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Forum Name: Miscellaneous Chest Diseases

Question: Exposed to active TB while on the job


 envisionist - Sun Oct 21, 2007 10:02 pm

First, thank you for taking the time to read and respond. It really is appreciated.

I'm a 27 y/o male with type 2 diabetes, NASH liver disease, diabetic neuropathy, and acid reflux. No past surgeries.

Family history of diabetes, heart disease, and various auto-immune disorders.

Currently taking metformin, nexium, and gabapentin.

I'll try and make this as short as possible but it is a scary situation for me.

I work as a deputy sheriff with the warrant division. We (my partner and I) got a call to back up a supervisor having problems with a suspect he was trying to arrest. We got to the house, went inside, stood right next to the suspect for about thirty minutes in a small living area with the guy smoking some cigarettes and coughing while the main deputy finished verifying paperwork. Our supervisor (main deputy at the scene that we were backing up) pointed to his chest once but we didn't know what he was trying to tell us.

The warrant was for a "writ of attachment" which is usually for possessing property from law suits etc. but in this case the county was ordering the man himself to be attached/taken into custody. The main deputy never told us specifics at the scene.

We follow behind the main deputy in our car and we end up at the state hospital's center for infectious diseases (this is when I start worrying). After we get out of the car, the main deputy finally makes it clear that the guy has active tb and wasn't complying with his treatment (starting and stopping). The nursing staff looks at the guy's paperwork and starts asking about why the guy and us are not wearing masks. They start asking all kinds of questions and get all over the main deputy (rightfully so). He didn't care. The paperwork was a writ of attachment for the man to be taken into custody and immediately transported to the state hospital's infectious diseases area due to non-compliance with treatment. The nurses confirmed from the paperwork that the suspect has active tb.

They tell us to go to a hospital immediately. The supervisor refuses to go but myself and my partner go. They gave us a tb skin test and we come back Monday for results.

The staff said that even if it comes back negative we have to come back for testing every six weeks for "quite some time" to be sure. My main concern, aside from my own health, is how this is going to affect my home life. What precautions (if any) should I be taking for the foreseeable future? Does my present health situation put me at greater risk? Should I limit contact with my wife and children? I'm the main cook in the family, is it safe to prepare food? Should my family get tested at some time?

I'm asking here because I always forget to ask something at the Dr's office and I want to cover as many bases as possible.

Again, I apologize for the length of this post but I wanted to provide as many details as possible. I sincerely thank you for your time.
 Debbie Miller, RN - Thu Nov 01, 2007 5:47 pm

User avatar Hello,
I understand your concern but I can allay your fears.

TB is something that is actually quite difficult to catch from someone in a single, limited interaction, and those at most risk are usually having close and regular contact with the infected person. Also, the fact the patient has been in treatment but is not currently compliant, could mean he has passed the period of being contagious, even though he has not completed the required regimen to make sure all bacteria are dead. These two factors (limited exposure and some treatment) do improve your odds of being infected.

Now, the next part of the puzzle - once you have had an exposure such as this (even if at a future date your test shows positive), your body develops antibodies to the bacteria and this is why the test shows up "positive." A positive skin test does not mean you have active TB and only active TB can be spread to another person (your wife, children, coworkers, etc.). So, your skin test can become positive, meaning you were infected, but your body's own immune system can keep it in check for some time. Meanwhile, the health department may offer antibiotic treatment (if your reaction is significant) that will kill the bacteria and you will not need to worry about it becoming active in the future. But, even during your treatment, which could take several months because of the nature of this bacteria, you would NOT be contagious to anyone. Only those with active disease, verified by abnormal chest x-ray and sputum sample labwork, are actually contagious to others.

The staff who wondered about the masks probably assumed the patient is still contagious, but a person is not contagious throughout the whole course of treatment, typically (I don't know his status at that time of course). The non-compliant person is taken into custody because if they do not kill the bacteria completely with the whole prescribed regimen of antibiotics, they can develop a resistant strain and become a threat to society. It is the responsibility of the local health department to make sure society is protected in this way so they do contact investigations and offer testing/treatment as needed.

You do not need to worry about food preparation, interaction with your family or anything else like that unless your test becomes positive, AND it is followed by a positive chest x-ray and sputum, indicating active disease (very unlikely it will reach that point because you will be treated earlier if you do show infection/exposure). So, relax, but do follow up on the recommended 'TB skin testing to be sure you catch any sign of infection early.

Let me know if you have other questions.

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