Tuberculosis Exposure

AntMarchingRN, RN · Feb 10, 2011

Don't rage....you're probably freaking over nothing.

Did they hire a person with active TB or who has been exposed to TB and is starting treatment?

There is a HUGE difference. I cant see someone with active TB being able to perform nursing duties, while on the other hand there are several instances where people are exposed, take the treatment (9-12months of daily pills), and continue to work. I was exposed in Costa Rica while I was in nursing school. I had a positive PPD and was started on 11 months of INH but was allowed to continue with clinicals. I had been exposed, but did not have active TB and was not putting anyone at risk. I was not contagious, just exposed. This was all monitored by my doc and my instructors were fully aware. I always have clear chest x-rays and now just can't get PPD, otherwise I am like any other RN.

I understand that you may not have a medical background so the idea of TB may be scary based on how it is portrayed, but you have to think about it rationally. Would they hire and put to work a person with active TB and risk themselves, their staff, and all the patients? That just isnt logical. Maybe if you google TB and look into it more you can get a better understanding of the differences in active TB and exposure.

TB doesnt always mean people coughing blood into napkins like on the old cowboy movies. Im sure your wife wont be working with Doc Holiday

Hope this helps you relax a little.

kritter01 · Feb 10, 2011

That does make me feel better.

I hope you're right to give this lady the benefit of the doubt.

And you're right about my ignorance of TB, but from what my fiance told me it does NOT sound pretty and can end in death. Scary stuff. I'll keep ya posted if you'd like; I'm sure I only got a part of the story in the five minutes she had to relate this to me.

Thanks.

cb_rn · Feb 10, 2011

How did your fiance find this out? Is it hearsay or did the person in question or manager actually pass along this information. If I were her I WOULD NOT go about spreading this information, its not good practice to talk about your coworkers or their medical conditions especially if the facts are questionable. She does not want to be "caught" spreading information that isn't 100% true, it might get very ugly.And in this case they certainly are, there is no way an employer would take that kind of risk. Suspected TB patients are put in negative pressure rooms/isolated/etc/etc. There is NO way whatsoever that anyone hired a person with active TB.

Chances are that the poster above me is correct and its just prophylactic tx. So hope that helps ease your mind a little but seriously, give her a nudge to make sure she doesn't get caught up in discussing it at work!!

Trauma Columnist · Feb 10, 2011

Please have your wife discuss her concerns at work. Her boss violated confidentiality by even telling your wife. You don't spread rumors when you have no facts to back them up.

We can't provide medical advice except to say that in the case of TB it would have to have been reported to the health dept and they would havevdealt with it.

This employer probably had exposure to TB themselves and had a positive skin test. This does NOT mean they have active TB.

Please please don't let your wife further these rumors.

Emergency RN · Feb 10, 2011

hello,
my name is kyle and my fiance is a lvn in texas (she's doing ltc). she just found out tonight that her boss knowingly hired a person with tuberculosis who starts treatment tomorrow. this person has been working there for the past week.
i have so many questions and i'm so full of rage, and i want to know if i'm making a big deal out of nothing...
what do we do? what if she gets sick? we have a four year old and nothing is scarier than thinking about her being infected with a deadly disease because her mom's boss wanted to keep the schedule full and let this infectious person work there.
this "boss" was also under the impression that tuberculosis was a blood-borne illness, not a highly-contagious airborne one.
thanks in advance,
kyle

i concur with all that everyone else stated, and wanted to just add another observation:

this "boss" was also under the impression that tuberculosis was a blood-borne illness, not a highly-contagious airborne one.

then in all likelihood, the new employee has some sort of extrapulmonary tb (ie tb in the kidneys, heart, bone, or some other organ), making it not likely to be spread by droplet or airborne vectors. miliary tb is 100% fatal, but only if left untreated. with early and appropriate treatment, mortality is less than 10% and that's usually with people already immunodeficient (cancer, hiv, immune depressed like transplant recipients, etc).

