Health Care Worker Unknowingly Infected with TB Potentially Exposes Over 600 Individuals

Tuberculosis is one of the world’s deadliest diseases, according to the Centers for Disease Control and Prevention (CDC), and now, it may have unknowingly spread through 3 health care facilities in southeast Michigan through a seemingly unlikely source: a health care worker.

The Michigan Department of Health and Human Services (MDHHS) along with the Livingston, Oakland, and Washtenaw county health departments have teamed up with 3 health care facilities “to determine the health status of patients and staff who have been identified as being in close contact with a health care worker recently diagnosed with tuberculosis,” the MDHHS announced in a recent press release.

While unknowingly infected with the disease, the individual worked at 2 hospitals, and a senior rehabilitation and a long-term care facility, potentially exposing over 600 individuals between May 1, 2017 and January 31, 2018, according to the MDHHS.

Tuberculosis bacteria is spread through the air from one individual to another through coughing or speaking. Individuals in close range run the risk of breathing in the bacteria and thus, falling ill themselves. According to the CDC, infected individuals are more likely to spread the disease to those they spend time with every day; this includes family members, coworkers, and in this case, potentially patients.

Currently, the health care worker is no longer working at this time and is receiving treatment. The MDHHS is working with the county health departments to identify patients and staff that may have been exposed, notify them, and encourage them to get tested for the disease.

This mass exposure serves as a reminder that although health care workers are instrumental in improving patient outcomes, sometimes they can do more harm than good by showing up to work when feeling ill. In fact, a recent study published in the American Journal of Infection Control found that 4 in 10 health care providers still choose to go to work while experiencing symptoms of infectious disease.

Furthermore, a mixed-method study found that 94% of health care workers included in the study “believed that working while sick placed patients at risk.” Nonetheless, this did not stop 83% of these same individuals from showing up to work at least once in the year before the study was performed, and approximately 10% from working while sick at least 5 times that same year.

As for the reasons behind their decisions to show up for work despite exhibiting symptoms?

Matt Linam, MD, MS, assistant professor of Pediatric Infectious Diseases at the University of Arkansas for Medical Sciences, stated in a past symposium that many of these workers believed they would let their patients or colleagues down if they did not show up; they believed they were abiding by the “cultural norm.” Furthermore, some of them shared that they were not aware of what is considered “too sick” to work, “especially as it relates to respiratory viral illness.”

“Trying to get health care workers to stay home when they’re ill is a big challenge and I think it’s a challenge for all hospitals. There’s this ingrained mentality that ‘we need to work,’ ‘we need to be there,’ there’s staffing challenges that are sometimes very real, and in some cases, we’ve actually created a system that penalizes health care workers for staying home,” Dr. Linam told Contagion ^® in an interview. “So, in order to really try to get health care workers to stay home when they’re ill, we really need to be more conscious about the system we’ve created.”

This is not to say that the Michigan health care worker knew he/she was sick and decided to go to work anyway, but it does underscore the need for those working in health care facilities to speak up if they see a colleague exhibiting symptoms. Tuberculosis symptoms to watch out for include: a bad cough that can last for 3 weeks or longer, chills, fever, weight loss, weakness or fatigue, among others.

The St. Joseph Mercy Ann Arbor and Livingston hospitals are offering blood tests and medical treatment as necessary to patients and staff who have been notified of potential exposure. According to the MDHHS, results will be available in a few days.