Tuberculosis (TB) is a serious infectious disease that poses a particular concern in long-term care (LTC) facilities due to the vulnerability of residents and the close living quarters that facilitate the spread of airborne illnesses. Understanding TB’s transmission, symptoms, and prevention is essential for protecting the health of both residents and staff.
What Is Tuberculosis?
TB is caused by the bacterium Mycobacterium tuberculosis and primarily affects the lungs, though it can spread to other organs such as the liver, skin, and bones if untreated. It spreads through the air in tiny droplets expelled when an infected person coughs, sneezes, or talks. In LTC settings, where individuals often live in close proximity and may have weakened immune systems, the risk of transmission is significantly higher.
After exposure, the body’s immune system typically responds within two to ten weeks, limiting the bacteria’s spread and keeping the infection latent. However, if the immune system is compromised—due to age, chronic illness, or medications—the infection can progress to active TB disease, making the individual both symptomatic and contagious.
Infection vs. Disease
Understanding the distinction between TB infection and TB disease is critical:
TB Infection (Latent TB): Individuals carry the bacteria but do not exhibit symptoms. The bacteria are inactive, the person does not feel sick, and they are not contagious. However, without preventive treatment, latent TB can develop into active TB later in life, especially if the immune system becomes weakened.
TB Disease (Active TB): The bacteria become active and multiply, leading to noticeable symptoms. At this stage, the person is contagious and requires medical treatment. A chest x-ray will typically show signs of disease.
Signs and Symptoms of Active TB
In residents and staff of LTC facilities, the following symptoms may indicate active TB disease:
A persistent cough lasting longer than 2–3 weeks
Chest pain
Fatigue or weakness
Unexplained weight loss
Loss of appetite
Chills and fever
Night sweats
Early identification of these symptoms is vital in preventing outbreaks within care homes.
Prevention and Control in LTC Facilities
Preventing TB in LTC settings involves several key measures:
Screening: Regular TB testing for both residents and staff, especially at the time of admission or employment.
Isolation: Prompt isolation of individuals showing symptoms until a diagnosis is confirmed or ruled out.
Treatment: Ensuring those with TB infection receive preventive medication and those with TB disease undergo full treatment with antibiotics.
Education: Training staff to recognize TB symptoms and understand transmission risks.
By remaining vigilant and proactive, long-term care facilities can minimize the risk of TB outbreaks and protect the health of their residents and staff.