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A single tuberculosis patient has the potential to expose a large number of patients and staff in a healthcare setting, according to a case study in the Morbidity and Mortality Weekly Report. The report is put out by the Centers for Disease Control and Prevention.

The study looked at tuberculosis outbreak at a large community hospital in 2002. A patient with unrecognized TB, who also had HIV infection, exposed 1,045 people in a three-week period. The study says the HIV infection could have masked the TB symptoms. Seventy-five percent of those exposed were healthcare staff. Four patients and a healthcare worker were later diagnosed with TB – and all of them were on the same ward as the TB-positive patient.

“Although the incidence of TB continues to decline, heightened awareness and vigilance is required by hospital staff to identify and treat persons with suspected TB promptly,” the report says.

The report recommends patients with suspected TB be placed in respiratory isolation until infectious TB is ruled out. The reports says TB patients need to wear a surgical mask when being transported for procedures that cannot be performed in an isolation room. It also recommends that hospital infection-control programs have protocols for HIV-infected patients with pulmonary symptoms similar to TB.

The report can be found at www.cdc.gov/mmwr/index.html.