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A systematic review of evidence that was published after release of the 2005 CDC guidelines for preventing Mycobacterium tuberculosis transmission in health care settings found that a low percentage of health care workers have a positive tuberculosis (TB) test at baseline and upon serial testing. The CDC published its conclusions in the May 17 Morbidity and Mortality Weekly Report.
Health care workers should be considered to be at increased risk for TB if they answer “yes” to any of the following statements:
- Residence for a month or more in a country with a high TB rate
- Current or planned immunosuppression, including HIV
- Receipt of an organ transplant
- Treatment with a tumor necrosis factor-alpha antagonist, chronic steroids, or other immunosuppressive medication or
- Close contact with someone who has had infectious tuberculosis since the last test.
The updated recommendations for testing US health care personnel include:
- Screening for TB with an individual risk assessment and symptom evaluation at baseline (preplacement)
- TB testing with a tuberculin skin test for people without documented prior latent TB
- No routine serial TB testing at any interval after baseline in the absence of a known exposure or ongoing transmission
- Encouragement of treatment for all health care personnel with untreated latent TB, unless treatment is contraindicated
- Annual symptom screening for health care personnel with untreated latent TB, and
- Annual TB education of all health care personnel.
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA