What is the first step after a health care worker is exposed to tuberculosis?

• A. Start airborne isolation for the exposed worker
• B. Conduct an individual risk assessment and symptom screening
• C. Initiate full TB treatment immediately
• D. Notify public health authorities and wait for guidance

Answer: (B)

After a tuberculosis exposure in a healthcare setting, the immediate priority is to determine how likely infection is for the exposed worker and whether they have any TB-related symptoms. This is done through an individual risk assessment and symptom screening. This step helps decide the next actions, such as whether baseline TB testing (TST/IGRA) or chest imaging is needed, and whether any preventive measures or follow-up are warranted. It also avoids unnecessary interventions.

Starting airborne isolation for the exposed worker isn’t the right first move, because isolation is aimed at preventing transmission from a person with active TB, not to manage someone who was exposed but may or may not be infected. Notifying public health authorities and awaiting guidance is important in certain contexts, but it follows a risk assessment to determine what guidance is needed. Initiating full TB treatment immediately isn’t appropriate without evidence of infection or active disease.