Health care workers with tuberculosis infected during work in the Netherlands

G. de Vries ^1*, M.M.G.G. ebek ², C.S.B. Lambregts-van Weezenbeek ²

¹ Dept of Tuberculosis Control, Public Health Service Rotterdam, The Netherlands
² KNCV Tuberculosis Foundation, The Hague, The Netherlands

^* To whom correspondence should be addressed. E-mail: devriesg{at}ggd.rotterdam.nl.

	Abstract

The risk of health care workers (HCWs) for tuberculosis (TB) attributable to occupational exposure is difficult to determine as well as the conditions contributing to this risk. The objective of the study was to determine which tuberculosis (TB) cases among health care workers (HCWs) in the Netherlands were infected during work and to analyse factors that contributed to infection and subsequent disease.

The total study population consisted of 101 cases over a five-year period. In 67 (66%) the route of infection could be determined by epidemiological and microbiological information. Of these cases, 42% (28/67) were due to infection at work in the Netherlands, 28% (19/67) community acquired and 30% (20/67) infected abroad.

The 28 cases infected at work were subject to an in depth analysis. Delayed diagnosis of the index case, especially in the elderly patient, was the main cause of patient-to-HCW transmission; in some circumstances inadequate infection control measures contributed to transmission.

A high suspicion of TB by the clinician, adequate infection control measures by hospital authorities and early identification of latent TB infection by occupational and public health specialists are relevant to prevent tuberculosis among health care workers.