Common Conditions: TB, Lice and Scabies
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Common Conditions: TB, Lice and Scabies

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Infections, Nutrition and Food Safety

Common Conditions: TB, Lice and Scabies

Other Common Conditions

There are many other diseases that are not caused by bloodborne pathogens. These diseases may spread through the air, perhaps when someone sneezes. Other pathogens live on the skin or other surfaces.

Care workers need to be familiar with these conditions for the benefit of their health and their clients health.

This unit will cover a range of other conditions that care workers may encounter throughout their work. It will discuss how to identify the conditions and the best way to treat them and prevent their spread.

Tuberculosis (TB)

Tuberculosis (TB) is a problem. Eight million new cases occur each year in the world. Since 1985, the number of U.S. cases reported each year has remained above 22,000.

Millions of people have TB infection and have no symptoms of the disease, but they can transmit the disease to others. An estimated 10-15 million persons in the U.S. are infected with TB bacteria. That is why TB screening is needed, especially for those who work in a health care setting.

Anyone can contract TB. Click the icon to examine those who are at high risk of contracting the disease.

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Those at high risk of contracting TB include:

People living in substandard housing and the homeless.

Immigrants from areas where TB is common.

Residents of supervised living facilities and group homes /nursing homes.


People who have immunosuppressant diseases such as HIV/AIDS, or those who have had a recent organ transplant.

IV drug abusers.

Figure 1. TB is commonly found in the lungs

Tuberculosis (TB) – Healthcare Workers

TB is transmitted via the airborne route. The TB pathogens are in the air and can be inhaled. Repeated, prolonged exposure is necessary to contract TB.

The disease is not spread through sharing belongings or touching something that a sick person has touched.

Symptoms of the disease include:

Cough and fatigue

Weight loss and night sweats

Weakness and fever

Tuberculosis (TB) – Screening

Screening for the TB is done with a skin test. If the result of the skin test is positive, it means you have been exposed to TB bacteria. THIS DOES NOT MEAN YOU HAVE AN ACTIVE CASE OF TB. You will need to seek medical advice to see if you have active TB.

Once you have a positive skin test, you will need a chest x-ray to screen for the presence of TB even if you are healthy. A chest x-ray is done to determine if TB disease is present and what kind of treatment is indicated.

In many cases, a positive TB test must be reported to local authorities as the disease can be spread by air.

Figure 2. A TB skin test


The most common symptom of lice infestation, called pediculosis, is itching in the affected areas. Symptoms vary depending on which type of lice is present.

Lice are tiny insects (one is called a louse) that live on humans and survive by feeding on blood. When a large number of lice live on a person, it is called an infestation.

Three different kinds of lice infest humans: head lice, pubic lice (“crabs”) and body lice. Infestations are easily spread from one person to another through close bodily contact or through shared clothing or personal items (such as hats or hair brushes).

Always remember that lice are easily spread! Take precautions when working with a client who has a lice infestation.

Lice – Diagnosis and Treatment

A close visual examination for live lice or their eggs, called nits in the hair is usually all that is needed to diagnose an infestation of head lice. A health professional may confirm the diagnosis with microscopic examination.

Pubic lice and body lice can also be diagnosed with a close visual examination of the affected areas or the person's clothing.

Both lice and nits must be destroyed to get rid of an infestation. The most common treatment is a topical nonprescription or prescription cream, lotion, or shampoo to kill the lice and eggs.

Sometimes a second treatment is needed to make sure that all the eggs are destroyed.

Figure 3. Lice can be determined by a microscopic test


Scabies are tiny, eight-legged mites that are hard to see without a magnifying glass. They dig underneath the skin and cause itching so severe it may make it difficult for the person to sleep at night.

An early scabies rash will show up as little red bumps, (looks like hives), tiny bites, or pimples. Later the bumps may become crusty or scaly. Scabies usually starts between fingers, on elbows or wrists, buttocks, or waist. Sometimes the person will have long red marks from where the mite has been crawling under the skin.

People in group settings such as nursing homes or group homes are more likely to get scabies.

Always have a magnifying glass to examine your client such as scabies! They are easily transmitted.

Scabies – Diagnosis and Treatment

Usually a dermatologist will be able to tell if a person has scabies just from looking at the skin. If not, he/she can do a simple diagnostic test.

Scabies is easy to treat with special creams and lotions however you are providing care to a client with scabies, be sure to follow these tips:

Wash all of the person’s clothes, sheets, and towels in hot water. Dry the clothing and linens completely in the dryer.

Vacuum the whole house and throw out the vacuum cleaner bag.

Treat all family members for scabies at the same time, whether they itch or not. That will keep scabies from spreading.

Universal Precautions

Care workers, like all health care professionals, must take precautions to help prevent the spread of diseases and infestations throughout their work.

Universal precautions are designed to prevent health care workers from transferring infections to patients, and from infecting themselves.

Disease causing agents may be present in body substances, even when a person does not look or act sick. Therefore, universal precautions should be used whenever you come into contact with body fluids from any other person.

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Universal Precautions

The purpose of universal precautions is to minimize exposure to bloodborne pathogens. To be safe, universal precautions apply to any fluid from the body.

• Approach all clients as if they were HIV or HBV infectious.

• Blood is the single most important source of HIV, HBV, and other bloodborne pathogens in the workplace.

• Plan ahead when you are working with a client and use the appropriate protective equipment, such as gloves.

• Know the limitations of the protective equipment you are using, when the equipment can protect you and when it cannot.

• Do not recap needles. Do not break or otherwise manipulate needles.

• Place contaminated sharps in puncture-resistant containers.

• Wash hands immediately after contamination or removing gloves.


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