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Division of Public Health Services Disease Handbook for Childcare Providers Bureau of Infectious Disease Control REVISED –January 2018 TUBERCULOSIS Tuberculosis (TB) is a disease caused by a certain type of bacterium. A person who is sick with active tuberculosis disease may spread the germ when they cough or sneeze. If others inhale the bacteria from the air, they may become infected . But not everyone who is exposed will become infected. A person with Latent TB infection does not feel sick and cannot spread the germs to others. Does infection mean you will be sick? No. Many people were infected with TB many years ago when the dise ase was very common. Only 5-10% of people who are infected will ever get the disease unless they have an impaired immune system. What is a TB test? A skin test is a method of determining if a person has been infected with the TB germ. A positive TB ski n test reaction, however, does NOT necessarily mean the person has TB disease. Like the skin test there is a blood test that can test for tuberculosis infection. This test is often called an IGRA (Interferon gamma release assay). The IGRA does not diagnose active TB disease. The IGRA is currently not recommended for children under two. How is the test given? For the skin test--a small amount of PPD (purified protein derivative) is injected just under the surface of the skin on the fore arm. In 48 to 72 hours, a healthcare provider or nurse will read the test by inspecting the skin. The IGRA is a simple blood draw and there is no return visit for reading necessary and a doctor will help determine the results. Who should have tuberculosis test? Persons who have been exposed to an active case of TB, persons born in a foreign country (where TB is common), people infected with HIV (human immunodeficiency virus), healthcare workers and pre-school age childcare staff. It is a law that persons with a positive IGRA be reported to the Bureau of Infectious Disease Control. Persons who have a documented positive reaction to a TB skin test do not need repeat skin tests. All persons with a positive skin test or a positive IGRA should be evaluated yearly for signs of active disease. How can TB be prevented? People who have a positive reaction to a TB skin test or a positive IGRA can prevent disease by taking medications. Who should be excluded? A person with a positive TB skin test or positive IGRA should have a m edical examination and a chest x-ray and discuss with a healthcare provider about taking preventive therapy. Persons diagnosed or suspected to have active TB disease should be reported immediately to the Bureau of Infectious Disease Control and should be excluded from attending or working in a childcare center until they are determined to be non- infectious by both a healthcare provider and the Bureau of Infectious Disease Control. Reportable? Yes. Suspect and cases of active t uberculosis and persons with a positive IGRA are reportable by New Hampshire law to the Division of Public Health Services, Bureau of Infectious Disease Control at (603) 271-4496. |