Do We Need TB Testing After Exposure to a Confirmed Case?

Q: Do We Need TB Testing After Exposure to a Confirmed Case?

Hello： Tuberculosis can be transmitted through airborne droplets, but prolonged exposure is typically required for infection to occur. <br>Generally, about one-third of household contacts will become infected (90% of those infected will never develop the disease in their lifetime

Regarding tuberculosis (TB)?

Dr.
Yang: Hello, my grandmother was recently hospitalized at Chiayi Chang Gung Memorial Hospital.
A week ago, the hospital suspected she had a tuberculosis infection, which was later confirmed.
She was placed in an isolation room during the suspicion phase.
My brother, sister, and my sister's child visited her.
However, she was suddenly discharged and returned home yesterday (August 3rd).
I also entered my grandmother's room to bring her food.
Usually, my mother and grandfather help change her diapers.
Should we all get tested?

Ping, 30~39 year old female. Ask Date: 2013/08/04

Dr. Yang Wenda reply Pulmonology

Hello: Tuberculosis can be transmitted through airborne droplets, but prolonged exposure is typically required for infection to occur.
Generally, about one-third of household contacts will become infected (90% of those infected will never develop the disease in their lifetime), while only 10% of contacts may develop the disease at some point in their lives (similar to how a grandmother may develop it in old age due to weakened health).
Public health nurses at health centers will conduct further examinations for household contacts if they have had a single exposure lasting 8 hours or more, or a cumulative exposure of 10 hours or more.
Wishing you well!

Reply Date: 2013/08/04

More Info

When it comes to tuberculosis (TB) testing after potential exposure to a confirmed case, it is essential to understand the dynamics of TB transmission and the recommendations for screening. Tuberculosis is an airborne infectious disease caused by the bacterium Mycobacterium tuberculosis. It primarily spreads through the air when a person with active TB coughs, sneezes, or talks, releasing tiny droplets that can be inhaled by others.

In your situation, since your grandmother was confirmed to have active TB and you, your siblings, and your family members had contact with her during her hospitalization, it is advisable to undergo TB testing. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommend that individuals who have been in close contact with someone diagnosed with active TB should be screened for TB infection. This is particularly important if the contact occurred while the individual was infectious, which is typically when they are symptomatic and have not yet started treatment.

The testing process usually involves a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA), which are both used to determine if someone has been infected with the TB bacteria. The TST involves injecting a small amount of tuberculin into the skin and checking for a reaction after 48-72 hours. The IGRA is a blood test that measures the immune response to specific TB proteins. Both tests have their advantages and limitations, and the choice between them may depend on individual circumstances, such as prior BCG vaccination status or the likelihood of false-positive results.

Given that your grandmother was in isolation, it is crucial to consider the timing of your exposure. If you were in close proximity to her while she was symptomatic and infectious, the risk of transmission increases. Symptoms of active TB can include a persistent cough, weight loss, night sweats, and fever. However, it is also important to note that not everyone who is exposed to TB will become infected, and not everyone who is infected will develop active TB disease.

If you and your family members are asymptomatic and have no risk factors for TB, the initial step would be to get tested. If the test results are positive, further evaluation will be necessary, which may include a chest X-ray to check for active disease. If the results are negative, it is still advisable to monitor for any symptoms of TB over the following weeks and months, as it can take time for the infection to become detectable.

In summary, yes, you and your family members should get tested for TB after exposure to your grandmother, especially given the confirmed diagnosis of active TB. Early detection and treatment are crucial in preventing the spread of TB and ensuring the health and safety of everyone involved. If you have any further concerns or questions, it is best to consult with a healthcare provider who can provide personalized advice based on your specific situation.

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