[MCOH-EH] Positive TB reactors question

[Chow, Curtis - MMCR]

In California it seems we have the most stringent screening process. All forms of screening include a questionnaire and I would encourage you to do the same. We do TST and QFT testing. Both of our order forms have the 5-question symptom questionnaire. You're more than welcome to copy it. 
To answer your question below, past-positive and those with BCG history are given a QFT. The past-positive may have been due to BCG or other factors i.e. "allergic" to tuberculin solution. Even those that went through Tb treatment I would go ahead and do a QFT at least once (to confirm they were really positive to begin with). Those w BCG that just do the questionnaire have no empirical evidence other than not having symptoms of active TB. There BCG vaccine immunity may wane too. I find a percentage of BCG recipients to be positive on IGRA testing indicating exposure to Tb w conversion to the latent form.  I think BCG last only 10 years in most people but there haven't been any publications of that sort and the European Union has not considered giving BCG to adults. Hope this helps.

Curtis

Curtis Chow, FNP, PA, COHN-S, COEE, CEES, CSPHP
Employee Health Coordinator
Dignity Health, Mercy Medical Center, Redding
Employee Health Department
2175 Rosaline Ave.
Redding, CA. 96001
530-225-6194 (O)
530-526-5150 (M)
530-225-7281 (F)

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Subject: MCOH-EH Digest, Vol 253, Issue 68

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Today's Topics:

   1. Re:  Positive TB reactors (Wintermeyer, Stephen F.)


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Message: 1
Date: Thu, 1 Mar 2018 15:59:22 +0000
From: "Wintermeyer, Stephen F." <swinterm at iu.edu>
To: "'MCOH/EH'" <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Positive TB reactors
Message-ID: <0bbc5a902fb045f69ba50844178fa84d at BL-CCI-D1S02.ads.iu.edu>
Content-Type: text/plain; charset="utf-8"

Deborah,

Please help me understand your process.

When you state you do Annual TB Assessment/Questionnaires, are you referring only to individuals with a past positive TB test or all individuals?

If you are referring to past positives, I do not understand the of a Quantiferon Gold if the TB Questionnaire is concerning.  If the individual is already considered to be a past positive, what additional information does the Quantiferon Gold give you?

Stephen Wintermeyer, MD, MPH
Director
Associate Professor of Clinical Medicine

Campus Health
Indiana University-Purdue University Indianapolis Coleman Hall, Suite 100
1140 West Michigan Street
Indianapolis, IN  46202
317-274-8214

[IUPUI_ACR.H]



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Deborah A. Pruim via MCOH-EH
Sent: Thursday, March 01, 2018 7:38 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Cc: Deborah A. Pruim <dpruim at lcmh.org>; MCOH-EH <mcoh-eh-bounces at mylist.net>
Subject: Re: [MCOH-EH] Positive TB reactors

We do annual TB Assessment/Questionnaire.  If there is a concern we can follow with a Quanteferon Gold or chest xray.
Have a great day!
Debbie
Deborah Pruim, RN, MSN, APRN, CNS
Employee Health Services
Little Company of Mary Hospital
2800 W. 95th Street
Evergreen Park, IL  60805
Monday ? Friday
6:30am-3pm
Phone:  708-229-5623
Fax:  708-229-6618
dpruim at lcmh.org<mailto:dpruim at lcmh.org>
[cid:image001.png at 01D2A32C.E73F4EA0]



From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Kathy.Dayvault at dekalbmedical.org<mailto:Kathy.Dayvault at dekalbmedical.org>
Sent: Wednesday, February 28, 2018 4:02 PM
To: MCOH/EH
Cc: MCOH-EH
Subject: Re: [MCOH-EH] Positive TB reactors

For past positive, we always do an annual TB Assessment.


Kathy Dayvault, RN, BSN, MPH
 Manager, Occupational Health and Safety  WorksWell Onsite  Dekalb Medical  2701 North Decatur Road  Decatur, GA 30033
ph: 404.501.4972 Fax:404-501-2045
kathy.dayvault at dekalbmedical.org<mailto:kathy.dayvault at dekalbmedical.org>




From:        April Tainter <April.Tainter at thedacare.org<mailto:April.Tainter at thedacare.org>>
To:        "'mcoh-eh at mylist.net'" <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>,
Date:        02/28/2018 04:35 PM
Subject:        [MCOH-EH] Positive TB reactors
Sent by:        "MCOH-EH" <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>>
________________________________



Does anyone know if it is a requirement to assess for symptoms of active TB in past positive reactors?  I currently do a yearly questionnaire for symptoms but others in my system don't.  Thank you for any guidance you can offer.

April Tainter RN
Employee Health Nurse

[Description: cid:image001.png at 01D0D11B.A449DA50]

ThedaCare Medical Centers-Shawano/New London/Waupaca P 715-701-0168 F 715-524-9983

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