Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska Alaska Tuberculosis Program Manual - Epidemiology - State of Alaska
For roles and responsibilities, refer to the “Roles, Responsibilities, and Contact Information” topic in the Introduction 1.18. State Laws and Regulations See the Statutes and Regulations section for more information on: 7 AAC 27.213. Tuberculosis skin test http://www.legis.state.ak.us/basis/folioproxy.asp?url=http://wwwjnu01.legis.state.ak.us/cgibin/folioisa.dll/aac/query=[group+!277+aac+27!2E213!27!3A]/doc/{@1}/hits_only 7 AAC 12.571. Employee health program http://www.legis.state.ak.us/basis/folioproxy.asp?url=http://wwwjnu01.legis.state.ak.us/cgibin/folioisa.dll/aac/query=[group+!277+aac+12!2E571!27!3A]/doc/{@1}/hits_only 7 AAC 12.650. Employee health program http://www.legis.state.ak.us/basis/folioproxy.asp?url=http://wwwjnu01.legis.state.ak.us/cgibin/folioisa.dll/aac/query=[group+!277+aac+12!2E650!27!3A]/doc/{@1}/hits_only Tuberculin Skin Testing of School Children: Program Standards Tuberculin skin testing of school children Alaska law requires that children who enroll in specific grade-levels – kindergarten and grade seven – or in the district in grades kindergarten or higher for the first time, are to be tuberculin skin tested within 90 days of enrollment in school. (27 AAC 27.213) In addition, the Tuberculosis Control Program requires that students in all grades be skin tested annually at schools in which the majority of students are Asian or Alaska Native (these groups have the highest risk of tuberculosis in Alaska) and at schools in which the prevalence rate of tuberculosis infection exceeds 1%. Schools required to test students in all grades are notified in writing by the Tuberculosis Control Program. Tuberculin skin testing of school children is done by public health nurses at schools which lack personnel capable of conducting the testing. The school district is responsible for obtaining a consent form signed by the child’s parent or guardian prior to administration of a tuberculin skin test to a child in the parent’s absence. All children with undocumented or previously negative tuberculin reactions should be skin tested. Prior BCG vaccination is not a contraindication to tuberculin skin testing. The only exception to testing is if a physician provides a written statement that the test “…would be injurious to the health and welfare of the child or members of the family or household ” (27 AAC 27.213). It is also the school district’s responsibility to suspend a child under AS 14.30.045 (4) if “…(1) the child fails to submit to a PPD skin test required under this section; or (2) the 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 Targeted Testing for Latent Tuber culosis Infection 3.3 R e v i s e d N o v e m b e r 2 0 1 2
child or a person acting on behalf of the child fails to provide the district or non-public school, within 30 days after referral under (c) of this section, a written and signed statement of a health care provider stating that the child is not infectious from tuberculosis to others.” (27 AAC 27.213). Schools are responsible for completing and sending the School Tuberculin Testing Report to the Alaska TB Program by the deadline. The results of screening should be provided to the school district by public health nurses or others who administer testing. See the Forms section of the manual 18.1. High-Risk Groups Certain factors identify persons at high risk for tuberculosis (TB) infection and/or for progression to TB disease. Persons in the high-risk groups listed in Table 1: Persons at High Risk for Tuberculosis Infection and Progression to Tuberculosis Disease are candidates for tuberculin skin testing or TB screening in Alaska Persons with risk factors from both columns may be at much higher risk than those with risk factors in only one column. For example, an individual born in a high-TB-prevalence country with HIV infection is at much higher risk of having active TB than a US-born individual with HIV infection. 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 Targeted Testing for Latent Tuber culosis Infection 3.4 R e v i s e d N o v e m b e r 2 0 1 2
- Page 1 and 2: Alaska Tuberculosis Program Manual
- Page 3 and 4: Purpose............................
- Page 5 and 6: Monthly assessment of adherence ...
