Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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References 1 CDC. Treatment of latent tuberculosis infection: maximizing adherence. TB Fact Sheets [Division of Tuberculosis Elimination Web site]. April 2005:1. Available at: http://www.cdc.gov/tb/pubs/TBfactsheets.htm . Accessed February 1, 2007. 2 CDC. Chapter 5: treatment of Latent Tuberculosis Infection.. Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]. Updated October 2004. Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm Accessed December 5, 2010. 3 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005;54(No. RR-12):15. 4 CDC. Treatment of latent tuberculosis infection: maximizing adherence. TB Fact Sheets [Division of Tuberculosis Elimination Web site]. April 2005:1. Available at: http://www.cdc.gov/tb/pubs/TBfactsheets.htm . Accessed February 1, 2007. 5 CDC. Treatment of latent tuberculosis infection: maximizing adherence. TB Fact Sheets [Division of Tuberculosis Elimination Web site]. April 2005:1. Available at: http://www.cdc.gov/tb/pubs/TBfactsheets.htm . Accessed February 1, 2007. 6 CDC. Chapter 5: treatment of Latent Tuberculosis Infection.. Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]. Updated October 2004. Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm Accessed December 5, 2010. 7 CDC. Summary. In: Chapter 5: treatment of Latent Tuberculosis Infection.. Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]. Updated October 2004. Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm Accessed December 5, 2010. 8 CDC . “Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection. MMWR 2011; 60(48); 1650-1653. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6048a3.htm?s_cid=mm6048a3_w 9 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR,2005;54(No. RR-12):39. 10 ATS, CDC, IDSA. Controlling tuberculosis in the United States: recommendations from the American Thoracic Society, CDC, and the Infectious Diseases Society of America. MMWR 2005;54(No. RR-12):10. 11 CDC, NTCA. Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the National Tuberculosis Controllers Association and CDC. MMWR 2005;54(No. RR-15):13. 12 CDC. In: Chapter 5: treatment of Latent Tuberculosis Infection.. Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]. Updated October 2004. Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm Accessed December 5, 2010. 13 CDC, NTCA. Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005. MMWR 2005;54(No. RR-17):59; and CDC: Chapter 5: treatment of Latent Tuberculosis Infection.. Core Curriculum on Tuberculosis (2004) [Division of Tuberculosis Elimination Web site]. Updated October 2004. Available at: http://www.cdc.gov/tb/webcourses/CoreCurr/index.htm Accessed December 5, 2010. 14 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):27. 15 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):31, 36. 16 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):36. 17 CDC . “Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection. MMWR 2011; 60(48). Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6048a3.htm?s_cid=mm6048a3_w 18 CDC . “Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection. MMWR 2011; 60(48); 1650-1653. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6048a3.htm?s_cid=mm6048a3_w 19 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):4. 20 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):28–29. 21 CDC . “Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection. MMWR 2011; 60(48); 1650-1653. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6048a3.htm?s_cid=mm6048a3_w 22 Francis J. Curry National Tuberculosis Center. Pediatric Tuberculosis: An Online Presentation [Francis J. Curry National Tuberculosis Center Web site]. San Francisco, CA; 2007: Slides 59–60. Available at: http://currytbcenter.ucsf.edu/products/product_details.cfm?productID=ONL-10 . Accessed October 28, 2011. 23 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):20. A L A S K A T U B E R C U L O S I S P R O G R A M M A N U A L Treatment of Latent Tuberculosis Infection Revised November 2012 8.26
