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Multidrug-resistant tuberculosis. Recommendations for reducing risk during travel for healthcare and humanitarian work.
Ann Am Thorac Soc 2014; 11(3):286-95AA

Abstract

Healthcare and humanitarian workers who travel to work where the incidence of multidrug-resistant tuberculosis (MDR TB) is high and potential transmission may occur are at risk of infection and disease due to these resistant strains. Transmission occurs due to inadequate transmission control practices and the inability to provide timely and accurate diagnosis and treatment of persons with MDR TB. Patients risk exposure if active TB is unrecognized in workers after they return to lower-risk settings. Guidance for risk reduction measures for workers in high-risk areas is limited, and no studies confirm the efficacy of treatment regimens for latent TB infection due to MDR TB. Bacille Calmette-Guérin (BCG) vaccination decreases the risk of active TB and possibly latent infection. IFN-γ release assays differentiate TB infection from BCG vaccination effect. A series of risk reduction measures are provided as a potential strategy. These measures include risk reductions before travel, including risk assessment, TB screening, education, respirator fit testing, and BCG vaccination. Measures during travel include use of respirators in settings where this may not be common practice, transmission control practices, triaging of patients with consistent symptoms, providing education for good cough etiquette, and provision of care in well-ventilated areas, including open air areas. Risk reduction measures after return include TB screening 8 to 10 weeks later and recommendations for management of latent TB infection in areas where the likelihood of MDR TB exposure is high.

Authors+Show Affiliations

1 Department of Medicine, Division of Infectious Diseases, University of Texas Health Center at Tyler, Tyler, Texas.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24673692

Citation

Seaworth, Barbara J., et al. "Multidrug-resistant Tuberculosis. Recommendations for Reducing Risk During Travel for Healthcare and Humanitarian Work." Annals of the American Thoracic Society, vol. 11, no. 3, 2014, pp. 286-95.
Seaworth BJ, Armitige LY, Aronson NE, et al. Multidrug-resistant tuberculosis. Recommendations for reducing risk during travel for healthcare and humanitarian work. Ann Am Thorac Soc. 2014;11(3):286-95.
Seaworth, B. J., Armitige, L. Y., Aronson, N. E., Hoft, D. F., Fleenor, M. E., Gardner, A. F., ... Nardell, E. A. (2014). Multidrug-resistant tuberculosis. Recommendations for reducing risk during travel for healthcare and humanitarian work. Annals of the American Thoracic Society, 11(3), pp. 286-95. doi:10.1513/AnnalsATS.201309-312PS.
Seaworth BJ, et al. Multidrug-resistant Tuberculosis. Recommendations for Reducing Risk During Travel for Healthcare and Humanitarian Work. Ann Am Thorac Soc. 2014;11(3):286-95. PubMed PMID: 24673692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multidrug-resistant tuberculosis. Recommendations for reducing risk during travel for healthcare and humanitarian work. AU - Seaworth,Barbara J, AU - Armitige,Lisa Y, AU - Aronson,Naomi E, AU - Hoft,Daniel F, AU - Fleenor,Michael E, AU - Gardner,Adrian F, AU - Harris,Drew A, AU - Stricof,Rachel L, AU - Nardell,Edward A, PY - 2014/3/29/entrez PY - 2014/3/29/pubmed PY - 2014/12/17/medline SP - 286 EP - 95 JF - Annals of the American Thoracic Society JO - Ann Am Thorac Soc VL - 11 IS - 3 N2 - Healthcare and humanitarian workers who travel to work where the incidence of multidrug-resistant tuberculosis (MDR TB) is high and potential transmission may occur are at risk of infection and disease due to these resistant strains. Transmission occurs due to inadequate transmission control practices and the inability to provide timely and accurate diagnosis and treatment of persons with MDR TB. Patients risk exposure if active TB is unrecognized in workers after they return to lower-risk settings. Guidance for risk reduction measures for workers in high-risk areas is limited, and no studies confirm the efficacy of treatment regimens for latent TB infection due to MDR TB. Bacille Calmette-Guérin (BCG) vaccination decreases the risk of active TB and possibly latent infection. IFN-γ release assays differentiate TB infection from BCG vaccination effect. A series of risk reduction measures are provided as a potential strategy. These measures include risk reductions before travel, including risk assessment, TB screening, education, respirator fit testing, and BCG vaccination. Measures during travel include use of respirators in settings where this may not be common practice, transmission control practices, triaging of patients with consistent symptoms, providing education for good cough etiquette, and provision of care in well-ventilated areas, including open air areas. Risk reduction measures after return include TB screening 8 to 10 weeks later and recommendations for management of latent TB infection in areas where the likelihood of MDR TB exposure is high. SN - 2325-6621 UR - https://www.unboundmedicine.com/medline/citation/24673692/full_citation L2 - http://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201309-312PS?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -