Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Use the Tuberculosis Screening Questionnaire / Chest X-ray Interpretation Request to document history and TB screening assessment. Forms are available in the Forms section of this manual 18.1. See the “Work or school clearance” topic in this section for additional information on clearing individuals with prior positive TSTs for work or school 7.20. Live-Virus Vaccines The Mantoux TST can be administered in conjunction with all vaccines. However, the measles (MMR) vaccine—and possibly mumps, rubella, varicella, and live attenuated influenza vaccines—may transiently suppress the response to PPD. 14 Therefore, if a vaccine containing live virus (e.g., measles) has already been given, the TST should be deferred until (or repeated) at least four weeks after the vaccine was administered. When giving the TST and the live virus vaccine, one of the following three sequences should be used: Apply the TST at same visit as the live virus vaccine. Delay the TST at least four weeks if the live virus vaccine is given first Apply the TST first and then give the live virus vaccine when the TST is measured 15 Multiple Puncture Tests Multiple puncture tests (MPTs), such as the Tine test, should not be used. The MPTs are not reliable because the amount of tuberculin injected intradermally cannot be precisely controlled and there is no standard for interpretation. A L A S K A T U B E R C U L O S I S C O N T R O L P R O G R A M M A N U A L Diagnosis of Latent Tuber culosis Infection R e v i s e d N o v e m b e r 2 0 1 2 7 . 10
Administration of the Tuberculin Skin Test The TST should be placed by a healthcare worker who has received appropriate training and is following written protocols. Table 3: BEFORE YOU BEGIN TO ADMINISTER A TUBERCULIN SKIN TEST Before You Begin to Administer a TST Review Information Gather Equipment CDC. Mantoux Tuberculin Skin Test Facilitator Guide. Available at: http://www.cdc.gov/tb/education/Mantoux/guide.htm Your agency’s Infection control procedures Alcohol pads or alternative skin cleanser Safety needle Tuberculin syringe (Do not pre-draw tuberculin into syringes prior to test.) Purified protein derivative (PPD) (Tubersol® or Aplisol®: See the warning in the text below in this table.) Sharps container Optional: gloves, depending on institutional policy Note: Opened PPD tuberculin vials must be dated and discarded after 30 days. See the package insert for appropriate storage information. Read the PPD labels carefully before administering a TST. The packaging of tetanus toxoid-containing vaccines (TTCVs) is similar to Tubersol ® and Aplisol ® , and all are refrigerated. See CDC’s “Inadvertent Intradermal Administration of Tetanus Toxoid--Containing Vaccines Instead of Tuberculosis Skin Tests” MMWR July 30, 2004 / 53(29);662-664 at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5329a5.htm A L A S K A T U B E R C U L O S I S C O N T R O L P R O G R A M M A N U A L Diagnosis of Latent Tuber culosis Infection R e v i s e d N o v e m b e r 2 0 1 2 7 . 11
- Page 91 and 92: 50 CDC. National plan for reliable
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- Page 109 and 110: Antituberculosis Drug Rifapentine (
- Page 111 and 112: Reporting Reactions The table below
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Administration <strong>of</strong> the Tuberculin Skin Test<br />
The TST should be placed by a healthcare worker who has received appropriate training<br />
and is following written protocols.<br />
Table 3: BEFORE YOU BEGIN TO ADMINISTER A TUBERCULIN SKIN TEST<br />
Before You Begin to Administer a TST<br />
Review<br />
Information<br />
Gather<br />
Equipment<br />
CDC. Mantoux Tuberculin Skin Test Facilitator Guide. Available at:<br />
http://www.cdc.gov/tb/education/Mantoux/guide.htm<br />
Your agency’s Infection control procedures<br />
Alcohol pads or alternative skin cleanser<br />
Safety needle<br />
Tuberculin syringe (Do not pre-draw tuberculin into syringes prior to test.)<br />
Purified protein derivative (PPD) (Tubersol® or Aplisol®: See the warning in the text below<br />
in this table.)<br />
Sharps container<br />
Optional: gloves, depending on institutional policy<br />
Note: Opened PPD tuberculin vials must be dated and discarded after 30 days. See the<br />
package insert for appropriate storage information.<br />
Read the PPD labels carefully before administering a TST. The packaging <strong>of</strong><br />
tetanus toxoid-containing vaccines (TTCVs) is similar to Tubersol ® and<br />
Aplisol ® , and all are refrigerated. See CDC’s “Inadvertent Intradermal<br />
Administration <strong>of</strong> Tetanus Toxoid--Containing Vaccines Instead <strong>of</strong><br />
<strong>Tuberculosis</strong> Skin Tests” MMWR July 30, 2004 / 53(29);662-664 at<br />
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5329a5.htm<br />
A L A S K A T U B E R C U L O S I S C O N T R O L P R O G R A M M A N U A L Diagnosis <strong>of</strong> Latent Tuber culosis Infection<br />
R e v i s e d N o v e m b e r 2 0 1 2<br />
7 . 11
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