How does PTB develop? TB bacilli enters the body and lodges in the lungs (TB Infection). In the lungs, they multiply and slowly eat the cells and the body begins to experience symptoms (TB Disease)  A person who develops a TB disease, when remain untreated, can then begin to infect others. In some cases, the TB germ migrates to other body organs and begin to destroy them, thus the advent of extra-pulmonary (outside) cases of Tuberculosis like TB of the meninges, bones, etc. A TB disease that remains untreated leads to death.

Airborne to prevent the transmission of highly contagious or virulent infections spread by small airborne droplets (smaller than 5 microns) examples know or suspected TB, chicken pox.

Airborne Precautions: spread of microbes on small droplet nuclei through the air ( 5 microns); which transmit 3 feet in air. (ie) TB, Mumps; Pertussis; Influenza; SARS. Private room / or cohort clients, and mask worn if within 3 feet.

TB can be transmitted in just about any setting. It can be spread in places such as homes or worksites. However, TB is most likely to be transmitted in health care settings when health care workers and patients come in contact with persons who have unsuspected TB disease, who are not receiving adequate treatment, and who have not been isolated from others. All health-care settings need an infection-control program designed to ensure the following:

• Prompt detection of TB disease;
• Airborne precautions; and
• Treatment of people who have suspected or confirmed tuberculosis (TB) disease.

Overview of TB Infection-Control Measures

The TB infection-control program should be based on the following three-level hierarchy of control measures:

1. Administrative controls
2. Environmental controls
3. Use of respiratory protective equipment

Administrative Controls

The first and most important level of the hierarchy, administrative controls, are management measures that are intended to reduce the risk or exposure to persons with infectious TB.  These control measures consist of the following activities:

• Assigning someone the responsibility for TB infection control in the health care setting;
• Conducting a TB risk assessment of the setting;
• Developing and implementing a written TB infection-control plan;
• Ensuring the availability of recommended laboratory processing, testing, and reporting of results;
• Implementing effective work practices for managing patients who may have TB disease;
• Ensuring proper cleaning, sterilization, or disinfection of equipment that might be contaminated (e.g., endoscopes);
• Educating, training, and counseling health care workers, patients, and visitors about TB infection and disease;
• Testing and evaluating workers who are at risk for exposure to TB disease;
• Applying epidemiology-based prevention principles, including the use of setting-related TB infection-control data;
• Using posters and signs to remind patients and staff of proper cough etiquette (covering mouth when coughing) and respiratory hygiene; and
• Coordinating efforts between local or state health departments and high-risk health-care and congregate settings.

Environmental Controls

The second level of the hierarchy is the use of environmental controls to prevent the spread and reduce the concentration of infectious droplet nuclei.  This includes two types of environmental control.

• Primary environmental controls consist of controlling the source of infection by using local exhaust ventilation (e.g., hoods, tents, or booths) and diluting and removing contaminated air by using general ventilation.
• Secondary environmental controls consist of controlling the airflow to prevent contamination of air in areas adjacent to the source airborne infection isolation (AII) rooms; and cleaning the air by using high efficiency particulate air (HEPA) filtration, or ultraviolet germicidal irradiation.

Respiratory Controls

The third level of the hierarchy is the use of respiratory-protection control. It consists of the use of personal protective equipment in situations that pose a high risk of exposure to TB disease.

Use of respiratory protection equipment can further reduce risk for exposure of health care workers to infectious droplet nuclei that have been expelled into the air from a patient with infectious TB disease. The following measures can be taken to reduce the risk for exposure:

• Implementing a respiratory protection program;
• Training health care workers on respiratory protection; and
• Educating patients on respiratory hygiene and the importance of cough etiquette procedures.

Determining the Infectiousness of TB Patients

The infectiousness of a TB patient is directly related to the number of droplet nuclei carrying M. tuberculosis (tubercle bacilli) that are expelled into the air.  The number of tubercle bacilli expelled by a TB patient depends on the following factors:

• Presence of a cough
• Cavity in the lung
• Acid-fast bacilli on sputum smear
• TB disease of the lungs, airway, or larynx
• Patient not covering mouth and nose when coughing
• Not receiving adequate treatment or having prolonged illness
• Undergoing cough-inducing procedures
• Positive sputum cultures

Patients can be considered noninfectious when they meet all of the following three criteria:

• They have three consecutive negative AFB sputum smears collected in 8- to 24-hour intervals (one should be an early morning specimen);
• They are compliant with an adequate treatment regimen for two weeks or longer; and
• Their symptoms have improved clinically (for example, they are coughing less and they no longer have a fever).

