[MCOH-EH] Staff member on Humira with exposure to patient with active TB

[Tara Dockery]

Hello Laura -

Wow, what a predicament you have been placed in!
I wanted to give you a reference from when I had a TB treatment question. Out here in Washington State they have a TB ECHO program where they take questions, scenarios, etc. about Tuberculosis and they have a team of specialist who will give advice on the question, treatment course, what have you.

https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Tuberculosis/TrainingandEducation/TBECHO is the website, and I submitted my question to Lana Tyer, and they asked me to present on their case studies. They also offer didactic presentations so you can listen in and learn from other cases, etc. and it seems they would be open to helping you to decide with the question you have, to help promote learning and best practice from others.

I assume if it were me I would wait until the results come back to decide,  however you are correct in saying there are other factors at play in the employee's immunity at play, so I might ask a specialist their opinion. I am not sure if you have such resources in your state, so I thought I would share what I know. They were very helpful with my question in the past, and offered alternative scenarios for consideration, and courses of medication and length of treatment recommendations to allow my provider to make a good call on what treatment he chose to give.

Tara

Tara Lee Dockery, IP, MT(ASCP), BS | Infection Preventionist and Employee Health
Ocean Beach Hospital and Medical Clinics
174 1st Ave North | P.O. Box H | Ilwaco |WA | 98624
Phone: 360.642.6307 | Cell : 509-760-7397 | Fax: 360-642-6309  |tdockery at oceanbeachhospital.com<mailto:tdockery at oceanbeachhospital.com>

[cid:image003.png at 01D40E32.E65AC8D0]<http://www.oceanbeachhospital.com/>

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




From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Radke, Laura L. M.D.
Sent: Monday, February 10, 2020 7:43 AM
To: 'mcoh-eh at mylist.net' <mcoh-eh at mylist.net>
Subject: [MCOH-EH] Staff member on Humira with exposure to patient with active TB


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I'm wondering if I can solicit some opinions from the group regarding a situation we have.  We have a staff member (patient care) with rheumatoid arthritis, currently on Humira and and another RA med, who was exposed to an individual hospitalized with active tuberculosis.  She has had immediate testing with Quantiferon, but the result is pending.  Her last test result was in May of this year and was negative.  The question has arisen as to whether she should receive immediate treatment given her immunosuppression.  I'm interested to hear what members of the group would do in this situation and what drugs you would use for treatment - treat as latent with single agent or treat with more drugs due to her immunosuppression or follow her testing and symptoms and treat as needed.

Thank you in advance for your input!

Laura L Radke, MD
Medical Director, F&MCW Occupational Health Services
Phone:  262-253-8197  | Fax:  262-253-5152 Cell Phone:  414-530-0723
E-mail: laura.radke at froedtert.com<mailto:laura.radke at froedtert.com>

Froedtert & the Medical College of Wisconsin Workforce Health / North Hills Health Center Building B First Floor
W129 N7055 Northfield Dr.
Menomonee Falls, WI 53051


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