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

[John Keogh]

Hi ,
In the US who pays for IGRA? In Canada the employee has to pay.
Regards,
Dr.Tom Keogh

On Thu, Feb 9, 2023 at 1:11 PM Warner Hudson <hudson.warner at gmail.com>
wrote:

> Yes me too; couldn’t say it better.
>
> Sent from my iPhone
>
> On Feb 9, 2023, at 6:45 AM, wendy thanassi <wendy.thanassi at gmail.com>
> wrote:
>
> 
>
> Great summary by Dr. Swift and I also agree with Sally Foster-Chang’s
> baseline test.
>
>
>
> So, I’m not adding anything to this conversation except support and
> endorsement!
>
>
>
> Have a great day 😊,
>
> Wendy
>
>
>
> *Wendy Todaro Thanassi MD, MA, MRO*
>
> Medical Director, Workforce Health and Wellness
>
> Clinical Professor, Primary Care and Population Health Science
>
>
>
> *Stanford Medicine*
>
> 300 Pasteur Dr., H0124
>
> Stanford, CA 94303
>
> Cell: 650-380-1131
>
> thanassi at stanford.edu
>
>
>
> *Veterans Affairs Palo Alto Health Care System*
>
> 3801 Miranda Ave, MC 11-EH
>
> Palo Alto, CA 94304
>
> Wendy.thanassi at va.gov
>
>
>
> *From: *MCOH-EH <mcoh-eh-bounces at mylist.net> on behalf of Swift, Melanie
> D., M.D., M.P.H. via MCOH-EH <mcoh-eh at mylist.net>
> *Date: *Wednesday, February 8, 2023 at 12:10 PM
> *To: *MCOH-EH <mcoh-eh at mylist.net>
> *Cc: *Swift, Melanie D., M.D., M.P.H. <Swift.Melanie at mayo.edu>
> *Subject: *Re: [MCOH-EH] [EXTERNAL] Re: TB screening question
>
> 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
> Rochester, MN 55905
>
>
>
> *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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> Center Occupational Health Section. It is currently moderated by Joe
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> List membership is free, but only subscribers may post to the list.
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> MediTrax / Occupational Health Systems, Inc. provides financial support to
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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
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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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-- 
*Dr. J. Thomas Keogh *
B.Sc., M.D., C.C.F.P., F.C.F.P., LM., C.C.B.O.M.,F.C.B.O.M., C.I.M.E.,
C.A.M.E

Occupational Medicine Consultant
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