title: Transmission and Institutional Infection Control of Tuberculosis.
abstract: Tuberculosis (TB) transmission control in institutions is evolving with increased awareness of the rapid impact of treatment on transmission, the importance of the unsuspected, untreated case of transmission, and the advent of rapid molecular diagnostics. With active case finding based on cough surveillance and rapid drug susceptibility testing, in theory, it is possible to be reasonably sure that no patient enters a facility with undiagnosed TB or drug resistance. Droplet nuclei transmission of TB is reviewed with an emphasis on risk factors relevant to control. Among environmental controls, natural ventilation and upper-room ultraviolet germicidal ultraviolet air disinfection are the most cost-effective choices, although high-volume mechanical ventilation can also be used. Room air cleaners are generally not recommended. Maintenance is required for all engineering solutions. Finally, personal protection with fit-tested respirators is used in many situations where administrative and engineering methods cannot assure protection.
authors: Division of Global Health Equity, Brigham & Women's Hospital, Boston, Massachusetts 02115.
authors: Edward A
authors: EA
authors: Nardell
mesh_terms: D000553:Ambulatory Care; D003428:Cross Infection / Q000517:prevention & control* / Q000635:transmission; D004779:Environment Design; D006282:Health Personnel; D006760:Hospitalization; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009784:Occupational Diseases / Q000517:prevention & control; D012134:Respiratory Protective Devices; D012307:Risk Factors; D014376:Tuberculosis / Q000517:prevention & control* / Q000635:transmission; D014691:Ventilation / Q000379:methods