[Histonet] TB Exposure

[Morken, Tim - Labvision]

Karen, your yearly test is your baseline. You now need to have another test
in a few weeks (assuming you don't get sick in the meantime) to check for
seroconversion.

The only reported links of TB seroconversion due to cryostat sectioning are
anecdotal and could only prove "association" with cryostat sectioning (in
other words, it was the only exposure they could document, but it could not
be proved absolutely that it was this exposure which caused the infection).

Even so, precautions are definitely in order. TB is a Biosafetly level 3
agent, and demands very stringent precautions to work with. 

Here are some links about TB exposure in the histology lab 

A research paper by a pathologist assistant, with many references (including
the reports referred to above):
www.pathologistsassistants.org/Public_content/w03%20essay.doc

CAP document from an audio conference concerning lab infection control
http://www.cap.org/apps/docs/education/lapaudio/wordppt/lapaudio_071801_ccs.
doc



Tim Morken


-----Original Message-----
From: Bauer, Karen [mailto:Bauer.Karen <@t> mayo.edu] 
Sent: Wednesday, June 02, 2004 9:31 AM
To: Histonet (E-mail)
Subject: [Histonet] TB Exposure


Hi to all,

I'm curious to find out what different procedures are out there dealing with
possible TB exposures.  

We had a lung case that we did a frozen section on, not realizing that it
was a possible TB case.  After special stains and cultures came back
positive, one of our Pathologists told the tech who did the frozen to go get
a baseline TB skin test done and then follow up 12 weeks later.  When she
went to receive the test, they turned her away, stating that she does not
qualify as an exposure.  An exposure is defined as "being within the same
confined space for at least one hour with a clinically symptomatic patient
without respiratory protection".  So, I'm a little confused.  If we are
doing a frozen on TB infected lung tissue, with no hood or ventilation
drawing the air away from us, spraying Cyto-Cool all over it (probably
causing the bacteria to scatter all over), then why do we get fitted for
special masks to protect ourselves?  We do wear our masks if we know a
patient is infected with TB, but do not routinely wear them for every lung
case.  And, if we are only exposed by being with the patient, then we should
never have to wear our masks. 

How are others dealing with this?

Thanks in advance!!

Karen Bauer HT(ASCP)
Histology Supervisor


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