TB exposure & treatment

westcoastgirl · Jun 22, 2005

I am only a student so cannot speak to your next steps for treatment etc, just sharing some personal experience here...

I had a positive PPD. My chest X Ray was clear, no sign of infection...I was born overseas and received the BCG vaccination as a child. I've heard from severl RN and MD.s that's the reason for my positive PPD, even though I don't have and never had active TB. However my PCP was obligated to get me to a specialist and get me started on INH for 9 months as soon as the PPD results came back. It was explained to me that's how the US system works - you're PPD positive? get on meds, no ifs and buts.

Shouldn't you have gotten your PPD results back though?

Bird2 · Jun 22, 2005

Internationally Adopted child had positive PPD, and CXR (results unknown to me at present) and was started on INH (as was the entire family). I was in an unventilated small room (hearing and vision room) with this child for extended time (language barrier). Had MY PPD test done approx 1 month ago. What precautions should I take at this point??? Do I need a repeat test or treatment? Can someone PLEASE give me some insight, or direct me to a site that might can answer my questions????
Appreciate ANY help and advice on this matter!!!! :uhoh21:

I tell employees that if they are exposed to let me know so that they can be retested. I would call your local Health Dept and let them know about the exposure. They will retest you and monitor you. Keep in mind that the average healthy person will just breath the germs in and out without usually becoming infected. Reality is most of us can get exposed standing in a grocery store line chatting with the stranger next to us. Call the Health Dept, you will feel better just knowing that experts are involved.

Bird2 · Jun 22, 2005

Oops. I forgot to ask if the pts were on INH when you were in the room with them or after the fact?

zacarias, ASN, RN · Jun 22, 2005

Retesting is fine. You said that you didn't know the child's CXR results. The + PPD on the child only says that they have been exposed to active TB in their life. (Or that they've had a BCG vaccination.) The only way for YOU to be exposed is if you're around someone who has active TB and it seems unlikely this kid has active TB. In short, a positive PPD in and of itself doesn't a contagious person make.

gapeach674 · Jun 23, 2005

The child was started on INH after the positive PPD, and was not on INH at the time in question. My PPD last month was negative, how long should you wait before repeating a PPD (wouldn't repetative testing increase risk of a postitive PPD result) ?

Thank you to all replies, it is much appreciated. I think I will also check out the OSHA website to see if they have any recommendations. Will post any info that I come across.

Nurse Ratched, RN · Jun 23, 2005

(wouldn't repetative testing increase risk of a postitive PPD result) ?

No worries - testing doesn't make you test positive. :) Exposure to _active_ TB (not latent TB) can make you test positive.

Wait 3 months before retest. Don't sweat this. Zacarias gave excellent advice.

Maddog53 · Jun 24, 2005

Internationally Adopted child had positive PPD, and CXR (results unknown to me at present) and was started on INH (as was the entire family). I was in an unventilated small room (hearing and vision room) with this child for extended time (language barrier). Had MY PPD test done approx 1 month ago. What precautions should I take at this point??? Do I need a repeat test or treatment? Can someone PLEASE give me some insight, or direct me to a site that might can answer my questions????
Appreciate ANY help and advice on this matter!!!! :uhoh21:

Hi,

I am an Infection Control Nurse, you really do not have to take any treatment at this point. A positive PPD does not indicate that your child has an active infection to TB, a positive PPD indicates he/she was exposed to TB at some time. The reason you and your family is on INH is to prevent latent TB from showing up sometime in the future :) Relax, if your child had an active infection they would be on a 4 drug coctail , and your local DPH would be at your house every day. :)

Another possibility is depending where your child is from, he/she may have had the BCG vac. This vaccine is given in areas where TB is a common condition.

Re-planting your PPD as a screening tool will be required, but also know that in healthy people contracting TB is not a common event. Also get the results of your child's chest X-ray results and talk to his/her doctor.

It would also be interesting to know if you were in this small room before or after starting on INH. But again, most of us are exposed and never are infected.

A great website is the CDC site, it has most of the CORRECT information you need. So relax and enjoy your child.

KJRN79 · Jun 24, 2005

Hi,
I am an Infection Control Nurse, you really do not have to take any treatment at this point. A positive PPD does not indicate that your child has an active infection to TB, a positive PPD indicates he/she was exposed to TB at some time. The reason you and your family is on INH is to prevent latent TB from showing up sometime in the future :) Relax, if your child had an active infection they would be on a 4 drug coctail , and your local DPH would be at your house every day. :)
Another possibility is depending where your child is from, he/she may have had the BCG vac. This vaccine is given in areas where TB is a common condition.
Re-planting your PPD as a screening tool will be required, but also know that in healthy people contracting TB is not a common event. Also get the results of your child's chest X-ray results and talk to his/her doctor.
It would also be interesting to know if you were in this small room before or after starting on INH. But again, most of us are exposed and never are infected.
A great website is the CDC site, it has most of the CORRECT information you need. So relax and enjoy your child.

One other thing to consider....did the child appear ill? Was he/she coughing? If not, I would think that you could put your mind at ease ...if he didn't appear ill and wasn't coughing...wouldn't your risk of exposure be less?