Since the beginning of February 2014, several cases of active tuberculosis (TB) have been diagnosed in Delaware. Of these, three cases were in a highly infectious stage of the disease and diagnosis should have been made months earlier, when the individuals first become symptomatic. Earlier diagnosis is vital as it significantly reduces the chance for potential exposures and possible transmission of the disease to healthcare providers and visitors/patients to healthcare facilities, as well as the general public.
Although Delaware has enjoyed a low incidence of TB for many years, the Division of Public Health wishes to remind health care providers that TB continues to be a threat, and urges providers to consider TB when evaluating patients.
Active TB is a legally reportable illness in Delaware. To report a case of active TB, please contact the TB Clinic in your county. Phone numbers are provided below under “Additional Information”.
TB should be considered early if individuals in the following categories present with a compatible clinical picture. (Note: this is not an exhaustive list, for further information visit www.cdc.gov/tb.)
Whenever TB is considered on the differential diagnosis for a patient based on a clinically compatible picture (signs, symptoms, radiology), such patients should be placed in an Airborne Infection Isolation room (AII) pending exclusion of TB. Providers are reminded that pre-emptive placement of such patients in airborne isolation is safer and less time consuming in the long term for staff and patients than is retroactively locating, testing, and treating infected individuals after TB exposure has occurred.
The vast majority of active TB is treated by specialists in DPH’s three TB Clinics, and individuals should be referred to them, unless patient condition indicates immediate hospitalization is necessary. If this is the case the TB clinics should be notified of the patient’s diagnosis as soon as possible and while the patient is still in the hospital. The TB Clinics’ referral numbers are listed below. Treatment of culture-positive cases should always be based on the results of drug sensitivity testing. Drug-sensitive TB is generally treated with a combination of 4 medications given by directly observed therapy (DOT) over a period of several months. DOT is legislated in Delaware for all active TB cases.
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