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Mycobacterium Tuberculosis
Decline
•During 2000 - 16,377 cases of TB
(5.8/100,000 of U.S. population) were
reported to CDC
•7% dec from 1999
•39% dec from 1990
•In 1992 there was a resurgence of TB in U.S.
(due to AB resistance, immigration, travel,
HIV+)
Population at highest risk –
foreign born
Rate per Population
Source: CDC
Mycobacterium Tuberculosis (TB)
•Slow growing bacteria that primarily
affects the respiratory tract of humans.
•Other areas that can be affected:
TB Spreading
•What happens after the bacteria have
entered the body?
Begins to grow in alveoli (small air sacs) of
lungs and then spreads throughout lung
and body via blood
1 Lung Anatomy
5
3
4
Source: CDC
Incubation
•What is usual TB incubation period?
2-10 weeks for TB infection
Up to 2 years for TB disease (highest risk)
•TB infected (Latent TB): (carrier)
Positive Skin Test, but not contagious (& no
symptoms)
•TB disease/active:
 + Skin test and showing symptoms (bad cough,
fever, chills, blood in sputum) and is highly
contagious
Testing
PPD (Purified Protein Derivative) – tuberculin
injected intradermally & read 48 hours later
PPD Testing
Source: CDC
Transmission
•Inhalation of infectious particles:
Infectious particles are carried in 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
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Infected Person
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Cough-Sneeze-Talking
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Transmitting Droplets
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Inhalation of Droplets
Respirator
•A PPE device that removes air contaminants
such as dust, mists, and aerosols from ambient
air
•TB Respirator filters out material down to 0.3
microns at 95% efficiency (N95).
NIOSH approved
TB Respirator Mask
N 95 NIOSH Approved
Must be fit tested
(sized correctly)
TB (AFB) Isolation
•Acid Fast Bacilli (AFB) isolation room:
Warning signs
Must be maintained under negative pressure.
Exhaust air from isolation room away from air
intakes for building, usually on 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 TB Risk
•High Risk Settings:
Health care settings
Correctional institutions
Homeless shelters
Long-term care facilities for the elderly
Drug treatment centers