Riben P D, Epstein J B, Mathias R G
Health Facility Epidemiology/Environmental Health, Vancouver Hospital and Health Sciences Centre.
J Can Dent Assoc. 1995 Jun;61(6):492, 495-8.
The number of new cases--or incidence--of tuberculosis is increasing in nearly every region of the world. A number of forces have resulted in the increased incidence of TB in developed countries, including the HIV epidemic, homelessness, and emigration from highly endemic regions. Although the number of new cases in Canada is relatively constant, the TB experience in the United States serves as a reminder that this situation could change rapidly. The appearance of multidrug-resistant tuberculosis has added to the urgency of situation. The basic methods of preventing TB transmission include preventing the release of the organism into the air, removing the organism from the air, and preventing the inhalation of the organism. Identifying and appropriately treating every person with active tuberculosis is an extremely important component of the control strategy; adequate ventilation, filtering air, and ultraviolet germicidal irradiation are methods used to remove the organism from the air; and masks and other personal protective devices, such as high-efficiency particulate air filters (HEPA), have been suggested as a means of preventing inhalation of the organism. In addition, identifying new TB infections and using chemoprophylaxis often prevents infection from progressing to active disease. Given the route by which tuberculosis is transmitted, it is necessary for both dentists and allied dental personnel to be aware of the risks they may face in day-to-day practice, and the means by which they can protect themselves and their patients.
全球几乎每个地区的结核病新发病例数(即发病率)都在上升。多种因素导致发达国家结核病发病率上升,包括艾滋病毒流行、无家可归以及来自高流行地区的移民。尽管加拿大的新发病例数相对稳定,但美国的结核病情况提醒人们,这种情况可能迅速改变。耐多药结核病的出现加剧了形势的紧迫性。预防结核病传播的基本方法包括防止病菌释放到空气中、从空气中清除病菌以及防止吸入病菌。识别并妥善治疗每一位活动性结核病患者是控制策略的极其重要组成部分;充分通风、过滤空气和紫外线杀菌照射是从空气中清除病菌的方法;口罩和其他个人防护设备,如高效空气过滤器(HEPA),已被建议作为防止吸入病菌的手段。此外,识别新的结核感染并使用化学预防措施通常可防止感染发展为活动性疾病。鉴于结核病的传播途径,牙医和牙科辅助人员有必要了解他们在日常工作中可能面临的风险,以及他们保护自己和患者的方法。