ANNAPOLIS – Christie Brown places a properly fitted blue mask over her mouth and nose before she enters the isolation room at Mercy Medical Center in Baltimore.
Mercy is where the most severe cases of tuberculosis in Baltimore are treated and Brown, a clinical nurse, works with the sickest of the sick.
Baltimore has the second-highest number of tuberculosis cases in Maryland.
Brown’s mask is her primary defense from catching this deadly airborne disease. Yet, despite the danger, she still treats the patients with vigilance.
Nurses at Mercy follow strict guidelines to ensure they are protected from the lethal bacterial infection. Working with patients who have the airborne disease can be scary at times, but these nurses say it’s all part of the job.
“One of the biggest issues is to educate (the patients),” Brown said. “We make sure they know why everyone’s wearing a mask. We try not to make them feel isolated.”
Patients suspected of having active tuberculosis are housed in a negative pressure room. It looks like an ordinary hospital room but when the door opens, air is sucked in, so germs are not released in the hallways. The air inside is circulated to the outside of the building.
Last year, 185 people were quarantined in Mercy’s isolation room. Most of them were infected with the HIV virus. Of those, several had active tuberculosis, which tends to strike those with weakened immune systems.
The major precaution nurses take is making sure everyone is fitted with a mask and wears it whenever they are in contact with a patient. Some of the sickest patients come through the intensive-care ward at Mercy, and the risk is that there they could easily transmit an infectious disease to others.
“We’re exposed to a lot in our career,” said Brown, who added the nurses are well practiced at moving infectious patients into isolation. “The idea is to keep it contained.”
As drug-resistant strains of tuberculosis have developed over the years, treatment of active tuberculosis now requires taking four drugs for up to two years, a far cry from the one drug used in the early 20th century.
The treatment, which is inexpensive and cures more than 95 percent of the cases, is only available to a fifth of the world’s 15 million active tuberculosis sufferers.
Since tuberculosis symptoms mimic other ailments, including the common cold and pneumonia, doctors with even a suspicion of the disease put patients on medication immediately until a diagnosis is made.
“Tuberculosis can make you very sick,” said Toni Gervasio, a nurse and infection control practitioner at Mercy. “People still die from tuberculosis and a lot of people don’t realize it.”
Marilyn Linthicum, a nurse and patient-care coordinator at Mercy, said most of the patients in the isolation room are so sick they are on ventilators. The issue is whether the patient is going to live.
If patients recover well enough to leave Mercy, the local health department starts directly observed therapy, a program in which a nurse watches patients take their medication. While the strategy has proven to be effective, it sometimes poses problems for patients.
They are isolated for two weeks and compliance can be tough for patients. Gervasio recalls an incident when a teen-ager with active tuberculosis had to go to a long-term facility because they feared he would not follow the quarantine at home.
While nurses at Mercy see few deathly ill tuberculosis patients, it is evident the bacteria is coming back worse than it was before, said Gervasio. That is why she advocates education as a means of controlling cases, something she said is already happening. “I have seen more on television, which is good because the public needs to be educated about it because it’s here, ” said Gervasio. “It’s good that they are understanding more about it.” -30- CNS-4-25-01