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With historically low rates of tuberculosis in the United States and ongoing challenges with TB tests, there may be a temptation to drop one’s guard against TB in health care workers. The American College of Occupational and Environmental Medicine (ACOEM) has a clear message: Remain vigilant to prevent occupational infections.
In recent guidance the ACOEM notes that the high worldwide rate of latent TB infection and rising rates of multi-drug resistant and extensively drug-resistant TB pose a risk to health care workers.
In fact, in the 1980s, a resurgence of TB combined with less stringent infection control measures led to some hospital-based transmission of TB, ACOEM reminds.
“If we don’t keep up the scrutiny and assign resources to TB screening of health care workers, we could easily slip back,” says Amy J. Behrman, MD, FACP, FACOEM, medical director for Occupational Medicine at the University of Pennsylvania Health System and lead author of the ACOEM guidance. “We should build on our successes and not be complacent about the ongoing risk.”
ACOEM emphasizes important “action steps” to reduce the risk of TB exposure, including having a high level of suspicion of TB in patients with cough and fever who have risk factors, such as the homeless, incarcerated, or those from countries in which TB is endemic. Patients suspected of having active TB should wear a mask when not in an isolation room, and health care workers who have contact with them should wear respiratory protection, ACOEM says.
For more on this story see the April 2014 issue of Hospital Employee Health