Minimizing tuberculosis risk to hospital personnel and students exposed to unsuspected disease.
A 15-month prospective study of the personnel and students exposed to initially unsuspected active cases of tuberculosis was undertaken to define the risk of their acquiring infection. Eight of 484 (1.65%) personnel exposed to 17 initially unsuspected tuberculosis patients and 5 of 2013 (0.25%) unexposed personnel with similar risk but no known exposures developed positive tuberculin skin tests. This greater than sixfold increase in conversion rate for the exposed group was significant (chi-2=14.83; P=0.0003). Delay in making the diagnosis in these patients was associated with failure to apply a tuberculin skin test on admission in 14 patients and radiologic misinterpretation in 15. A comprehensive surveillance method involving the Employee and Student Health Departments as well as the Public Health Department is suggested to minimize the risk of undiagnosed tuberculosis.
D003428:Cross Infection / Q000517:prevention & control*; D003937:Diagnosis, Differential; D006801:Humans; D009784:Occupational Diseases / Q000517:prevention & control*; D010564:Personnel, Hospital; D011446:Prospective Studies; D011859:Radiography; D012882:Skin Tests; D013223:Statistics as Topic; D013337:Students, Medical; D014376:Tuberculosis / Q000175:diagnosis / Q000517:prevention & control*; D014391:Tuberculosis, Miliary / Q000000981:diagnostic imaging; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging; D014768:Virginia