Tuberculosis - Risk of continued transmission in healthcare workers.

INTRODUCTION

Control of tuberculosis (TB) in healthcare workers requires an early recognition of contacts, the adoption of efficient protective measures and screening for cases of latent tuberculosis (TL) and recent TL.

AIMS: Systematic screening for TB and TL in healthcare workers with contact with patients or other workers with TB and risk of contagion.

MATERIAL AND

METHODS

In a hospital with approximately 5400 workers 13 screenings were performed September 2007- December 2008 due to risk of continued TB. These consisted of clinical observation, tuberculin skin test (PT), Quantiferon(R)-TB Gold (QTF) test if PT > or =10mm and <15 mm and chest X-ray. The diagnoses were performed according to the recommendations of the Portuguese Pulmonolgy Society (SPP).

RESULTS

792 workers (563 men; 229 women) were included in the 13 screenings. Of these, 75 presented symptoms and 31 had radiology abnormalities. PT was performed in 490 workers, with results <10 mm in 250, > or =10 and <15 mm in 175 (QTF positive in 36) and > or =15 mm in 65. Of the screened workers, 280 had a previous PT > or =15 mm, and therefore it was not repeated. 1 case of active TB was diagnosed in a worker, as well as 408 cases of TL (51.5%) and 42 cases of recent TL (5.3%).

CONCLUSIONS

TB is considered an occupational disease in healthcare workers. The screening of contacts and TL cases is an important tool for an early diagnosis of active disease and for identifying the cases with higher risk of future disease.