“A person with active TB will have symptoms. A person with latent, or inactive, TB will have no symptoms.

You may still have a TB infection, but the bacteria in your body is not yet causing harm. You may experience other symptoms related to the function of a specific organ or system that is affected. Coughing up blood or mucus (sputum) is a sign of in TB of the lungs. Bone pain may mean that the bacteria have invaded your bones.

These symptoms can also occur with other diseases, so it is important to see a healthcare provider and to let them find out if you have TB. If you think you have been exposed to TB, get a TB test.”

American Lung Association (https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-diagnosis)

Symptoms of active TB include a cough that contains thick, cloudy, and sometimes bloody mucus from the lungs, called sputum, for more than two weeks, tiredness and weight loss, night sweats and a fever, a rapid heartbeat, swelling of the lymph nodes, and shortness of breath and chest pain.

DIAGNOSIS:

There are numerous ways for a doctor to diagnose a patient with tuberculosis. Doctors can typically find latent, or not active, TB by doing a tuberculin skin test, where TB antigens are injected under the skin. If the patient has TB bacteria within their body, a red bump will appear at the injection spot in two days. A blood test can also be performed to detect if a patient has TB. For doctors to discover pulmonary TB, they will often test a sample of mucus from the lungs to see if the TB bacteria are present there. Other tests may include further testing on sputum, or mucus from the lungs, other blood tests, or a chest X-ray to find pulmonary TB. To diagnose extrapulmonary TB, a doctor may take a sample of tissue, or a biopsy, to test as well as a CT scan or an MRI to get a clear visual of the inside of the patient’s body.

TREATMENT:

In the majority of cases, doctors will combine four antibiotics to treat active TB, and it is essential for patients to take this medicine for a minimum of six months.

A majority of patients are cured of the TB bacteria if they take all the required medicine necessary to destroy the infection. If tests performed by a doctor reveal active TB is still present in the body after six months, treatment will continue for another two or three months. In the worst case scenario, if the TB bacteria is still resistant to multiple antibiotics, called multidrug-resistant TB, treatment will be necessary for one year or longer. Patients with latent TB may be treated with one antibiotic they consume daily for nine months or with a combination of antibiotics taken once a week for twelve weeks. Ensuring every dose is taken reduces the risk of a patient with latent TB to develop active TB.

“A total of 1.3 million people died from TB in 2022 (including 167 000 people with HIV). Worldwide, TB is the second leading infectious killer after COVID-19 (above HIV and AIDS).

In 2022, an estimated 10.6 million people fell ill with tuberculosis (TB) worldwide, including 5.8 million men, 3.5 million women and 1.3 million children. TB is present in all countries and age groups. TB is curable and preventable.

Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Only about 2 in 5 people with drug resistant TB accessed treatment in 2022.”

World Health Organization – WHO  (https://www.who.int/news-room/fact-sheets/detail/tuberculosis)

  TB commonly affects lungs.

Spreads via coughing and talking near someone so in active TB the patient is put in droplet isolation.  A restricted room and anyone who visits the pt in the room wears a mask.

Tuberculosis is an infectious disease usually caused by Mycobacterium tuberculosis bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body.

Approximately 8.6 million individuals are diagnosed with tuberculosis (TB), and 1.3 million will die of the disease globally, but it is commonly found in the developing world. TB is a highly contagious but treatable infection that predominantly affects the lungs and throat, but can also spread to the kidney, bones, and brain. So what is tuberculosis exactly? Find out what causes this highly contagious infection, who is most at risk for developing it, and how to treat the different kinds and prevent the spreading of this old world disease.

Tuberculosis, commonly abbreviated to TB, is an infection caused by slow-growing bacteria that festers in areas of the body containing an abundant amount of blood and oxygen, hence why it is commonly found in the lungs. TB found in the lungs is known as pulmonary TB and tuberculosis that spreads to other organs is called extrapulmonary TB. TB is highly contagious, but treatment is often effective and can take between six to nine months to treat, or in severe cases, can take up to two years to treat an infected patient. TB can also be either latent or active. Latent TB is when the immune system is defending the body against TB bacteria and keeping it from becoming active, with no visible symptoms. Active TB is when the TB bacteria are growing inside of the body and symptoms have become noticeable in the patient, and it is easy to spread the disease to others= CONTAGIOUS.

