[MCOH-EH] TB screening

[Borkowski, Michael]

Jayme

Thanks for sharing this approach.


1)      Is it evidence based?

2)      What do you do with the patient/employee during the 1 month interim period? (Chest xray, symptom survey, and/or allowed to see patients?)


Thanks

mb

Michael Borkowski, MD, MPH
Medical Director, F&MCW Occupational Health Services
Phone:  414-777-1959  | Fax:  262-253-5152
Cell Phone:  414-881-3762
E-mail: michael.borkowski at froedtert.com

Froedtert & the Medical College of Wisconsin
400 Woodland Prime
N74 W12501 Leatherwood Ct.
Menomonee Falls, WI 53051

froedtert.com

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Jayme Kasman
Sent: Monday, April 03, 2017 11:53 AM
To: Contact
Subject: Newsletter / Marketing: Re: [MCOH-EH] MCOH-EH Digest, Vol 252, Issue 115

We repeat quantiferon testing for low positives. 0.35-1.0 in 1 month. If the second test is positive, then the patient is considered positive.  If the second test is less than 0.35, then the patient is considered negative.

For our indeterminate results, we repeat in 1 month. If the second test is also indeterminate, then we administer at skin test. If the patient has not had another skin test in the last year, then we do a 2 step. The boosted result will be more accurate.


Jayme Kasman RN, MSN
Employee Health Nurse
Barton Occupational Health

P. 775.589.8935  F. 775.589.8987

jkasman at bartonhealth.org<mailto:jkasman at bartonhealth.org>

www.bartonhealth.org<http://www.bartonhealth.org/>

[https://mail.google.com/mail/?ui=2&ik=b8532528bb&view=fimg&th=15af7017e7914857&attid=0.1&disp=emb&realattid=e96e766403a6ab9f_0.1&attbid=ANGjdJ-BoVObuRd1FAdwnRBKbbbsmjVOdUUzTvgayEYJKlWxVJ5huNWqQsp72DED4EAD1maA5K0PY7zq-smcKYYO31rVz0BcgsSny7ma1A-9K1Cf6G28dtOjfwUyh6E&sz=w216-h180&ats=1490202778218&rm=15af7017e7914857&zw&atsh=1]

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of Thrasher, Terri
Sent: Friday, March 31, 2017 9:23 AM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] TB screening and indeterminates

I place a ppd at the same time I repeat the QFT

From: MCOH-EH [mailto:mcoh-eh-bounces+terri.thrasher<mailto:mcoh-eh-bounces%2Bterri.thrasher>=cchmc.org at mylist.net<mailto:cchmc.org at mylist.net>] On Behalf Of Tara Dockery
Sent: Friday, March 31, 2017 12:12 PM
To: MCOH/EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net><mailto:mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>>
Subject: Re: [MCOH-EH] TB screening and indeterminates

For our borderline we had one that was retested in a week, as per the protocol on the reference lab result, and it came back as borderline again. This was expensive, and time consuming. To remedy the situation we did a Mantoux PPD and that came out negative.

When we had an indeterminant employee (seemed to mention they may have had a low lymphocyte count??) rather than retesting the employee because she mentioned she had been taking a new kind of vitamin and supplement, so presuming the employee was healthy and we didn?t want to look into her lymphocyte count and open a can of worms, we decided there could have been an interfering substance and decided to use the old Mantoux skin test PPD, which also came back negative for her.

So in both scenarios, to save time and money, I do believe in the future we will back up with a Mantoux PPD.


This is what I found to work for us
Tara



Tara Lee Dockery, IP, MT(ASCP), BS
Infection Prevention and Employee Health

Ocean Beach Hospital and Clinics
174 First Avenue North
Ilwaco, Washington 98624

tdockery at oceanbeachhospital.com<mailto:tdockery at oceanbeachhospital.com><mailto:tdockery at oceanbeachhospital.com<mailto:tdockery at oceanbeachhospital.com>>
Office Phone  360 ? 642 - 6307
Cell Phone 509-760-7397<tel:509-760-7397>
Fax  360-642-6309<tel:360-642-6309>



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>] On Behalf Of Yvonne Noel
Sent: Friday, March 31, 2017 8:41 AM
To: MCOH/EH <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] TB screening and indeterminates

If you are using the  Quaniferon Gold test, would you mind sharing your reference ranges?  If you have set up a borderline or indeterminate reference range, can you tell me how individuals who test in this range  are managed, e.g. repeat testing in two months.


[cid:image019.png at 01D01A13.D55BFA20]<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.childrens.com_&d=DwMGaQ&c=P0c35rBvlN7D8BNx7kSJTg&r=Jmg5o1TWVLt02_ZQHrHWz9cq2GUFrnmW1sIeobramoY&m=dnPaBJHqvYDZPD0PztdjO7tEYH2q5qe217Yftqn64bw&s=LHRUoprRdD5vHk8J9Af385AiQYsbPE2_-OjpRaFnowI&e=>

Yvonne Noel, RN, COHN-S, CIC
Manager
Occupational Health & Wellness
O: 214.456.8983<tel:214.456.8983>
F: 214.456.2665<tel:214.456.2665>
E: mary.noel at childrens.com<mailto:mary.noel at childrens.com><mailto:mary.noel at childrens.com<mailto:mary.noel at childrens.com>>




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