Tuberculosis (TB) is a serious health concern for many people, mostly in developing countries, but some populations have a higher chance of catching the disease than others (Lawlor, 2007). The population of interest here is health care workers, because they are always exposed to more diseases and problems than other populations are. They have higher instances of some diseases, and they put themselves at risk each day from the various types of germs that they encounter. Some people who come to hospitals and doctors' offices are very sick and do not realize how serious their situation is or exactly what they have, and this is often true of tuberculosis because it is still rather unexpected in developed countries like the United States (Lawlor, 2007). Only around ten percent of people in the United States have tuberculosis, and most of them have a latent infection that does not have any symptoms or cause them any problems (Lawlor, 2007).
There was a story several years back about a man who flew on a commercial airline from one country to another, knowing that he had TB. People all around him on the airline had to be hunted down and tested for the disease, but luckily he did not spread it to others. There was a lot of public outcry regarding it, however, because he risked the lives of a lot of individuals. TB can be deadly, and once a person contracts it, it can be almost impossible to get rid of easily (Lawlor, 2007). There are some strains of it that are becoming very resistant to the antibiotics that are currently offered, and these strains mean that TB is mutating and changing, as well as that it may become more wide-spread and harder to control in the future. For the health care worker, that is a very serious and very real concern (Lawlor, 2007).
Agent of Disease
The disease is spread through coughing, sneezing, or through saliva - similar to the flu or a cold (Kidder, 2004). Since that is the case, people who work around sick people and who see patients every day have to be more careful. The disease itself is a bacteria, and it generally attacks the lungs (Kidder, 2004). It can, though, attack the nervous system, the gastrointestinal system, or other areas of the body, depending on the person and how he or she reacts to the bacteria (Kidder, 2004). Skin, bones, and joints can also be affected by TB (Kidder, 2004). Many people carry the latent version of the bacteria in third world and developing countries, but they do not have symptoms. When they carry TB around, though, they cannot pass it on to others unless their infection becomes active (Kidder, 2004). If the infection becomes active they will have prolonged coughing, usually with blood in the sputum, trouble breathing, fatigue, weight loss, fever, night sweats, and other related symptoms (Kidder, 2004). Naturally, however, the symptoms may be different if the TB bacteria choose to attack a part of the body other than the lungs.
Vulnerability of the Health Care Worker Population
For people who work in health care, tuberculosis is of higher concern because they might be exposed to people who are not aware that they have the disease. The chance of exposure is much higher, as well, because of the volume of people with health problems that these workers see each day. Since many people carrying TB do not have many symptoms they would not be coming to health care workers for this problem and would not be isolated or screened for it, at least not right away. Even people who come to doctors or hospitals with TB symptoms could also have something else, such as a bad cold or the flu, so many health care workers do not stop and really consider the possibility of the person having TB instead of something more common and more routine.
Environmental Factors for Disease Vulnerability
The main, mitigating factor for disease vulnerability in this population stems from the fact that they are exposed to so many sick people (Joint, 2000). There are also the chances of being stuck with a needle that was used to draw blood and/or being otherwise contaminated, even if that person is not their specific patient. Biohazards are a very real concern for all kinds of people who work in health care settings, and even in the United States, Britain, and other well-developed countries there are many people who can still get very sick and pass that sickness on to others (Joint, 2000).
The suppressed immune systems that people can have when they are under too much stress and working very long hours can also contribute to the chance of acquiring TB, because the body will not be strong enough to fight off the disease like it otherwise would (Joint, 2000). If a health care worker has a chronic medical condition or is taking certain, specific medications, that worker is also at higher risk for acquiring the TB bacteria and should try to avoid environments where transmission could take place - but of course this is not always possible (Joint, 2000).
People transmit TB through coughing, sneezing, and spitting, or other saliva contact (Dormandy, 2000). Even kissing could potentially transmit it, although it would be unlikely. When a person coughs or sneezes, air (and anything in it) is expelled from the body much more violently, and that is one of the reasons that the TB bacteria can travel to people around the infected person so easily (Dormandy, 2000). People who have prolonged and heavy contact with TB-infected individuals generally have their own infection rate of more than twenty percent (Dormandy, 2000). More than forty thousand infected droplets can be expelled from a person's body with each sneeze, for example, and each one of those droplets has the potential to infect someone else (Dormandy, 2000). A large dose of the bacteria is not needed to cause infection, and a single droplet would be enough.
Methods of Control
The best method for control is for people who are not infected with TB to stay away from those who are until those people have been sufficiently treated and are no longer contagious. That is not always possible, though, in health care settings. For those who must work around TB patients, care is certainly needed. There is a vaccine used for children that works relatively well, but it does not work for adults, and they are the ones who most often acquire the bacteria and the problems that are caused by it (Blumberg, Leonard, & Jasmer, 2005). Since adults cannot be reliably and sufficiently vaccinated for TB, health care workers should isolate those who have active TB infections and should wear gloves and masks and eye protection at all times when they are working with TB patients (Blumberg, Leonard, & Jasmer, 2005).
The more protected they are from aerosolization of infected droplets the better their chances of avoiding infection (Blumberg, Leonard, & Jasmer, 2005). The key, of course, is to locate anyone with active TB and treat them promptly so that they do not infect more people. Those with latent TB should also be treated, but the situation is not as dire because they are not infectious and cannot transmit their sickness to anyone else simply by coughing or sneezing around them (Blumberg, Leonard, & Jasmer, 2005). Only around ten percent of latent TB infections ever turn into active ones that could spread the disease (Blumberg, Leonard, & Jasmer, 2005). Prevention and antibiotics are the only recognized methods for treatment of TB (Blumberg, Leonard, & Jasmer, 2005).
Social and Cultural Influences
Because health care workers are such a diverse group, social and cultural influences play many roles in the disease. Some people naturally worry about getting…