Pulmonary TB is contagious, however extrapulmonary TB does not spread as easily as it is usually contained within another part of the body. TB spreads when an individual has active TB breathes out air that has the TB bacteria in it and another individual breathes in the bacteria from the air. Even more bacteria can become airborne when an infected person coughs or laughs as well.

RISK FACTORS IN DEVELOPING TUBERCULOSIS:

1-Those at risk of developing TB are individuals who have HIV or another illness that weakens the immune system, individuals who have close contact with a patient with active TB such as living in the same house as an infected patient, and those caring for a patient with active TB, such as doctors and nurses.

2-Other risk factors include individuals who live or work in crowded places such as prisons, nursing homes, homeless shelters or wherever individuals may have active TB, as well as individuals who abuse drugs and alcohol.

3- Individuals with poor access to health care, where it is commonly seen in the developing world, as well as homeless individuals and migrant farm workers.

4-As well, traveling to places where untreated TB is common puts an individual at risk, such as Latin America, Africa, Asia, Eastern Europe, and Russia. It is important to note individuals who are at a high risk for developing TB should get tested once or twice a year.

5-As well, traveling to places where untreated TB is common puts an individual at risk, such as Latin America, Africa, Asia, Eastern Europe, and Russia. It is important to note individuals who are at a high risk for developing TB should get tested once or twice a year.  So people who make it in the United States via customs with this disease or left here to another country picking up TB bringing it in America passing customs put many at risk and pick up the TB and continue spreading it till treated and healed.  Just like the others who pick it up in or out of America but spread it in the U.S.  There needs to be closer checking on visitors coming in or citizens that leave home and come back in America to be checked for TB.  This will help decrease the amount of people in America with TB by getting diagnosed immediately with treatment.

“According to the Centers for Disease Control and Prevention, Health Literacy is the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions.

Health literacy is important for everyone because, at some point in our lives, we all need to be able to find, understand, and use health information and services.

Studies consistently show that a significant number of people have problems reading, understanding, and acting on health information.

This is an issue because health information is complex and can be hard to understand, and health providers are not necessarily skilled communicators. When organizations or people create and give others health information that is too difficult for them to understand, or we expect them to figure out health services with many unfamiliar, confusing or even conflicting steps, a health literacy problem is created.

Patients also bring a wide range of learning needs to the healthcare experience.

Basic literacy skills, language, age, disability, cultural context, and emotional responses can all affect the way people receive and process information — and the way people process information, in turn, has a direct impact on health outcomes and cost.”

District Health Department (https://www.dhd10.org/healthy-literacy-month/)

“Domestic Violence Awareness Month (DVAM) is a national campaign dedicated to raising awareness about domestic violence. Every October, organizations and individuals unite across the country for a national effort to uplift the needs, voices, and experiences of survivors. Congress declared the month of October to be Domestic Violence Awareness Month in 1989.”

Domestic Violence Awareness Project (https://www.dvawareness.org/HealHoldCenter)

“During hip replacement, a surgeon removes the damaged sections of the hip joint and replaces them with parts usually constructed of metal, ceramic and very hard plastic. This artificial joint (prosthesis) helps reduce pain and improve function.

Also called total hip arthroplasty, hip replacement surgery might be an option if hip pain interferes with daily activities and nonsurgical treatments haven’t helped or are no longer effective. Arthritis damage is the most common reason to need hip replacement.”

MAYO CLINIC (https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042)

“October was first designated as National Down Syndrome Awareness Month in the 1980s and has been recognized every October since. It is a time to celebrate people with Down syndrome and make others aware of their abilities and accomplishments.

People with Down syndrome are just like everyone else. They have similar dreams and goals, and they want to have successful careers and families. They can drive, go to work, go to college, go on dates, get married, and contribute to society.”

Special Oympics (ttps://www.specialolympics.org/stories/news/national-down-syndrome-awareness-month#:~:text=October was first designated as,are just like everyone else.)