Investigation of patient contacts of heath care workers with infectious tuberculosis: 6 cases in the Paris area

Abstract

Setting: From June to October 2003, six cases of infectious tuberculosis were reported in health care workers (HCWs) working in hospitals in the Paris area.

Objective: To describe a method of investigation to identify tuberculosis infection in patient contacts.

Design: To define the cohort of patient contacts, the risk of contamination was evaluated based on 1) the degree of infectiousness of the HCW, 2) patient characteristics, and 3) the proximity and length of exposure.

Results: The number of patient contacts selected was very variable. A small proportion was investigated in consultation, except for a paediatric service in which 43 patient contacts were identified and where the information was managed within the service. In this cohort, two patient contacts presented tuberculous infection with an unclear link with the infectious HCW. In adults, the analysis of the information gathered was difficult due to the different screening practices used.

Conclusion: These results show the importance of better targeting screening of patient contacts and of improving the detection of tuberculosis cases among HCWs.