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U.S. Department of Health and Human Services


Core Curriculum on Tuberculosis, 2000

Chapter 8
Infection Control in Health Care Settings


The infectiousness of TB patients is directly related to the number of tubercle bacilli that they expel into the air. Infectiousness usually declines very rapidly after adequate therapy is started. The main goal of an infection control program is to detect TB disease early and to isolate and promptly treat persons who have TB. An infection control program should involve three types of controls administrative controls, engineering controls, and personal respiratory protection and should be based on a risk assessment of the setting (inpatient and outpatient). Administrative controls (e.g., the prompt detection of suspected cases, isolation of infectious patients, and appropriate treatment) comprise the primary strategy for infection control. Administrative controls also include training and education and TB screening for health care workers (HCWs). In addition, three types of engineering controls may be used to prevent the transmission of TB: ventilation, high-efficiency particulate air (HEPA) filtration, and ultraviolet germicidal irradiation (UVGI).

In places where administrative and engineering controls may not fully protect health care workers from infectious droplet nuclei, HCWs should use personal respirators. Precautions to prevent airborne transmission are particularly important in TB isolation rooms and during and immediately after procedures that stimulate coughing (e.g., sputum collection, bronchoscopy, and aerosolized pentamidine treatments).

Coordination with the health department is necessary in order to report all confirmed or suspected TB patients, conduct contact investigations, and plan for follow-up care for patients known to have or suspected of having TB.


After working through this chapter, you will be able to

  • Explain when a TB patient can be considered noninfectious;
  • List the three types of controls in an effective infection control program;
  • Explain the purpose and the characteristics of a TB isolation room;
  • Describe the circumstances when personal respirators should be used.


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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