Spread of TB via droplet nuclei of sputum can occur from TB infected patients when they cough, sneeze, talk, or sing. The persons at greatest risk of contracting tuberculosis are household contacts of patients with active TB, exposure to persons from foreign countries where TB is endemic, and exposure of health care workers (doctors, nurses, aides, etc), particularly from bronchoscoping, suctioning, and giving aerosol medications to patients with active TB.
Remember, that when examining a patient who is unknown to the examiner, care must always be taken that the patient not breathe directly into the health care worker’s face. This is especially true in the Emergency Room and in Outpatient Clinic where patients are seen for the first time.
Good ways to prevent spread of TB are the use of isolation rooms, masking of patients who need to be transported to various areas of the hospital, and most important of all is to start all suspected active TB patients on medication as eradication of cough (the best method of transmission) and also eradication of mycobacterial organisms occur very quickly once treatment is begun.
In hospitalized patients with active TB, negative pressure isolation rooms are appropriate, especially if the patient has smear-positive active TB.