TB test, indicating "exposure". Subsequently, not everyone who has a positive TB test will go on to have TB because if the clinician has a positive TB test, they willl be prescribed the appropriate anti-TB meds and they should end up without the disease. The bummer is, if one tests + for TB per the tine test, they will ALWAYS test positive, so the tine test is no longer an option. Yearly chest xrays are required in order to assure no active disease.

Many years ago, 2 nurses on our unit tested positive for TB exposure in our routine screening process. No one knows who the patient was who had active TB. We both had to take INH for a year. Now, years later, I still receive yearly chest xrays for screening. 4 years ago I had a spot on my lung. A CT ruled out TB. It's always in the back of my mind but I do not dwell on it.

Up Vote Up Vote ×
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

It's easy to be exposed to TB. Millions of people, including healthcare workers, have positive tuberculin skin tests, which indicates that they have been exposed to the TB mycobacterium at some point in time. My skin tests were negative when I first became a nurse in early 2006. For the past couple of years I've been having positive skin tests and, therefore, I now need chest x-rays to rule out TB every few years.

On the other hand, it's harder to actually develop tuberculosis.

Up Vote Up Vote ×
Specializes in Med/Surge, Psych, LTC, Home Health.

I think some, or even most places, do not even require you to get the yearly chest X-ray if you are a past reactor, i.e. have had a positive TB test in the past. They just ask you to stay aware of the symptoms of TB and get an Xray if you develop symptoms.

Up Vote Up Vote ×

I always had negative skin tests until a year after I became a nurse and started working at a nursing home. I was completely blown away by suddenly getting a positive reaction and I could remember my instructor's voice in my head saying how "impossibly difficult" it is to "acquire TB."

I received the INH treatment per protocol but I almost wish I never step foot in that nursing home in the first place!

Up Vote Up Vote ×
Specializes in Med/Surg, Ortho, ASC.

"I think some, or even most places, do not even require you to get the yearly chest X-ray if you are a past reactor, i.e. have had a positive TB test in the past. They just ask you to stay aware of the symptoms of TB and get an Xray if you develop symptoms."My facility has moved completely in the opposite direction. You are no longer allowed to have a procedure in the ASC if you cannot produce a negative CXR. Or, of course, be willing to undergo one on arrival here. A standard "negative" chest film interpretation is not good enough either. The radiographer must address the TB issue directly as in "no active disease" noted.

Up Vote Up Vote ×
Specializes in M/S, ICU, ICP.
hello! :jester: i was wondering how easy it is to get tb?? i have read up on it a little bit. i had a pat. the other day who was coughing around me. i tried to turn my head away. this pat. needed a lot of care, and i was in there most of the day.

tonight, we got word that the pat. is most likely tb postive and was moved swiftly away to the reverse isolation room. great. :grn: have you ever experienced this?? what are the odds i was exposed?? i was in there a lot the previous day with this pat. in a regular old room with no tb precautions.... :eek:

hi epona, i hope this link from the cdc, center for disease control and prevention, helps. it really is not that easy for someone to get tb unless the person is immune compromised to begin with, or they have prolonged exposure in crowded poorly ventilated living conditions.

on an educational note, tb is an airborne transmitted organism and would require airborne isolation. that is the negative pressure rooms and the special n95 masks. coughing is just one of the symptoms that can occur and even with the tb skin test, a positive reaction may only mean that the person was exposed to tb at some point in their life and developed antibodies to it. most of the patients i have seen have a variant called mycobacterium avium which is not "the bad one."

i have been exposed to tb many times prior to the days of isolation precautions and even had pluersy once while caring for a tb patient and i have never contracted it. hope the link helps answer some questions for you. the cdc site is a wonderful resource and please contact the infection control nurse at your facility in the meantime if you have any questions or will require a tb test. you will be fine i am sure.

http://www.cdc.gov/tb/topic/basics/default.htm

Up Vote Up Vote ×
Specializes in ICU, Telemetry.

I had a friend that worked at the health department in the surveillance area/dept -- they tracked the reportable diseases. I asked her about TB after I had the same kind of experience you did, and she told me, "Some people, you couldn't GIVE them TB if you tried; you could bathe them in TB, and they'd never catch it. Others, you could whisper 'TB' in the hallway and they come down with it. But if you've got a good immune system, you'll probably be okay." And I was.

Still hate those PPDs, tho...

Up Vote Up Vote ×

I was recently exposed to a patient that was tested positive for acid fast bacilli via bronchoscopy. I took care of that patient for 4 days in a row. Coughing constantly. I am a little freaked to say the least. What's even more distressing is that no one from infectious disease has come to talk to us about what will take place to ensure that we get properly tested or treated if need be.

Up Vote Up Vote ×
Specializes in ICU, LTACH, Internal Medicine.

It is easy to get EXPOSED. It is way less easy to get actual Tb.

NEJM still cites 10% risk of active disease after confirmed contact with following change of PPD to positive from confirmed negative:

NEJM Journal Watch: Summaries of and commentary on original medical and scientific articles from key medical journals

Although they state that it was the result of studies done decades ago.

Personally, I did open "mouth-to-mouth" rescue breathing on a guy who turned out to be positive with flourishing disease. Nothing happened.

Up Vote Up Vote ×
+ Add a Comment