Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Other Residential Settings Motels Homeless persons with infectious TB may be housed in a motel that has outside access to rooms (not via hallways). The motel manager must be advised of the following: 1. The patient is in respiratory isolation. 2. The manager should report to local public health agency staff if the manager becomes aware that the patient does not stay in the room or has guests. 3. The manager should advise motel staff that they are not to enter the room while the patient resides at the motel. (Arrangements should be made that once a week, the patient sets out linens that need to be replaced. The staff can knock on the door and leave the linens for the patient to make his or her own bed.) 4. Upon release from isolation, the room should be aired out for one day before staff enter to clean. Afterwards, routine cleaning done between guests is sufficient, and there are no additional special cleaning requirements. 5. Local public health agency staff will be delivering medication to the patient (specify the frequency). 6. Arrangements have been made for food delivery to the patient. Healthcare Facilities or Residential Settings 1. Patients with infectious TB should be in appropriate respiratory isolation (airborne infection isolation rooms) when housed in healthcare facilities or residential settings. 2. If a facility does not have the capability to provide appropriate respiratory isolation, the patient should be transferred to a facility that can accommodate respiratory isolation until the patient is noninfectious. Once noninfectious, the person may return to the original facility. 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 INFECTION CONTROL 17.26 Revised November 2012
Return to Work, School, or Other Social Settings The decision of when to allow a patient to return to work, school, or other social settings should be made in consultation with the Alaska TB Program and/or the local PHN. The decision to permit a patient to return to work, school, or other social settings is based on the following: The characteristics of the patient with TB disease (e.g., whether the patient is likely to adhere to the regimen and follow treatment instructions) The characteristics of the TB disease itself (e.g., multidrug-resistant versus drugsusceptible TB, AFB sputum smear-positive versus smear-negative, cavitary versus noncavitary) The duration of current treatment (e.g., the patient has received standard multidrug antituberculosis therapy for two-to-three weeks or, if the patient AFB sputum smear that are negative or rarely positive, the threshold for treatment is four-to-seven days) 48 The environment(s) to which the patient will be returning 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 INFECTION CONTROL 17.27 Revised November 2012 Prior to notifying a patient that he or she is able to return to work or school, call the Alaska TB Program at 907-269-8000 for consultation. Drug-Susceptible Tuberculosis Disease Patients with drug-susceptible TB are no longer considered infectious if they meet all the criteria in Table 11. Table 11: RETURN TO WORK, SCHOOL, AND OTHER SETTINGS OF DRUG- SUSCEPTIBLE CASES OF TUBERCULOSIS 49 Criteria for Return to Work, School, or Other Social Settings: Patients with Suspected or Confirmed Drug-Susceptible Tuberculosis The patient is on adequate therapy for at least 2 weeks AND The patient has had a significant clinical response to therapy AND The patient has had 3 consecutive negative acid-fast bacilli (AFB) sputum smear results collected 8 to 24 hours apart, with at least 1 being an early morning specimen Source: CDC. Infectiousness. Core Curriculum on Tuberculosis (2000) November 2001.
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Other Residential Settings<br />
Motels<br />
Homeless persons with infectious TB may be housed in a motel that has outside access<br />
to rooms (not via hallways).<br />
The motel manager must be advised <strong>of</strong> the following:<br />
1. The patient is in respiratory isolation.<br />
2. The manager should report to local public health agency staff if the manager<br />
becomes aware that the patient does not stay in the room or has guests.<br />
3. The manager should advise motel staff that they are not to enter the room while the<br />
patient resides at the motel. (Arrangements should be made that once a week, the<br />
patient sets out linens that need to be replaced. The staff can knock on the door and<br />
leave the linens for the patient to make his or her own bed.)<br />
4. Upon release from isolation, the room should be aired out for one day before staff<br />
enter to clean. Afterwards, routine cleaning done between guests is sufficient, and<br />
there are no additional special cleaning requirements.<br />
5. Local public health agency staff will be delivering medication to the patient (specify<br />
the frequency).<br />
6. Arrangements have been made for food delivery to the patient.<br />
Healthcare Facilities or Residential Settings<br />
1. Patients with infectious TB should be in appropriate respiratory isolation (airborne<br />
infection isolation rooms) when housed in healthcare facilities or residential settings.<br />
2. If a facility does not have the capability to provide appropriate respiratory isolation,<br />
the patient should be transferred to a facility that can accommodate respiratory<br />
isolation until the patient is noninfectious. Once noninfectious, the person may return<br />
to the original facility.<br />
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 INFECTION CONTROL 17.26<br />
Revised November 2012