- Page 7 and 8: When to Expand a Contact Investigat
- Page 9 and 10: Introduction CONTENTS About the Ala
- Page 11 and 12: How to Use This Manual Portable Doc
- Page 13 and 14: Printing To access the print dialog
- Page 15 and 16: Abbreviations Refer to the list bel
- Page 17 and 18: QFT QuantiFERON ® -TB test QFT-G Q
- Page 19 and 20: Alaska Statutes and Regulations on
- Page 21 and 22: National and State Program Objectiv
- Page 23 and 24: Indicator 3 Thorough contact invest
- Page 25 and 26: National Standards and Recommendati
- Page 27 and 28: Roles and Responsibilities Contact
- Page 29 and 30: Local Public Health Agencies Table
- Page 31 and 32: Resources and References Resources
- Page 33 and 34: Introduction Purpose Use this secti
- Page 35 and 36: Contact investigation: Collecting,
- Page 37 and 38: Reporting Tuberculosis Detecting an
- Page 39 and 40: Prompt reporting (prior to culture
- Page 41 and 42: Use the Infectious Disease Report F
- Page 43 and 44: Data Collection Forms The following
- Page 45 and 46: Genotyping Genotyping is a useful t
- Page 47 and 48: References 1 ATS, CDC, IDSA. Contro
- Page 49: Introduction Purpose Use this secti
- Page 53 and 54: When to Conduct Targeted Testing Al
- Page 55 and 56: Alaska Program Standards for Health
- Page 57 and 58: B Notifications CONTENTS Introducti
- Page 59 and 60: Table 1: NUMBERS OF FOREIGN-BORN PE
- Page 61 and 62: chest radiograph and if sputum AFB
- Page 63 and 64: Follow-up of B1 and B2 Tuberculosis
- Page 65 and 66: Evaluation of B1, B2, and B Tubercu
- Page 67 and 68: Treatment Prescribe medications as
- Page 69 and 70: 12 Centers for Disease Control and
- Page 71 and 72: Introduction Purpose Use this secti
- Page 73 and 74: Tuberculosis Classification System
- Page 75 and 76: Table 2: PERSONS AT HIGH RISK FOR T
- Page 77 and 78: Table 3: WHEN TO SUSPECT PULMONARY
- Page 79 and 80: Diagnosis of Tuberculosis Disease T
- Page 81 and 82: 1. Exposure to Infectious TB: Ask p
- Page 83 and 84: Physical Examination A physical exa
- Page 85 and 86: For more information on chest radio
- Page 87 and 88: Laboratories should report positive
- Page 89 and 90: Guidelines for preventing the trans
- Page 91 and 92: 50 CDC. National plan for reliable
- Page 93 and 94: Introduction Purpose The overall go
- Page 95 and 96: Basic Treatment Principles Follow t
- Page 97 and 98: Treatment Regimens and Dosages Use
- Page 99 and 100: Table 3: FOUR TREATMENT REGIMENS FO
child or a person acting on behalf <strong>of</strong> the child fails to provide the district or non-public<br />
school, within 30 days after referral under (c) <strong>of</strong> this section, a written and signed<br />
statement <strong>of</strong> a health care provider stating that the child is not infectious from<br />
tuberculosis to others.” (27 AAC 27.213).<br />
Schools are responsible for completing and sending the School Tuberculin<br />
Testing Report to the <strong>Alaska</strong> TB <strong>Program</strong> by the deadline. The results <strong>of</strong><br />
screening should be provided to the school district by public health nurses<br />
or others who administer testing. See the Forms section <strong>of</strong> the manual<br />
18.1.<br />
High-Risk Groups<br />
Certain factors identify persons at high risk for tuberculosis (TB) infection and/or for<br />
progression to TB disease. Persons in the high-risk groups listed in Table 1: Persons at<br />
High Risk for <strong>Tuberculosis</strong> Infection and Progression to <strong>Tuberculosis</strong> Disease are<br />
candidates for tuberculin skin testing or TB screening in <strong>Alaska</strong><br />
Persons with risk factors from both columns may be at much higher risk than those with<br />
risk factors in only one column. For example, an individual born in a high-TB-prevalence<br />
country with HIV infection is at much higher risk <strong>of</strong> having active TB than a US-born<br />
individual with HIV infection.<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 Targeted Testing for Latent Tuber culosis Infection 3.4<br />
R e v i s e d N o v e m b e r 2 0 1 2
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