Page updated 30 April 2007
Only 'open' (cavitating) pulmonary tuberculosis is infectious to others
Nurse patients with open tuberculosis in a negative pressure side room
Special masks can be worn in the room of a patient with open tuberculosis
Respiratory care, surgery and autopsy in patients with infectious tuberculosis are risky to the staff performing these procedures (special maks must be worn)
Children and people with HIV are very prone to catching tuberculosis
- All staff are required to have had a pre-employment health screen. Staff in regular contact with patients or pathological material should be tuberculin skin test (Mantoux, Heaf or Tyne) positive, or be known to have had BCG immunisation (See Protection of Staff and Health Surveillance).
- New staff from areas of the world where the incidence of tuberculosis is high may be referred for a chest X-ray on entry. It is usually not considered necessary to perform prospective surveillance of staff who have been in contact with tuberculosis.
- Tuberculosis is transmitted by airborne aerosol droplets. Contact transmission is not important. Needlestick injury with pus contaminated by M. tuberculosis may cause local tuberculosis.
- It is essential to perform a risk assessment of visitors entering the room of a patient with tuberculosis (See Source Isolation). Patients should be asked to discourage children from visiting.
Notification of New Tuberculosis Cases
- All newly-diagnosed cases of tuberculosis must be notified to the Consultant in Communicable Disease Control (CCDC) for the Health District in which the patient lives, to ensure adequate contact tracing (See Notifiable Diseases).
- This is the responsibility of the doctor in charge of the patient. However, notification may be done centrally (eg by Senior Nurse or through the Microbiology Department by telephone or using a proforma [See Example Notification Form].) In addition, notification books are kept on some wards/floors and in Chest Clinics. If notification is done locally, please inform the Microbiology Department where a separate record will be kept. The Infection Control Team will inform the appropriate Chest Clinic if a case is identified so that contact tracing can be started without delay.
- It is the responsibility of the nurse-in-charge to inform the Infection Control Team (See Lines of Communication for your hospital) when a tuberculous patient is admitted to the ward, even if the patient is already on treatment.
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