Tuberculosis primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
Primary Prevention
BCG Vaccine
- Bacille Calmmette-Guerin (BCG) is a live attenuated vaccine derived from M. bovis.
- BCG vaccination is recommended for every infant that lives in a highly endemic area of TB or has a high risk of exposure to TB. [1]
- The administration of the vaccine protects against severe types of tuberculosis, such as miliary or meningeal tuberculosis.
- BCG vaccine is not recommended for children with HIV infection, however, children with unknown HIV status and born to HIV positive women, should be vaccinated. [1]
- There is no proven benefit of the vaccine for patients that already have been infected by tuberculosis.[2]
Screening
- Children with a close contact of TB should be evaluated for tuberculosis infection.
- TST
Prevention for International Travelers
- Travelers should avoid close contact or prolonged time with known TB patients in crowded, enclosed environment.
- Travelers who anticipate possible prolonged exposure to TB, such as medical staff, individuals in prison, or homeless shelter populations should have a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) test before leaving the United States.
Prevention in Health-Care Settings
- Confirmed cases of TB during hospitalization should meet the following recommendations:[3]
- Single-patient room with private bathroom.
- Healthcare workers and visitors should wear disposable respirators (at least N95).
- Doors should be closed as much time as possible.
- Adequate room ventilation or negative pressure should be assessed daily.
References
- ↑ 1.0 1.1 "WHO Guidance for national tuberculosis programmes on the management of tuberculosis in children, 2014" (PDF).
- ↑ Roy, A.; Eisenhut, M.; Harris, R. J.; Rodrigues, L. C.; Sridhar, S.; Habermann, S.; Snell, L.; Mangtani, P.; Adetifa, I.; Lalvani, A.; Abubakar, I. (2014). "Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis". BMJ. 349 (aug04 5): g4643–g4643. doi:10.1136/bmj.g4643. ISSN 1756-1833.
- ↑ "Guidelines for Preventing the Transmission of M. tuberculosis in Health-Care Settings, 2005".