2. Mycobacterium Tuberculosis

3. Decline During 2000, a total of 16,377 cases of tuberculosis (TB) (5.8 cases per 100,000 of population) were reported to CDC from the 50 states and the District of Columbia, representing a 7% decrease from 1999 and a 39% decrease from 1990. In 1992 there was a resurgence of TB in the United States.

4. Reported Cases Ethnicity Source: CDC

5. Rate per Population Source: CDC

6. Mycobacterium Tuberculosis (TB) A slow growing bacteria that primarily affects the respiratory tract of humans. Other areas that can be affected:

7. TB Growth What happens after the bacteria have entered the body?  They begin to grow in the alveoli (small air sacs) of the lungs and then spread throughout the lung and body.

8. 5 Lung Anatomy 3 4 Source: CDC 1

9. Incubation What is the usual incubation period?  2-10 weeks for TB infection  Up to 2 years for TB disease (highest risk) TB infected, Latent TB:  Positive Skin Test-not contagious TB disease/active:  Showing symptoms and is highly contagious

10. Treatment Multidrug resistant  They are trying many new different drug combinations to combat the drug-resistant strains. DOT  Directly Observed Therapy

11. Directly Observed Therapy DOT  Directly Observed Therapy Source: CDC

12. Testing Two major screenings available to the general population:  Tine Test (3 prong)  PPD (Purified Protein Derivative)

13. PPD Testing Source: CDC

14. Transmission Inhalation of infectious particles:  Infectious particles are carried in the air after an active TB individual speaks, coughs, sneezes, or certain medical procedures are performed. These particles are called droplet nuclei. 1-5 microns/ 1/5000 of an inch in size

15. ..... Infected Person

16. ...................................................................... Cough-Sneeze-Talking

17. ............................................................................................................................................................................................................ Infected Person Transmitting Droplets Cough-Sneeze-Talking

18. ........................................................................................................................................................................................................................................................................................................................................................................................................ Infected Person Transmitting Droplets Inhalation of Droplets Cough-Sneeze-Talking

19. Respirator A respirator is a personal protective device that removes air contaminants such as dust, mists, and aerosols from the ambient air. The ones used to protect against TB, filter out material down to 0.3 microns at 95% efficiency (N95).  NIOSH approved

20. Respirator

21. N 95 NIOSH Approved Must be fit tested

22. AFB Isolation Acid Fast Bacilli (AFB) isolation room:  Warning signs  Must be maintained under negative pressure.  Exhaust air from the isolation room away from air intakes for the building, usually on the roof.

23. Filters High Efficiency Particulate Air filter (HEPA):  Used to filter air for recirculation in an AFB isolation room at 0.3 microns at 99.97% efficiency.

24. Settings at Risk High Risk Settings:  Health care settings  Correctional institutions  Homeless shelters  Long-term care facilities for the elderly  Drug treatment centers

25. Where are your risks?