Tuberculosis - Risk of continued transmission in healthcare workers.
BACKGROUND
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.


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


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.
Costa
José Torres
JT
Occupational Health Unit, Hospital S. João, EPE - Porto, Portugal. zecatoco@sapo.pt
Silva
Rui
R
Sá
Raul
R
Cardoso
Maria João
MJ
Ferreira
José
J
Ribeiro
Carla
C
Miranda
Mário
M
Plácido
José Luís
JL
D000328:Adult; D005260:Female; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D008297:Male; D009784:Occupational Diseases / Q000175:diagnosis / Q000517:prevention & control*; D012307:Risk Factors; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000517:prevention & control* / Q000635:transmission*