After a volunteer with active pulmonary TB delivered mail and was exposed, what should the IP do first?

• A. Notify potential contacts to initiate TB skin testing at baseline and three months after exposure.
• B. Furlough volunteers and potentially exposed staff.
• C. Provide contacts with TB medication to prevent TST conversions.
• D. Notify public relations about the exposures.

Answer: (A)

The main idea is to protect health by quickly identifying who was exposed and determining their TB infection status. The first step after exposure to someone with active pulmonary TB is to conduct a contact investigation and start testing exposed individuals. Testing at baseline establishes whether someone already has latent TB infection, while a follow-up test about three months after exposure catches any new infections that were not detectable at baseline due to the window period. This approach lets you identify those who need further evaluation or treatment for latent TB infection and implement targeted monitoring and control measures.

Furloughing exposed volunteers or staff isn’t the immediate action you take without first assessing risk and testing results, and giving TB medication to everyone who was exposed isn’t appropriate without confirming infection status. Notifying public relations is not the primary clinical/public health step in this scenario.