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Tuberculosis Screening For Long Term Care and Retirement Home Residents
What is TB?
Tuberculosis is a disease caused by a germ often called TB. This germ enters the body through the air when someone who is sick with TB coughs, sneezes, or talks. People nearby may breathe in the germs and become infected. People who are infected have a small amount of TB in their lung that is not making them sick and cannot spread to others. However, people who are infected with the TB germ are at risk of developing active TB disease. People who have active TB disease are sick from TB and can spread their infection to others by coughing, sneezing or talking.
Why Do We Screen for TB?
All residents who move into a Nursing Home or Retirement Home setting must be screened for TB to make sure they are not showing signs or symptoms of active TB, and to prevent the spread of the germ to others. This requirement is outlined in both the Long-Term Care Homes Act, 2007 and Retirement Homes Act, 2010. http://www.e-laws.gov.on.ca
In the past, TB screening of residents included a TB skin test (TST), however routine TSTs upon admission to a nursing or retirement home are no longer recommended for residents 65 years of age and older. As people age, their TST result may become less reliable and more difficult to interpret. As well, preventative TB medication (to help prevent people who are infected from developing active TB disease) is more likely to cause side effects in the elderly so is not usually recommended.
What Kind of Screening is Required?
TB screening for residents admitted to a long-term care or retirement home settings includes a baseline chest x-ray with specific views (posterior-anterior and lateral) obtained within 90 days prior to, or up to 14 days after being admitted.
Residents less than 65 years may also have a two-step TB skin test, depending on the amount of TB disease in your community. This involves an initial TB skin test and then another one 7-21 days later if the first test is negative.
These assessments will help rule out active infectious TB. If active TB is suspected, the resident will then need to undergo further testing and evaluation.
For more information about TB, please call your local Public Health unit at 519-426-6170 or visit http://www.phac-aspc.gc.ca/tbpc-latb/fa-fi/
Adapted and reproduced with permission from Elgin St. Thomas Public Health, Grey Bruce Health Unit, Oxford County Public Health, Perth District Health Unit, Huron County Health Unit, and Middlesex-London Health Unit.