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Tuberculosis for Addiction Counselors

Tuberculosis for Addiction Counselors. Catherine Kroll, MPH, CPH. Basics. Agent: Bacteria Spread: Respiratory Droplets Symptoms: Prolonged cough-sometimes with blood! Fever/Night sweats Weight Loss. Infection vs. Active Disease.

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Tuberculosis for Addiction Counselors

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  1. Tuberculosis for Addiction Counselors Catherine Kroll, MPH, CPH

  2. Basics • Agent: Bacteria • Spread: Respiratory Droplets • Symptoms: • Prolonged cough-sometimes with blood! • Fever/Night sweats • Weight Loss

  3. Infection vs. Active Disease • Infection: Bacteria sleep in your body without causing illness • 10% of infected progress to active disease • Active disease: “event” occurs that wake up the bacteria and they reproduce leading to illness • Contagious if pulmonary • Can be in any body site

  4. History • Hippocrates • 460 BC • 1600s • Primary cause of death in Europe • U.S. Sanitariums • Community Treatment

  5. Testing • Infection • Skin Test • Blood Test • Contagious Disease • X-ray • Bacterial culture

  6. Treatment • Active Disease • 4 months to 2 years to treat • Standard Treatment • 4 drugs for 2 months then 2 drugs for remainder • Latent Disease • 9 months with INH • 4 months with Rifampin • 12 weeks with New DOT regime

  7. Drug Resistance • Evolution • Selective Pressure • Misuse of antibiotics • Not Directly Observed Therapy • Lack of new medications

  8. Cost of Drug Resistance • Depends on what medications person is resistant to • Recent AZ case • $250,000

  9. Role of Public Health Department • Ensure Treatment of Active Case • Directly Observed Therapy • Investigate Contacts • Identify • Screen • Evaluate/test • Treat

  10. Is it really a problem? • ~1/3 of the world’s population is infected • ~5% of the US population infected • 22 cases of active TB in Clark County in 2010

  11. What does it have to do with me? • Risk to become infected • Injection Drug Users • Homeless • Congregate Living Settings • Risk of moving from infection to contagious disease • Substance Abuse • Weak immune systems

  12. Link to Substance Abuse • Hotboxing • Smoking in an enclosed place so that smoke is repeatedly inhaled • Sharing bongs • Shot Gunning • Inhaling smoke directly into face of another person

  13. What happens if I get exposed? • Risk Assessment • Skin Testing or Blood Testing • Treatment

  14. What can I do? • Work within your program to refer symptomatic people for confidential testing • Get tested annually • WAC 388-805 • Call Clark County Public Health TB Program with questions • 360-397-8182

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