TB Exposure and Prevention

[Chai]

Shalom,



My partner works in our local jail booking in prisoners.  Last night alone two prisoners were brought in who had TB.  How does one protect oneself from TB?  Some prisoners brought in under the influence of drugs or alcohol are angry or sick and do such things as fight, spit, vomit, drool, and worse.  



There is a fan behind the desk that blows away from the booking officers and out toward the prisoners but, because of security issues, no external windows or doors for actual fresh air ventilation.  The environment is kept warm for the comfort of the prisoners, who are not allowed sweaters or jackets, but this means it is too warm for the booking officers to want to wear a face mask for their 12 hours shifts even if they were available. In addition, the officers are reluctant to wear anything on their faces, such as a mask, that could be dislodged to block their vision during a struggle with a prisoner. And, unfortunately, an increased number of hostile prisoners would likely target the faces of the booking officers in an attempt to remove or dislodge the mask just to disorientate the officers and, well, because they are drunk or high and behaving stupidly.



Thank you for your expertise and willingness to help.

[National Jewish]

Limiting the risk of tuberculosis (TB) transmission is too complex to review in a forum response.  Please check with your local health department.  Using the Center for Disease Control guidelines they could help determine what measures would work best in the situation that you have described.

[cdausman]

Your situation is not good. I would wear a mask all the time. If I'm not mistaken TB is transmitted through water droplets in the air from coughing and sneezing.

[caregiver222]

Tuberculosis is a terrible disease, and the preventative protocols once common during the 1920's have been entirely forgotten. If you are a health care provider and you try to use these protocols today, you seem like a nut. During the 1920's the definitive test of whether or not something was infectios was to powder it and make sure it came into contact with the bloodstream of a guinea pig. After an incubation period, the pig was tested. I have a number of studies from the 1920's. In TB sanatoriums newspapers and paper that were handled by TB patients were never permitted to leave the facility. I have a study in which a TB patient coughed mucus on newspaper, and the newspaper was then able to infect a guinia pig over twelve months later. The instroduction of hospital whites was preciptated by the discovery that a 5 percent chlorine bleach solution would disinfect TB contaminated clothing. In 1905 the discovery that ultraviolet light would destroy TB won a nobel prize. The other great advance was the introduction on linoleum,. which provided a smooth surface that could be wet mopped and the dust removed.

[Chai]

The history is very interesting - not to mention frightening that a contaminated year old newspaper could still cause infection.



I had no idea about the untraviolet light killing the TB organism.  I am going to research this and see if maybe my partner can bring such a light to work or if the jail will install some if they will work in such a general ambiance capacity.



Thanks.

[caregiver222]

Ultraviolet light will destroy the bacteria that causes tuberculosis. This is the reason multiple ultraviolet light fixtures are standard in every medical examiner's autopsy area. During the 1940's untraviolet fixtures were standard on every New York City Subway car, installed specifically to eliminate TB. The facility needs to be decontaminated and a five percent chlorox bleach solution will do the job. And well ventilated. Air exchanges are necessary. In Federal prison facilities holding areas for those known ton have TB are equiupped with positive pressure cells. That is to say, there is a differential inpressure between the cell and the surounding facility so as to keep the contamination within the cell. Contrary to popular belief you can get TB on the fingers, skin, eyes and bone. TB is not necessarily a disease of the lung. The CDC has a publication which outlines a protocol for facilities handing TB patients.