Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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US Department of Transportation. Hazardous Materials: Revision to standards for infectious substances. Part III 49 CFR Part 171. Federal Register (August 14, 2002). USPS. Mailing Standards of the United States Postal Service: Domestic Mail Manual (USPS Web site). Available at: http://pe.usps.com/ . References 1 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):18. 2 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):19. 3 APHL, The Future of Tuberculosis Laboratory Services: A Framework for Integration/Collaboration/Leadership. 2004. Available at: http://www.aphl.org/Documents/Global_docs/tb_task_force_future.pdf 4 CDC. Diagnostic microbiology. In: Chapter 5: diagnosis of TB. 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 November 1, 2006 5 ATS, CDC, IDSA. Diagnostic standards and classification of tuberculosis in adults and children. Am J Respir Crit Care Med. 2000;161:1376–1395. 6 Iseman, MD. A Clinician’s Guide to Tuberculosis, 2000. 1st ed. Philadelphia, PA: Williams & Wilkins; 2000:135–136. 7 Iseman, MD. A Clinician’s Guide to Tuberculosis, 2000. 1st ed. Philadelphia, PA: Williams & Wilkins; 2000:135–136. 8 Iseman, MD. A Clinician’s Guide to Tuberculosis, 2000. 1st ed. Philadelphia, PA: Williams & Wilkins; 2000:135–136. 9 National Jewish Medical and Research Center. How to Mail Specimens and Cultures to the National Jewish Mycobacteriology Laboratory. Denver, CO; March 2005:2. 10 National Jewish Medical and Research Center. How to Mail Specimens and Cultures to the National Jewish Mycobacteriology Laboratory. Denver, CO; March 2005:5–7. 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 Laborator y Services 12.15 Revised November 2012
Patient Education CONTENTS Introduction ........................................... 13.2 Purpose.............................................................. 13.2 Policy ................................................................. 13.2 General Guidelines .............................. 13.4 Education Topics .................................. 13.5 Language and comprehension barriers ............. 13.5 Medical diagnosis .............................................. 13.6 Contact investigation .......................................... 13.7 Isolation.............................................................. 13.7 Side effects and adverse reactions .................... 13.7 Adherence.......................................................... 13.8 Patient Education Materials ................. 13.9 Resources and References ............... 13.10 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 Patient Education 13.1 Revised November 2012
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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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Extrapulmonary Tuberculosis The bas
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Diagnosis of Latent Tuberculosis In
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Forms All required and recommended
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High-Risk Groups Certain factors id
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Diagnosis of Latent Tuberculosis In
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continually exposed to populations
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Administration of the Tuberculin Sk
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See “Two-Step Tuberculin Skin Tes
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See “Live-Virus Vaccines” under
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For more information on IGRAs and t
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Table 5: TARGETED TESTING FOR LATEN
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Treatment of Latent Tuberculosis In
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Policy Detailed information on the
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Window period prophylaxis is treatm
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Regimens Identify an appropriate re
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Dosages Once the appropriate regime
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Side Effects and Adverse Reactions
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If a patient reports to a healthcar
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Antituberculosis Drug Rifampin (RIF
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DOT is strongly encouraged for thos
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Table 7 describes the duration of t
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Alcoholism Alcohol-Related Treatmen
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Medication Administration and Pharm
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National Tuberculosis Controllers A
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24 CDC . “Recommendations for Use
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Diagnosis and Treatment of Latent T
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All children suspected or diagnosed
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Latent Tuberculosis Infection (LTBI
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History of BCG vaccination is not a
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Because of their higher specificity
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Table 3: COUNTRIES AND AREAS WITH A
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Treatment of Latent TB Infection (L
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For consultation regarding the trea
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Monitoring DOT is mandatory for INH
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For young infants, some experts rec
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TABLE 8: SIGNS AND SYMPTOMS OF PULM
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Treatment of Tuberculosis Basic pri
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Regime n 1 2 3 ❺ Table 10: FOUR T
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† 35 Table 11: DOSES*OF FIRST-LIN
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Monitoring Response to Treatment Ch
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Child Care and Schools: Children wi
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Other TB medications are not commer
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10 Centers for Disease Control and
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Case Management CONTENTS Introducti
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patient-centered approach to case m
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Alaska TB Program: Timeline for the
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For assistance with language issues
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Ascertain the extent of TB illness
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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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Page 283 and 284: Activity Purpose Maximum Time Inter
Page 285 and 286: Infectious Period Determine the inf
Page 287 and 288: In general, for the purposes of con
Page 289 and 290: General Guidelines for Interviewing
Page 291 and 292: Healthcare workers should remember
Page 293 and 294: Index Patient with Positive Acid-Fa
Page 295 and 296: Index Patient with Negative Acid-Fa
Page 297 and 298: Contact Evaluation, Treatment, and
Page 299 and 300: Definition of abbreviations: HIV =
Page 301 and 302: Note: An IGRA may be used in place
Page 303 and 304: When to Expand a Contact Investigat
Page 305 and 306: Figure 7: EVALUATION, TREATMENT, AN
Page 307 and 308: CDC’s “Framework of Program Eva
Page 309 and 310: Definitions of abbreviations: AIDS
Page 311 and 312: elease assay; LTBI = latent tubercu
Page 313 and 314: officials to distinguish between di
Page 315 and 316: References 1 ATS, CDC, IDSA. Contro
Page 317 and 318: 44 CDC, NTCA. Guidelines for the in
Page 319 and 320: Introduction Purpose Use this secti
Page 321 and 322: Available Laboratory Tests Table 2:
Page 323 and 324: Table 3: PCR Testing Algorithm and
Page 325 and 326: Table 4: SPECIMEN COLLECTION METHOD
Page 327 and 328: 5. If possible, send the specimen o
Page 329 and 330: Specimen Shipment There are three m
Page 331: Resources and References Resources
Page 335 and 336: treatment, common side-effects of m
Page 337 and 338: Education Topics During the initial
Page 339 and 340: 10. Explain the signs and symptoms
Page 341 and 342: Patient Education Materials Get th
Page 343 and 344: References 1 CDC. Module 4: treatme
Page 345 and 346: Introduction Purpose Use this secti
Page 347 and 348: National Guidelines The following g
Page 349 and 350: Transfer Notifications CONTENTS Int
Page 351 and 352: For roles and responsibilities, ref
Page 353 and 354: Follow-Up Type When to Initiate Not
Page 355 and 356: Action Transfers Within Alaska Tran
Page 357 and 358: Provide the patient with a. A copy
Page 359 and 360: References 1 CDC. International not
Page 361 and 362: Infection Control CONTENTS Introduc
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Page 365 and 366: Administrative Activities 13 Key ac
Page 367 and 368: Personal Respiratory Protection Alt
Page 369 and 370: For regulations in your area, refer
Page 371 and 372: Employee Health All employees, phys
Page 373 and 374: Figure 1: TWO STEP TESTING AND FOLL
Page 375 and 376: Isolation To reduce disease transmi
Page 377 and 378: Table 4: CRITERIA FOR PATIENTS TO B
Page 379 and 380: When to Initiate Airborne Infection
Page 381 and 382: 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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Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska

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