[MCOH-EH] PPDs

Hartley, Patrick patrick-hartley at uiowa.edu
Thu Jul 14 11:58:09 PDT 2016


Wendy:
When do you anticipate that the CDC will issue this new guidance? You indicated that an MMWR update will address this issue.
Thanks
Pat Hartley

Patrick G. Hartley, M.B., B.Ch., B.A.O., M.P.H.
Professor (Clinical) of Internal Medicine
Division of Pulmonary Diseases, Critical Care and Occupational Medicine
Medical Director: University Employee Health Clinic & Occupational Medicine Clinic
Carver College of Medicine
University of Iowa
Iowa City, IA 52242-1009
319-353-7072 (Office)
319-353-6406 (Fax)
patrick-hartley at uiowa.edu



-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Thanassi, Wendy
Sent: Thursday, July 14, 2016 1:44 PM
To: MCOH/EH
Subject: Re: [MCOH-EH] [EXTERNAL] Re: PPDs

This is the direction the MMWR update will go- toward less annual screening and more risk-based assessments.

That said, would someone kindly send me some copies of your " annual updates a TB History, Risk Assessment and/or Symptom Screen" and we'll see if we can adapt them for our setting?

Thank you!
Wendy

Wendy.thanassi at va.gov<mailto:Wendy.thanassi at va.gov>

Palo Alto VA, California

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Deborah S. Camp
Sent: Thursday, July 14, 2016 10:43 AM
To: MCOH/EH
Subject: [EXTERNAL] Re: [MCOH-EH] PPDs

We do QFT's on new hires.  On annual updates a TB History, Risk Assessment and Symptom Screen is done.  With no red flags, employee is cleared for a year.  This is based on the 2005 CDC guidelines.

Thanks

Newberry County Memorial Hospital
Newberry, SC
Deb Camp, RN, EH
Office:  803-405-7257
Fax:  803-405-7516

-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Patti Vomish
Sent: Wednesday, July 13, 2016 7:18 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] PPDs

Good Morning!

My hospital administrators are requesting that we stop our tuberculosis program. They would like to only place PPDs on new employees. This makes me a little nervous.
I know this has had to come on this site.
Is there anyway I can find what I am looking for here?

Thank you,

Patti Vomish




Patricia L. Vomish  RN COHN
Employee Health & Safety Nurse

401 E. Murphy Ave.
Connellsville, PA. 15601

Phone  724-626-2444
Fax     724-626-2445

email - pvomish at highlandshospital.org<mailto:pvomish at highlandshospital.org>
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Subject: MCOH-EH Digest, Vol 251, Issue 158

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Today's Topics:

   1. Re:  Should pregnant health care workers be restricted from
      caring for patients with active Shingles? (arlen rollins)
   2. Re:  Should pregnant health care workers be restricted from
      caring for patients with active Shingles?
      (Michael A. Sauri, MD, MPH&TM, FACP, FACPM)
   3. Re:  Should pregnant health care workers be restricted from
      caring for patients with active Shingles? (Hudson, T. Warner)


----------------------------------------------------------------------

Message: 1
Date: Tue, 12 Jul 2016 08:08:11 -0700
From: arlen rollins <arlenrollins at gmail.com<mailto:arlenrollins at gmail.com>>
To: "MCOH/EH" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Should pregnant health care workers be
        restricted from caring for patients with active Shingles?
Message-ID:

<CAHaiO641Usq3XhGYEkm1KeC9d_fPpLNZ+VqF-QEMMhnSsS5kGA at mail.gmail.com<mailto:CAHaiO641Usq3XhGYEkm1KeC9d_fPpLNZ+VqF-QEMMhnSsS5kGA at mail.gmail.com>>
Content-Type: text/plain; charset="utf-8"

Sounds like a good idea, I would defer to the CDC Arlen

On Tue, Jul 12, 2016 at 7:17 AM, Craig Thorne <Craig.Thorne at erickson.com<mailto:Craig.Thorne at erickson.com>>
wrote:

> Everyone, a question came up today from one of our nursing homes that
> I could use your help with, if you have a reference:
>
>
>
> *Should pregnant health care workers be restricted from caring for
> patients with active Shingles?*
>
>
>
> Thank you.
>
>
>
> Craig Thorne
>
>
>
> Craig D. Thorne, M.D., MPH, MBA
>
> Vice President and Medical Director
>
> Employee Health and Wellness
>
> Erickson Living
>
> 813 Maiden Choice Lane, Catonsville, MD. 21228-3679
>
> 443-257-0903 cell (preferred)
>
> 410-402-2224
>
> 410-469-3007 fax
>
> http://www.ericksonliving.com
>
>
>
>
>
> The information in this email is intended only for the person or
> entity to which it is addressed and may contain confidential and/or
> privileged material. Any review, retransmissions, dissemination or
> other use of or taking of any action in reliance upon this information

> by persons or entities other than the intended recipient is
> prohibited. If you receive this email in error, please contact the
> sender and delete the material from any computer.
>
> ---------------------------------------
> The MCOH-EH List is moderated by Joe Fanucchi MD FACOEM and Mike Band
DO.
> List membership is free, but only subscribers may post to the list.
> To post send messages to: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net> To become a subscriber,
> or to change your subscription options (turn off
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> MediTrax / Occupational Health Systems, Inc. provides financial
> support to ensure the list remains a free resource for the
> occupational health community.
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> List archives (public): http://mylist.net/archives/mcoh-eh/
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> Send administrative requests to: drjoe at meditrax.com<mailto:drjoe at meditrax.com>
> ---------------------------------------
>