since your gf is an lvn, i'm sure that she knows enough about getting tested routinely. if you're worried then it would be good to be tested too, as a part of your annual physical.

is the new colleague infectious? i don't know, but given the degree of legal and public health sanctions that could be applied to an employer for knowingly hiring a highly contagious person without warning or protecting other employees, patients and their contacts, i would doubt her boss would do so just to save a few bucks or fill a schedule. i suspect that your gf probably doesn't know the complete story. but frankly, like the other respondent stated, it is someone's private matter so i would be very careful about digging too deeply.

honestly, if tb was that easy to catch, every sneeze on the subway or bus would start an epidemic. if you're scared about the story from your gf, you'll be absolutely frightened to death if you knew the numbers of people who walk around with untreated tb. luckily, one generally has to live in close quarters contact, and or have chronically poor health, nutrition, and hygiene, to be an easy tb target.

my advice? don't worry too much about it.

ckh23, BSN, RN · Feb 10, 2011

Unless the person was in the infectious stage then there is nothing to worry about. If she is looking for a piece of mind she could always contact the health department for more info.

When I was doing my clinical for my BSN I worked with the county TB nurse and our standard protocol for people who were possibly exposed is a PPD asap and then another in 4-8 weeks.

MelEpiRN · Feb 10, 2011

I would never say TB is "highly contagious". You must have prolonged exposure with an infectious person coughing in your face a whole lot to catch it. A lot of variables come into this as well- how much TB the person has, if the TB bacterium is contained in the bottom of the lungs vs in the throat, etc. It's just not as easy to catch as a lot of people think.

Not to mention it is very rare in this country for people to die of it anymore. I wouldn't worry too much about this.

vald96 · Feb 10, 2011

according to infection control definition is airborne and i dont blame you for panicking but you have time to prevent it,either call the department of health or your physician so they can start screening,remember tuberculosis is treatable.

kritter01 · Feb 10, 2011

Whew. Thanks to everyone here for responding, you guys have made me feel a lot better.

I don't think it was a rumor... here's how the story "changed" after I talked to her a bit more:

Another nurse noticed the possible infected nurse with the PPD test on her arm and it was huge. Not within the 2-5mm accepted range (so I was told by my fiance). She contacted their DON who told the possible infected nurse to goto the emergency room. Since then she has not returned from the ER and noone knows more.

My fiance doesn't want to say anything to anyone about it, she just wanted to inform me. I guess I panicked a bit, but at least I came here instead of calling 911 and going to the ER :)

Thank you all,

I appreciate your comments very much.

-Kyle

Emergency RN · Feb 10, 2011

Whew. Thanks to everyone here for responding, you guys have made me feel a lot better.
I don't think it was a rumor... here's how the story "changed" after I talked to her a bit more:
Another nurse noticed the possible infected nurse with the PPD test on her arm and it was huge. Not within the 2-5mm accepted range (so I was told by my fiance). She contacted their DON who told the possible infected nurse to goto the emergency room. Since then she has not returned from the ER and noone knows more.
My fiance doesn't want to say anything to anyone about it, she just wanted to inform me. I guess I panicked a bit, but at least I came here instead of calling 911 and going to the ER :)
Thank you all,
I appreciate your comments very much.
-Kyle

A positive skin reaction just means that she has developed antibodies to TB (exposed somewhere in her lifetime, she can be active or not), or if she was from a foreign country, had been vaccinated with BCG (bacillus calmette-guerin vaccine against TB), as a child. Sending her down to the ED to get a chest XR was the proper next step. Why she didn't return from the ED could be for more innocent reasons, like the ED was too busy to deal with a perfectly healthy looking staff member with a positive skin test, and she had to sit and wait.

kids · Feb 11, 2011

Another nurse noticed the possible infected nurse with the PPD test on her arm and it was huge. Not within the 2-5mm accepted range (so I was told by my fiance). She contacted their DON who told the possible infected nurse to goto the emergency room. Since then she has not returned from the ER and noone knows more.

I have had a "huge" reaction to a PPD. Further testing showed it to be an allergic reaction.