[MCOH-EH] [EXTERNAL] Re: TB screening question

[Enass Awad]

Hi everyone:
Tagging along on the TB topic but about symptom screening questionnaires
for annual TB surveillance.
  When employees answer “ yes” for history of travel to a TB prevalent
country for one month or more , do you require them to do a test if they
are asymptomatic?

Same inquiry about what do you do if the employee answers yes to the “ do
you have current or planned immunosuppression !

Our hospital currently tests employees if they said yes to the travel
question whether or not they are symptomatic which am not sure is necessary
? Any one aware  of what data supports  this ? With the immune suppression
we are testing only those who are symptomatic !!

Thanks much ,
Enass Arahman, MD, MPH,FACOEM

Medical Director Employee Health Services
UC Davis Health
Sacramento, CA

On Wed, Feb 8, 2023 at 12:10 Swift, Melanie D., M.D., M.P.H. via MCOH-EH <
mcoh-eh at mylist.net> wrote:

> Dr. Thrasher, attached is the NTCA-ACOEM collaborative guidance document
> on TB testing and treatment in healthcare personnel. The preplacement
> evaluation recommendations for HCP with a prior positive TB test begin at
> the bottom of page e358.
>
>
>
> Recommendations are essentially the same for prior treated LTBI and prior
> treated active TB. Document the dates and confirmation of completed
> treatment. For active TB they should have a clearance document from their
> public health department at the completion of therapy. A symptom screen
> would be recommended, but as long as she is asymptomatic and you have
> documentation of her prior positive IGRA and/or TST at the time of her
> original diagnosis, documentation of complete treatment and clearance of
> the active infection, then there really is no testing or imaging
> recommended. The key will be obtaining that documentation. If she has none,
> then as Sally recommends you could get an IGRA now (likely would be
> positive) and follow your usual clearance process. You can do a single view
> CXR with abdominal shielding, should records be unavailable and you need to
> exclude active TB. If you have the records though, no need to image her
> unless she is symptomatic or her treatment wasn’t complete.
>
>
>
> Melanie
>
>
>
> *Melanie Swift, MD, MPH*
>
> (she/her)
> Vice Chair, Division of Public Health, Infectious Diseases and
> Occupational Medicine
>
> Medical Director, Mayo Clinic Physician Health Center
> <https://www.mayoclinic.org/departments-centers/preventive-occupational-aerospace-medicine/physician-health-center/referrals>
>
> Associate Medical Director, Occupational Health Service
>
> _______________________________
> *Mayo Clinic*
> 200 First Street SW
> <https://www.google.com/maps/search/200+First+Street+SW+%0D%0ARochester,+MN+55905?entry=gmail&source=g>
> Rochester, MN 55905
> <https://www.google.com/maps/search/200+First+Street+SW+%0D%0ARochester,+MN+55905?entry=gmail&source=g>
>
>
>
> *From:* MCOH-EH <mcoh-eh-bounces+swift.melanie=mayo.edu at mylist.net> *On
> Behalf Of *Sally Foster-Chang
> *Sent:* Wednesday, February 8, 2023 11:20 AM
> *To:* MCOH-EH <mcoh-eh at mylist.net>
> *Subject:* [EXTERNAL] Re: [MCOH-EH] TB screening question
>
>
>
> I’d do an IGRA. At least you would have a baseline.
>
>
>
> On Wed, Feb 8, 2023 at 12:02 PM dennis thrasher via MCOH-EH <
> mcoh-eh at mylist.net> wrote:
>
> Any recommendations for a new-hire nurse applicant? She is pregnant and
> has previously been treated for active TB.
> Thanks.
> Dennis Thrasher, MD, MPH
> sunnyside at dakotacom.net
> 520 247 1397
>
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> ---------------------------------------
> The MCOH-EH List has always been moderated by members of the ACOEM Medical
> Center Occupational Health Section. It is currently moderated by Joe
> Fanucchi MD FACOEM.
> List membership is free, but only subscribers may post to the list.
> To post send messages to: mcoh-eh at mylist.net
> To become a subscriber, or to change your subscription options (turn off
> email while you're on vacation, etc):   http://www.mcoh-eh.net
> 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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-- 
Enass Awad A/Rahman,MD,MPH
Department of Occupational Medicine
Mercy Medical Group
3000 Q Street
Sacramento,CA,95816
Tel: 916-733-3390


"We can enrich the world if we choose to embrace our similarities; we can
destroy the world if we choose to emphasize our differences."
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