Are Your Nursing Assistants in the Know About Tuberculosis?

Do your CNAs know that one third of the world’s population is infected with tuberculosis? While TB rates are down in the U.S., tuberculosis continues to be a serious problem. By sharing the following information and tips at your next CNA inservice meeting, you’ll arm your aides with the knowledge they need to continue the fight against TB.

What’s the Deal with Tuberculosis?

One hundred years ago TB was the number one cause of death in the United States. But, who cares? That was one hundred years ago! We’ve come a long way in controlling TB since then, right? Well, yes… and no.

Yes, we have tests to tell if people have TB and we have drugs to treat the disease. And, we’ve learned how to protect healthcare workers from being infected and how to keep other patients in a hospital safe from a patient with TB.

But, the bacteria that cause TB are not giving up! Still, nearly 14,000 new cases of TB are reported each year in the United States. The TB bacteria have learned how to outsmart our best drugs. And, they like to attack people who have weak immune systems-like people with AIDS.

These tiny bacteria cause a serious disease that usually attacks and damages the lungs, but can also affect other parts of the body like the kidneys, the spine and the brain.

A third of the world’s population (about 2 billion people) are infected with TB bacteria. And, one out of every ten of those people will become sick with active TB.

So, it has never been more important to practice proper infection control measures against TB. In fact, our government has “declared war” against TB. The goal is to get rid of the TB bacteria in the United States by the year 2010! Reaching this goal will require your help-keep reading to find out how you can become part of the solution!

TB Terms You Should Know

EXPOSED: People are exposed to tuberculosis when they share the same air as a person who has infectious TB.

TB SKIN TEST: There is a skin test for TB infection in which a small amount of testing fluid is injected just under the skin on the lower part of the arm. After two or three days, a health care worker checks for a positive reaction at the injection site. You might hear this test called a “Mantoux” test or a “PPD” test.

LATENT TB INFECTION: People with latent TB infection have no symptoms, don’t feel sick, can’t spread TB to others, and usually have a positive skin test reaction. But they may develop TB disease later in life if they do not receive treatment for latent TB infection.

TB DISEASE: People who show signs of being sick from the tuberculosis bacteria are said to have TB disease. They have active or infectious tuberculosis disease-and can spread it to others. People with TB disease show signs of having TB when doctors check their chest x-rays and look at their sputum under a microscope.

MULTIDRUG-RESISTANT TB (MDR TB) – TB disease caused by bacteria resistant to more than one drug often used to treat TB.

QUARANTINE: Keeping people who have active TB disease in quarantine means that they are made to stay in a hospital or in their homes until they are no longer infectious.

DIRECTLY OBSERVED THERAPY (DOT): Because many people don’t take their anti-TB medications properly, Directly Observed Therapy was developed. This is the name for the TB treatment in which healthcare professionals or other individuals actually watch people taking their anti-TB medications.

Signs & Symptoms of TB

  • A productive cough lasting longer than two weeks
  • Chest pain
  • Coughing up blood
  • Fever and chills
  • Sweating at night
  • Loss of appetite
  • Weight loss
  • Constant tiredness

How Is TB Spread?

  • The germs that cause TB are spread through the air.
  • TB can be spread from one person to another by coughing, laughing, sneezing, singing or even talking.
  • Tuberculosis is usually spread between family members, close friends, and people who spend time in crowded places together over long periods of time such as jails and homeless shelters.

The Tip Five Ways You Can Help Stop TB!


Remember that the symptoms of active tuberculosis include a lasting cough, chest pain, fever, chills, night sweats, fatigue, loss of appetite and weight loss.

Keep an eye on your clients for these signs, especially if they are over 65, are HIV+, have other chronic illnesses like diabetes or renal failure, or have been exposed to someone else with TB.


It’s not up to you-or your supervisor-to diagnose tuberculosis. But you must report changes in your clients that might mean they have TB. And, the sooner, the better!

Your supervisor will make sure the client gets tested and that everyone who works with the client protects themselves from possible infection.


Ask your clients to cover their mouth and nose with a tissue when coughing or sneezing. Then, throw the tissue in the trash.

Air out their rooms if possible (unless they are in a special isolation room). TB spreads in small closed spaces where air can’t move. Open a window if it’s not too cold. Consider using a fan to blow the room air out the window.

Remind your clients about how important it is that they take their anti-TB medication. Don’t let them forget-especially when they start feeling better.


Whenever you work with clients who have active TB-or who might have it-you must wear a personal respirator mask. Remember that a paper mask will not do any good. (The TB bacteria are small enough to fit through the weave of a paper mask.)

Be sure you have been fitted for the right size mask, and that you put in on before you enter the client’s area. Wear it the entire time you are with the client and take it off only after you leave!


Don’t ignore these important tests. If you don’t know when you are due for another TB test, ask your supervisor. Then, make sure you get it on schedule-don’t wait for someone to remind you. Getting tested on time could make a difference to you, your clients, your coworkers and your family.