Mycobacterium Tuberculosis

Decline
During 2000, a total of 16,377 cases of tuberculosis (TB) (5.8 cases per 100,000 of population) were reported to CDC from the 50 states and the District of Columbia, representing a 7% decrease from 1999 and a 39% decrease from 1990. In 1992 there was a resurgence of TB in the United States.

Reported Cases Ethnicity

Source: CDC

Rate per Population

Source: CDC

Mycobacterium Tuberculosis (TB)

A slow growing bacteria that primarily affects the respiratory tract of humans. Other areas that can be affected:

TB Growth
What happens after the bacteria have entered the body?
They begin to grow in the alveoli (small air sacs) of the lungs and then spread throughout the lung and body.

1 Lung Anatomy 3

4
Source: CDC

Incubation
What is the usual incubation period?
2-10 weeks for TB infection Up to 2 years for TB disease (highest risk)

TB infected, Latent TB:

Positive Skin Test-not contagious

TB disease/active:
Showing symptoms and is highly contagious

Treatment
Multidrug resistant
They are trying many new different drug combinations to combat the drug-resistant strains.

DOT
Directly Observed Therapy

Directly Observed Therapy

DOT
Directly Observed Therapy

Source: CDC

Testing
Two major screenings available to the general population:
Tine Test (3 prong) PPD (Purified Protein Derivative)

PPD Testing

Source: CDC

Transmission
Inhalation of infectious particles:
Infectious particles are carried in the air after an active TB individual speaks, coughs, sneezes, or certain medical procedures are performed.

These particles are called droplet nuclei. 1-5 microns/ 1/5000 of an inch in size

... .

Infected Person

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Infected Person

Cough-Sneeze-Talking

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Infected Person
. .. .. .... . .. . . . .. ...... ... ....
... ... . .. . . .. .... ... . ...... .. ....

Cough-Sneeze-Talking

Transmitting Droplets

. .. . . . .. ...... ... .... .. .... ... ..

Infected Person
. .. .. .... . .. . . . .. ...... ... ....
... ... . .. . . .. .... ... . ...... .. ....

Cough-Sneeze-Talking
. .. . .... .. . . . . . ... .... . . .... . ... .. . .. . .... .......... .. . . . . . .. . . ...... ... ..... . .... . .

... ...

.. ....

Transmitting Droplets

Inhalation of Droplets

Which lung is normal?

Respirator
A respirator is a personal protective device that removes air contaminants such as dust, mists, and aerosols from the ambient air. The ones used to protect against TB, filter out material down to 0.3 microns at 95% efficiency (N95).
NIOSH approved

Respirator

Respirator

N 95 NIOSH Approved

Must be fit tested

AFB Isolation
Acid Fast Bacilli (AFB) isolation room:
Warning signs Must be maintained under negative pressure. Exhaust air from the isolation room away from air intakes for the building, usually on the roof.

Filters
High Efficiency Particulate Air filter (HEPA):
Used to filter air for recirculation in an AFB isolation room at 0.3 microns at 99.97% efficiency.

Settings at Risk
High Risk Settings:
Health care settings Correctional institutions Homeless shelters Long-term care facilities for the elderly Drug treatment centers

Where are your risks?