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Tuberculosis Epidemic Among Hospital Personnel

Published online by Cambridge University Press:  21 June 2016

Charles E. Haley ,
Robert C. McDonald ,
Lois Rossi ,
Wilbur D. Jones Jr ,
Robert W. Haley  and
James P. Luby
Charles E. Haley
Affiliation:
Department of Internal Medicine, University of Texas South-western Medical Center, Dallas, Texas
Robert C. McDonald
Affiliation:
Department of Internal Medicine, University of Texas South-western Medical Center, Dallas, Texas
Lois Rossi
Affiliation:
Employee Health Service, Parkland Memorial Hospital, Dallas, Texas
Wilbur D. Jones Jr
Affiliation:
Mycobacleriology Section, Baclerial Diseases Division, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia
Robert W. Haley
Affiliation:
Department of Internal Medicine, University of Texas South-western Medical Center, Dallas, Texas
James P. Luby*
Affiliation:
Department of Internal Medicine, University of Texas South-western Medical Center, Dallas, Texas
*
University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75235-8859
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Abstract

Six employees of the emergency department at Parkland Memorial Hospital developed active tuberculosis in 1983-1984. Five of the cases occurred four to 12 months after exposure to the index case, a patient with severe cavitary tuberculosis seen in the emergency department in April 1983. One resident physician developed cavitary disease after exposure to this patient. An additional employee case may have resulted from transmission from one of the initial employee cases. One immunocompromised patient may have acquired tuberculosis as a result of exposure to the index case. In addition, the tuberculin skin tests of at least 47 employees exposed to the index case converted from negative to positive. Of 112 previously tuberculin-negative emergency department employees who were tested in October 1983, 16 developed positive skin tests, including the 5 employees with active disease. Fifteen of these new positives had worked on April 7, 1983, while the index case was in the emergency department (x2 = 20.6, P <0.00l). Factors related to the genesis of the epidemic included the disease characteristics in the index case and the recirculation of air in the emergency department. This investigation indicates that city-county hospital emergency department employees should be screened at least twice a year for evidence of tuberculosis and that the employee health services of such hospitals should regard the surveillance of tuberculous infection among personnel at a high-priority level.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 5 , May 1989 , pp. 204 - 210
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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