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Tuberculosis Among Adult Visitors of Children With Suspected Tuberculosis and Employees at a Children's Hospital

Published online by Cambridge University Press:  02 January 2015

Flor M. Muñoz ,
Lydia T. Ong ,
Diane Seavy ,
Denise Medina ,
Armando Correa  and
Jeffrey R. Starke
Flor M. Muñoz*
Affiliation:
Departments of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, Texas
Lydia T. Ong
Affiliation:
Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas
Diane Seavy
Affiliation:
Infection Control, Texas Children's Hospital, Houston, Texas
Denise Medina
Affiliation:
Infection Control, Texas Children's Hospital, Houston, Texas
Armando Correa
Affiliation:
Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas Infection Control, Texas Children's Hospital, Houston, Texas
Jeffrey R. Starke
Affiliation:
Department of Pediatrics, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas Infection Control, Texas Children's Hospital, Houston, Texas
*
Department of Molecular Virology and Microbiology, Baylor College of Medicine, MC-BCM-280, Houston, TX 77030
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Abstract

Objective:

Few children with tuberculosis (TB) have communicable disease, and most do not require isolation within the hospital. However, parents or adult visitors with unrecognized pulmonary TB may be a threat to hospital staff and other patients. We prospectively evaluated adults accompanying children hospitalized for suspected TB at a children's hospital to determine the frequency of undiagnosed, potentially contagious disease.

Methods:

From 1992 to 1998, chest radiographs were obtained from adult caretakers accompanying 59 consecutive children admitted to Texas Children's Hospital with suspected TB. A child and his or her family were placed under Airborne Precautions only if the child or the accompanying adult exhibited characteristics of potentially contagious disease. Annual rates of tuberculin skin test conversion in hospital employees were obtained for the same period.

Results:

Of the 105 screened adults, 16 (15%) had previously undetected pulmonary TB. These adults were associated with 14 (24%) of the 59 children. In all instances in which the adult was the patient's parent, he or she was the source of infection to the child. Only 8 (13.5%) of the 59 children required isolation. Tuberculin skin test conversion from a negative to a positive reaction occurred in 127 employees (8 per 1,000 employee-years at risk). Only 4 of these 127 employees performed activities involving direct patient contact. None was in contact with families with a known potentially contagious adult or pediatric patient.

Conclusions:

The risk of infection of healthcare workers from pediatric patients with primary TB appeared to be minimal, and most children with TB did not need isolation. Infection control efforts should be focused on accompanying adults and adult visitors. (Infect Control Hosp Epidemiol 2002;23:568-572).

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 10 , October 2002 , pp. 568 - 572
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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