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Tuberculosis for Addiction Counselors

Understanding the basics of tuberculosis (TB) is crucial for addiction counselors. Learn about TB history, symptoms, treatment, drug resistance, cost implications, public health roles, and the link between TB and substance abuse.

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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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