What is it about?
Hospital health workers are routinely screened for latent tuberculosis infection, but those working in outpatient services usually are not. In 2017 in Trieste, a paediatrician with undiagnosed tuberculosis working in an outpatient vaccination service infected 15 adults and nine children. The contact investigation involved almost 2,500 children and 151 adults: nine children tested positive and four developed active tuberculosis, while among close adult contacts eight tested positive and three had lung tuberculosis. Together with WHO experts, we calculated that the outbreak cost over one million euros. Regular screening of paediatric outpatient health workers would have cost only 2,600 to 11,400 euros, and screening all outpatient health workers 66,000 to 155,000 euros.
Featured Image
Photo by Usman Yousaf on Unsplash
Why is it important?
Even in a high-income country with low tuberculosis incidence, a single infected health worker can cause a costly outbreak involving vulnerable children. Our analysis shows that extending tuberculosis screening to outpatient health workers, at least those caring for children, is economically justified and could prevent harm and huge public health costs.
Perspectives
Managing this outbreak in Trieste was a demanding experience for our team and for many families. Turning it into lessons for prevention, with the help of colleagues from the WHO Global Tuberculosis Programme, was the best way to make sure something positive came out of it.
Professor Stefano Di Bella
Universita degli Studi di Trieste
Read the Original
This page is a summary of: Tuberculosis screening in outpatient healthcare workers: lessons from a high-income, low TB burden country, The International Journal of Tuberculosis and Lung Disease, September 2019, International Union Against Tuberculosis and Lung Disease,
DOI: 10.5588/ijtld.19.0060.
You can read the full text:
Contributors
The following have contributed to this page