24 CDC . “Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection. MMWR 2011; 60(48); 1650-1653. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6048a3.htm?s_cid=mm6048a3_w 25 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):43. 26 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):43. 27 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):43. 28 California Department of Health Services(CDHS)/California Tuberculosis Controllers Association(CTCA). TB case management—core components. CDHS/CTCA Joint Guidelines [CTCA Web site]. 1998:9. Available at: http://www.ctca.org/guidelines/index.html . Accessed July 11, 2006. 29 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):26–29, 38– 39. 30 CDC. Module 4: treatment of latent tuberculosis infection and tuberculosis disease. Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site]. 2008. Available at: http://www.cdc.gov/tb/education/ssmodules/pdfs/Module4.pdf . Accessed December 5, 2010. 31 CDC. Update: adverse event data and revised American Thoracic Society/CDC recommendations against the use of rifampin and pyrazinamide for treatment of latent tuberculosis infection—United States. MMWR 2003;52(No. 31): 735–736. 32 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):20–21; CDC. Monitoring. In: Chapter 6: treatment of LTBI. Core Curriculum on Tuberculosis (2000) [Division of Tuberculosis Elimination Web site]. Updated November 2001. Available at: http://www.cdc.gov/tb/pubs/corecurr/index.htm . Accessed July 11, 2006. 33 CDC. Module 9: patient adherence to tuberculosis treatment. Self-Study Modules on Tuberculosis [Division of Tuberculosis Elimination Web site].1999:6. Available at: http://www.cdc.gov/tb/education/ssmodules/module9/ss9contents.htm . Accessed December 5, 2010. 34 County of Los Angeles Tuberculosis Control Program. Tuberculosis Control Program Manual: 2003 Edition:2-10. Available at: http://www.lapublichealth.org/tb/TBManual/TBmanual.pdf . Accessed February 1, 2007. 35 CDC, NTCA. Guidelines for the investigation of contacts of persons with infectious tuberculosis: recommendations from the National Tuberculosis Controllers Association and CDC. MMWR 2005;54(No. RR-15):19. 36 CDC. Regimens. In: Chapter 6: treatment of LTBI. Core Curriculum on Tuberculosis (2000). August 2003. 37 County of Los Angeles Tuberculosis Control Program. Tuberculosis Control Program Manual: 2003 Edition:2.10. Available at: http://www.lapublichealth.org/tb/TBManual/TBmanual.pdf . Accessed February 1, 2007. 38 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No. RR-6):10 39 Brudkey K, Dobkin J. Resurgent tuberculosis in New York City. Am Rev Respir Dis 1991;144:745-749; In: Isake, L. Introduction to the symposium. Alcoholism and tuberculosis: an overview. Alcohol Clin Exp Res February 1995;19(1):1– 2. 40 Saukkonen, JJ, Cohn, DL, Jasmer, RM, Schenker, S, Jereb, JA, Nolan, CM, Peloquin, CA, et al. An official ATS statement: hepatoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174:937. 41 Saukkonen, JJ, Cohn, DL, Jasmer, RM, Schenker, S, Jereb, JA, Nolan, CM, Peloquin, CA, et al. An official ATS statement: hepatoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174:947. 42 Saukkonen, JJ, Cohn, DL, Jasmer, RM, Schenker, S, Jereb, JA, Nolan, CM, Peloquin, CA, et al. An official ATS statement: hepatoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174:935. 43 CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR 2000;49(No.RR-6):16-18. 44 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):20-21. 45 Saukkonen, JJ, Cohn, DL, Jasmer, RM, Schenker, S, Jereb, JA, Nolan, CM, Peloquin, CA, et al. An official ATS statement: hepatoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174:937. 46 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):24. 47 Saukkonen, JJ, Cohn, DL, Jasmer, RM, Schenker, S, Jereb, JA, Nolan, CM, Peloquin, CA, et al. An official ATS statement: hepatoxicity of antituberculosis therapy. Am J Respir Crit Care Med 2006;174:935. 48 ATS, CDC, IDSA. Treatment of tuberculosis. MMWR 2003;52(No. RR-11):10. 49 Brudkey K, Dobkin J. Resurgent tuberculosis in New York City. Am Rev Respir Dis 144:745-749, 1991. In: Isake, L. Introduction to the symposium. Alcoholism and tuberculosis: an overview. Alcohol Clin Exp Res February 1995;19(1):1– 2. 50 Gelmanova, IY, Keshavjee S, Golubchikova VT, Berezina VI, Strelis AK, Yanova GV, Atwoodr S, Murray M. Barriers to successful tuberculosis treatment in Tomsk, Russian Federation: non-adherence, default and the acquisition of multidrug resistance. Bulletin of the World Health Organization September 2007;85(9):647–732. Accessed January 8, 2008. Available at: http://www.who.int/bulletin/volumes/85/9/06-038331/en/index.html. 51 Gelmanova, IY, Keshavjee S, Golubchikova VT, Berezina VI, Strelis AK, Yanova GV, Atwoodr S, Murray M. Barriers to successful tuberculosis treatment in Tomsk, Russian Federation: non-adherence, default and the acquisition of multidrug resistance. Bulletin of the World Health Organization September 2007;85(9):647–732. Accessed January 8, 2008. Available at: http://www.who.int/bulletin/volumes/85/9/06-038331/en/index.html. 52 CDC. Approaches to improving adherence to antituberculosis therapy – South Carolina and New York, 1986-1991. MMWR 1993;42(04):74–75, 81. A L A S K A T U B E R C U L O S I S P R O G R A M M A N U A L Treatment of Latent Tuberculosis Infection Revised November 2012 8.27
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Alaska Tuberculosis Program Manual
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Purpose............................
