Put Your N-95 Respirators Away: TB Exposure is on the Decline

[Melissa Mills]

Okay, so maybe it's not time to toss out your N-95. However, a recent update from the Centers for Disease Control and Prevention and the National Tuberculosis Controllers Association shows an overall decline of TB cases. The organizations also report that TB cases following occupational exposure have dropped, too.

This new information has created a few updated recommendations

• All healthcare personnel should get a baseline TB risk assessment, screening for symptoms, and TB skin or blood test upon hire
• Annual testing is not recommended for healthcare personnel unless there is a known exposure or ongoing transmission in your facility
• Personnel with an untreated latent TB infection should be screened each year for symptoms and treatment is highly-encouraged
• All staff should receive yearly TB education, which includes information about risk factors, TB infection control policies and procedures, and a list of signs and symptoms
• Personnel with a positive TB skin or blood test should be evaluated for symptoms and have a chest x-ray performed to rule out the disease

Understanding Your Risk

Tuberculosis is an infectious disease that mainly affects your lungs. TB is spread through tiny droplets that are released into the air following sneezing and coughing. Once it's in the air, the droplets can be breathed in by others, and they can become infected. The disease was once thought to be rare in developed countries. However with the increase of HIV, it gained momentum in the mid-1980s.

The disease is difficult to treat because many drugs have become resistant. Treatment can take several months, and the patient will need to be separated from others until they are no longer actively contagious.

Symptoms

Active TB creates severed illness. It can make you sick shortly after you contract the condition, or it can make you sick years later. The main signs and symptoms include:

• Coughing up blood
• Persistent cough (lasting three or more weeks)
• Chest pain
• Fatigue
• Unintentional weight loss
• Fever
• Night sweats
• Loss of appetite
• Chills

TB can also remain in your body in an inactive or latent state. This means that you have the bacteria in your body. However, the disease doesn't make you ill. Latent TB can become active, so it's important for people who have latent TB to receive treatment to decrease the spread of the illness.

What Are The High-Risk Populations?

You may be at an increased risk of contracting TB if you work with high-risk populations. Here are a few populations you need to consider:

Patients with Weakened Immune Systems

Your immune system helps to keep you safe from TB and other infections. If you have a weakened immune system, you may be at an increased risk of contracting the condition.

Pediatric or geriatric populations

A few diseases that can put you and your patients at a higher risk include:

• HIV/AIDS
• Malnutrition
• Diabetes
• Severe kidney disease
• Drugs used to treat RA, Psoriasis, or Crohn's
• Chemotherapy drugs
• Certain cancers
• Drugs used to prevent rejection of transplanted organs

Traveling to Foreign Areas

TB runs rampant in some under-developed areas. If you or your patient has been to one of these areas, you may need to consider the possibility of TB:

• Latin America
• Russia
• Africa
• Asia
• Caribbean Islands

Other Populations

There are a few situations that can also place patients at an increased risk of contracting TB. Those individuals with poor overall health and medical care, those with substance abuse issues or those who use tobacco are more vulnerable to TB.

[prmenrs, RN]

30 or 40 years ago, TB was "on the decline" also. Then, along came AIDS, and, whamm-o, TB was back, better than ever. Don't trust it.

Having been one of the people who unwisely thought we had the beast cornered, and was soooo wrong, I think we shouldn't ever take TB for granted. It's been around longer than we have. jmo.

[Leader25, ASN, BSN, RN]

On 8/19/2019 at 2:57 PM, Melissa Mills said:

TB runs rampant in some under-developed areas. If you or your patient has been to one of these areas, you may need to consider the possibility of TB:

• Latin America
• Russia
• Africa
• Asia
• Caribbean Islands

They are all in this country already,no need to travel to run into health risk.

[protos frontida 9, BSN]

Thank you.

I know you are a hard worker and try to stay up with with all the newest trends and knowledge regarding communicable infectious diseases. I receive a subscription from the CDC and HHS. It seems like one comes every month and the other one is weekly. I do not read everything but enough to get the gist of what is going on.

We have made some gains in areas however, we are going backward if we let people come into the country without proper vetting. My comment is made because I am the wife of an immigrant. I know what it takes to get into the country legally and I know the difference in those that do not take the time to learn the language, culture, and people of the accepting country. Having traveled to Europe, and the Middle East, I can say that in those countries one does as the Romans do and not the other way around. It is the same in our country and it has a lot to do with respecting our laws and our values.

TB vaccines were developed many years ago but they were not that effective and only given to people going to those countries for military purposes. My friend received a TB vaccine many years ago when going to Guam. Again, it is well documented they were not that effective.

I have not been to Haiti but I have several Haitian friends that ask me why America allowed so many sick people come into the country when we do not take care of our own. I have no answer except to say we help who we can. These are the educated Haitians who came the correct way.

In my opinion, the border wall is a good idea. I do not like spending the money on it but on the same note, it goes without saying that it will save lives. Border agents are getting shot on the border and sometimes it does not even make the news. I am very much against the financial and sexual exploitation of the people that come into our country. It makes me ill to think about the rapes, people used as 'mules' to carry drugs putting them at the great danger. The elites are for open borders because they are making money. It is dirty money. There is no doubt about that.

Keep up your good work and I will too. Happy Labor Day! I appreciate your suggestion about the book. Most of the time I go to those places and see first hand what the issues are and how to deal with them. I have been to the border several times. My daughter has been on mission trips to Mexico and they are lovely people.

Helen

[nursej22, MSN, RN]

Helen,

I am not sure what you mean by "the elites are for open borders..." Do you mean the Trump Corporation, who has employed undocumented workers for years? Do you mean Koch Foods, owners of the meat packing factories in Mississippi that were recently raided? Do you mean farmers that depend on undocumented workers to milk cows, move irrigation pipe and harvest crops?

Please do not pin this desire for open borders cr** on the Democrats. A bipartisan bill in immigration reform passed the Senate several years ago and the Republican Speaker of the House refused to bring to a vote. No Democrat has called for open borders, period. Many have called for reform, humane treatment , and due process of law. Many of the people coming across the Southern border are not illegal. They are coming in the "correct" way. They must be on US soil to request asylum. They are fleeing threats of imminent violence for conditions that our country helped to create.

I care for people with active TB disease. Several in the last 2 years came to the US in the "correct" way. They had latent infections (which is not infectious) and were not treated, or treated inadequately. As health care workers we are obligated to use universal precautions which included having coughing patients wear a mask, and wearing mask ourselves in the presence of a cough illness. A big, stupid, expensive wall is not going to work better than that.

[protos frontida 9, BSN]

I am sorry you feel that way.

Helen