--
Dr. Arlen J. Rollins
Tel:216 410 4970
Fax: 480 247 2821
arlenrollins at gmail.com<mailto:arlenrollins at gmail.com>
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Message: 2
Date: Tue, 12 Jul 2016 11:33:53 -0400
From: "Michael A. Sauri, MD, MPH&TM, FACP, FACPM" <msauri at ohcmd.com<mailto:msauri at ohcmd.com>>
To: "'MCOH/EH'" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Should pregnant health care workers be
        restricted from caring for patients with active Shingles?
Message-ID: <000d01d1dc52$ccc86850$665938f0$@ohcmd.com<mailto:000d01d1dc52$ccc86850$665938f0$@ohcmd.com>>
Content-Type: text/plain; charset="us-ascii"

Craig,

The majority of Hospital Infection Control Varicella Prevention policies are based on the 2007 MMWR ACIP's Recommendations for the Prevention of
Varicella (MMWR Vol 56, 6-22-07, RR04, 1-40).   Most OB-Gyne will
serosurvey
their pregnant patient for evidence of immunity to Varicella in the peri-natal period.  Most hospitals will require a Varicella titer on their new hire HCWs as a means to document their immunity prior to working with patients.  In my hospital, it is their policy that any HCW (including pregnant HCW) without documented immunity be reassigned away from Varicella patients and active Shingles patients.  If a pregnant HCW with no documentation of immunity has already been exposed, they are referred to their OB-Gyne for counselling, to validate their susceptibility to varicella, and for consideration for the administration of VariZIG or VZIG.
Information on VariZIG (which is replacing VZIG) can be found in MMWR
3-3-2006 and MMWR 7-19-13.   Since varicella vaccine is not 100%
protective,
the ACIP (2007) also recommends that the exposed HCW's with documented immunity monitor themselves for any evidence of varicella infection for
21 weeks (28 days if they received VariZIG or VZIG) following an exposure and report this to Infection Control in their Healthcare facility (ACIP 2007).
I hope this is helpful.



Best wishes,

Michael



Michael  A. Sauri, MD, MPH&TM, FACP,

FACPM, FACOEM, FRSTM&H, CTropMed

Medical Director

Occupational Health Consultants

15005 Shady Grove Road, Suite 450

Rockville, MD 20850

301-738-6420

Fax 301-738-2215

 <mailto:msauri at ohcmd.com> msauri at ohcmd.com<mailto:msauri at ohcmd.com>

 <http://www.ohcmd.com> www.ohcmd.com<http://www.ohcmd.com>



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Craig Thorne
Sent: Tuesday, July 12, 2016 10:18 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>
Subject: [MCOH-EH] Should pregnant health care workers be restricted from caring for patients with active Shingles?



Everyone, a question came up today from one of our nursing homes that I could use your help with, if you have a reference:



Should pregnant health care workers be restricted from caring for patients with active Shingles?



Thank you.



Craig Thorne



Craig D. Thorne, M.D., MPH, MBA

Vice President and Medical Director

Employee Health and Wellness

Erickson Living

813 Maiden Choice Lane, Catonsville, MD. 21228-3679

443-257-0903 cell (preferred)

410-402-2224

410-469-3007 fax



http://www.ericksonliving.com





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Message: 3
Date: Tue, 12 Jul 2016 18:11:10 +0000
From: "Hudson, T. Warner" <TWHudson at mednet.ucla.edu<mailto:TWHudson at mednet.ucla.edu>>
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Should pregnant health care workers be
        restricted from caring for patients with active Shingles?
Message-ID:

<2134A5387858914BBE80D079ECF6880C7554B4BE at SOPEXMB3.ad.medctr.ucla.edu<mailto:2134A5387858914BBE80D079ECF6880C7554B4BE at SOPEXMB3.ad.medctr.ucla.edu>>
Content-Type: text/plain; charset="us-ascii"

We are same as Melanie.  Warner

T. Warner Hudson, MD FACOEM, FAAFP
Medical Director, Occupational and Employee Health UCLA Health System and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID
27132 E-mail twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu<mailto:twhudson at mednet.ucla.edu>>
Website www.ohs.uclahealth.org<http://www.ohs.uclahealth.org<http://www.ohs.uclahealth.org<http://www.ohs.uclahealth.org>>

From: MCOH-EH
[mailto:mcoh-eh-bounces+twhudson=mednet.ucla.edu at mylist.net] On Behalf Of Swift, Melanie
Sent: Tuesday, July 12, 2016 7:24 AM
To: MCOH/EH
Subject: Re: [MCOH-EH] Should pregnant health care workers be restricted from caring for patients with active Shingles?

Hi Craig,
I'm assuming you have a policy to confirm varicella immunity or vaccination at hire.
If a worker has immunity then they should not be restricted, regardless of pregnancy status.
If a worker lacks immunity and can't be vaccinated, then they should be restricted from caring for patients on airborne precautions for disseminated zoster or primary chickenpox, and from direct contact with vesicles.


Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic http://occupationalhealth.vanderbilt.edu

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Craig Thorne
Sent: Tuesday, July 12, 2016 9:18 AM
To: mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: [MCOH-EH] Should pregnant health care workers be restricted from caring for patients with active Shingles?

Everyone, a question came up today from one of our nursing homes that I could use your help with, if you have a reference:

Should pregnant health care workers be restricted from caring for patients with active Shingles?

Thank you.

Craig Thorne

Craig D. Thorne, M.D., MPH, MBA
Vice President and Medical Director
Employee Health and Wellness
Erickson Living
813 Maiden Choice Lane, Catonsville, MD. 21228-3679
443-257-0903 cell (preferred)
410-402-2224
410-469-3007 fax

http://www.ericksonliving.com



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