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Monthly assessment of adherence ...
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When to Expand a Contact Investigat
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Introduction CONTENTS About the Ala
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How to Use This Manual Portable Doc
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Printing To access the print dialog
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Abbreviations Refer to the list bel
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QFT QuantiFERON ® -TB test QFT-G Q
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Alaska Statutes and Regulations on
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National and State Program Objectiv
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Indicator 3 Thorough contact invest
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National Standards and Recommendati
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Roles and Responsibilities Contact
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Local Public Health Agencies Table
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Resources and References Resources
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Introduction Purpose Use this secti
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Contact investigation: Collecting,
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Reporting Tuberculosis Detecting an
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Prompt reporting (prior to culture
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Use the Infectious Disease Report F
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Data Collection Forms The following
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Genotyping Genotyping is a useful t
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References 1 ATS, CDC, IDSA. Contro
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child or a person acting on behalf
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When to Conduct Targeted Testing Al
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Alaska Program Standards for Health
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B Notifications CONTENTS Introducti
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Table 1: NUMBERS OF FOREIGN-BORN PE
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chest radiograph and if sputum AFB
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Follow-up of B1 and B2 Tuberculosis
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Evaluation of B1, B2, and B Tubercu
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Treatment Prescribe medications as
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12 Centers for Disease Control and
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Tuberculosis Classification System
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Table 2: PERSONS AT HIGH RISK FOR T
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Table 3: WHEN TO SUSPECT PULMONARY
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Diagnosis of Tuberculosis Disease T
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1. Exposure to Infectious TB: Ask p
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Physical Examination A physical exa
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For more information on chest radio
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Laboratories should report positive
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Guidelines for preventing the trans
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50 CDC. National plan for reliable
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Introduction Purpose The overall go
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Basic Treatment Principles Follow t
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Treatment Regimens and Dosages Use
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Table 3: FOUR TREATMENT REGIMENS FO
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† 4 Table 4: DOSES*OF FIRST-LINE
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Figure 1:TREATMENT ALGORITHM FOR DR
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a. In remote locations in Alaska, m
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Antituberculosis Drug Rifampin (RIF
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Antituberculosis Drug Rifapentine (
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Reporting Reactions The table below
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Response to Treatment For consultat
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Figure 2: MANAGEMENT OF TREATMENT I
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Post-Treatment Evaluation Routine f
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Treatment in Special Situations Tre
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Resources For consultation regardin
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with an increase in overall complet
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Liver Disease Management of TB in p
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After the initial phase (first two
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Page 131 and 132: Resources and References Resources
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Page 135 and 136: Forms All required and recommended
Page 137 and 138: High-Risk Groups Certain factors id
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Page 149 and 150: For more information on IGRAs and t
Page 151 and 152: Table 5: TARGETED TESTING FOR LATEN
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Page 157 and 158: Policy Detailed information on the
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Page 161 and 162: Regimens Identify an appropriate re
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Page 165 and 166: Side Effects and Adverse Reactions
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Page 173 and 174: Table 7 describes the duration of t
Page 175 and 176: Alcoholism Alcohol-Related Treatmen
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Page 179: National Tuberculosis Controllers A
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Page 185 and 186: All children suspected or diagnosed
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Page 189 and 190: History of BCG vaccination is not a
Page 191 and 192: Because of their higher specificity
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Page 197 and 198: For consultation regarding the trea
Page 199 and 200: Monitoring DOT is mandatory for INH
Page 201 and 202: For young infants, some experts rec
Page 203 and 204: TABLE 8: SIGNS AND SYMPTOMS OF PULM
Page 205 and 206: Treatment of Tuberculosis Basic pri
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Page 219 and 220: Case Management CONTENTS Introducti
Page 221 and 222: patient-centered approach to case m
Page 223 and 224: Alaska TB Program: Timeline for the
Page 225 and 226: For assistance with language issues
Page 227 and 228: Ascertain the extent of TB illness
Page 229 and 230: medical/health problem. The date of
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necessary to teach people how to ta
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Treatment Plan Components Recommend
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Implementation Activities To begin
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o Indicate the number of doses prov
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Review the status of the contact in
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For more information, see the “Di
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importance of continued treatment a
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5. Review information with the prov
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Completion of Therapy The case mana
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Case Closures Other than Completion
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Conduct a case management meeting o
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Biweekly (BIW) doses of TB medicati
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Use DOT with other measures such as
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It is important not to send a mixed
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Medical Orders Progressive Interven
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CDC. Module 9: “Patient Adherence
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36 New Jersey Medical School Nation
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75 CDC. Module 9: patient adherence
