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  1. Management of health care workers after inadvertent exposure to tuberculosis : a guide for the use of preventive therapy.

    Article - En anglais

    Objective 

    To quantify the protection of previously infected persons from developing tuberculosis after intense exposure.

    Setting 

    6 hospitals and 22 nursing homes in which heavy tuberculosis exposure had occurred.

    Measurements 

    Results of tuberculin skin tests before and after exposure and the development of tuberculosis among known reactors, both converters and nonconverters.

    Intervention 

    All converters were given preventive therapy with isoniazid as soon as they could be identified.

    Nonconverters and previously known reactors were not treated.

    Results 

    In 6 hospital outbreaks, largely aborted by prompt preventive therapy, 98 of 336 nonreactors (29%) showed skin test conversion, and, before therapy could be started, 19 (19% [95% Cl, 12% to 29% ]) had developed tuberculosis.

    Conclusions 

    Healthy persons who remain nonreactive to tuberculin after heavy exposure have escaped infection and require no chemotherapy.

    However, if exposure is discovered immediately, it is wise to start preventive therapy in particularly heavily exposed nonreactors and discontinue it if the skin test result is still negative at 3 months.

    Persons who react after exposure fall into three groups : 1) converters, in whom the risk for tuberculosis warrants preventive chemotherapy, regardless of age ; 2) reactors with no preexposure test results, who should be treated as converters ; and 3) previously known reactors, in whom the risk for tuberculosis generally is too slight to warrant therapy.

    Mots-clés Pascal : Tuberculose, Poumon, Risque infectieux, Travailleur(protection), Exposition professionnelle, Guide, Prévention, Traitement, Facteur risque, Homme, Mycobactériose, Bactériose, Infection, Appareil respiratoire pathologie, Poumon pathologie

    Mots-clés Pascal anglais : Tuberculosis, Lung, Infectious risk, Worker(protection), Occupational exposure, Guide, Prevention, Treatment, Risk factor, Human, Mycobacterial infection, Bacteriosis, Infection, Respiratory disease, Lung disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0397198

    Code Inist : 002B30A01C. Création : 01/03/1996.