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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. | |