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Introduction Purpose A contact inve
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For roles and responsibilities, ref
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Decision to Initiate a Contact Inve
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chest radiographic findings that ar
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In general, a contact investigation
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Time Frames for Contact Investigati
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Circumstances unique to Alaska may
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Circumstances unique to Alaska may
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Activity Purpose Maximum Time Inter
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Infectious Period Determine the inf
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In general, for the purposes of con
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General Guidelines for Interviewing
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Healthcare workers should remember
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Index Patient with Positive Acid-Fa
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Index Patient with Negative Acid-Fa
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Contact Evaluation, Treatment, and
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Definition of abbreviations: HIV =
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Note: An IGRA may be used in place
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When to Expand a Contact Investigat
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Figure 7: EVALUATION, TREATMENT, AN
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CDC’s “Framework of Program Eva
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Definitions of abbreviations: AIDS
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elease assay; LTBI = latent tubercu
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officials to distinguish between di
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References 1 ATS, CDC, IDSA. Contro
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44 CDC, NTCA. Guidelines for the in
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Available Laboratory Tests Table 2:
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Table 3: PCR Testing Algorithm and
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Table 4: SPECIMEN COLLECTION METHOD
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5. If possible, send the specimen o
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Specimen Shipment There are three m
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Resources and References Resources
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Patient Education CONTENTS Introduc
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treatment, common side-effects of m
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Education Topics During the initial
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10. Explain the signs and symptoms
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Patient Education Materials Get th
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References 1 CDC. Module 4: treatme
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National Guidelines The following g
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Transfer Notifications CONTENTS Int
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For roles and responsibilities, ref
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Follow-Up Type When to Initiate Not
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Action Transfers Within Alaska Tran
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Provide the patient with a. A copy
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References 1 CDC. International not
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Infection Control CONTENTS Introduc
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of TB infection control principles
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Administrative Activities 13 Key ac
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Personal Respiratory Protection Alt
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For regulations in your area, refer
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Employee Health All employees, phys
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Figure 1: TWO STEP TESTING AND FOLL
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Isolation To reduce disease transmi
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Table 4: CRITERIA FOR PATIENTS TO B
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When to Initiate Airborne Infection
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Confirmed Tuberculosis Disease A pa
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Multidrug-Resistant Tuberculosis Di
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Environmental Controls in the Patie
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Return to Work, School, or Other So
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Tuberculosis Infection Control in P
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Transportation Vehicles To prevent
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7 CDC. Guidelines for preventing th
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Forms: Alaska State Public Health L
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ALASKA STATE PUBLIC HEALTH LABORATO
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Anchorage Alaska State Public Healt
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INDEX CASE INFORMATION Name: DOB: /
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CONTACT Name: Tuberculosis Contact
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Directly Observed Therapy (DOT) Cal
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B. Documents patient care activitie
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Alaska TB Program Section of Epidem
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Treatment Summary for Active TB Nam
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Interjurisdictional Tuberculosis No
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Latent Tuberculosis Infection (LTBI
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Alaska Tuberculosis Program 9210 Va
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Instructions for Collecting Sputum
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TB Case Management Information Requ
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Table 1: First-line anti-tuberculos
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Return the fax to the Drug Room (90
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Stock Orders: A small supply of
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TB/LTBI Medication Return Form Reas
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TB/LTBI Stock Medication Request FA
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TB Medication Dose Monitoring Regim
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TB Medication Dose Monitoring Regim
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ALASKA DEPARTMENT OF HEALTH AND SOC
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Tuberculosis Discharge Planning Che
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PART 2: 8. Have you ever been told
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Tuberculosis Treatment Contract Dep
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Statutes and Regulations Contents I
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Regulations Infection Control 7 AAC
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place of work is remote from patien
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(2) the child or a person acting on
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Glossary acid-fast bacilli (AFB): M
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eaction size on a later test, which
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disseminated TB: See miliary TB. dr
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immunocompromised and immunosuppres
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include medical history and TB symp
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thousands to millions of copies of
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secondary (TB) case: A new case of
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eproducing TB organisms from respir
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