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

[Tara Dockery]

For our facility if they are a hire with us we absorb the cost, but if they are a contracted worker they should have documentation in place before starting, so those are the ones that it is up to them and whoever they work with. We have had issues with our contracted workers not being  up to snuff and able to provide documentation of both doses of MMR or dates for Hep B, etc. and we had given a little bit of leniency with testing, but now there are so many travelers if they are going to have us do the titer for them then we should charge for it, as they should come ready to work!

Tara Dockery
Infection Prevention
Ocean Beach Hospital

________________________________
From: MCOH-EH <mcoh-eh-bounces at mylist.net> on behalf of John Keogh <dr.jtkeogh at gmail.com>
Sent: Wednesday, February 15, 2023 10:03 AM
To: MCOH-EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: TB screening question


CAUTION: This email originated from outside your organization. Exercise caution when opening attachments or clicking links, especially from unknown senders.

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<mailto: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<mailto: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<mailto: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<mailto:Wendy.thanassi at va.gov>



From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto: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<mailto:mcoh-eh at mylist.net>>
Date: Wednesday, February 8, 2023 at 12:10 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Swift, Melanie D., M.D., M.P.H. <Swift.Melanie at mayo.edu<mailto: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://linkprotect.cudasvc.com/url?a=https%3a%2f%2fwww.mayoclinic.org%2fdepartments-centers%2fpreventive-occupational-aerospace-medicine%2fphysician-health-center%2freferrals&c=E,1,Nee4QjoF9Ax2bIYdS0GYhHWYMlaEImkc63NfzOyNOgjbYtiKt3Rdn-k35cXBORyZJdEzUxvLnGF8glCR92aD8mpo7Kk9oofat-4y0YNZ&typo=1>

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<mailto: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<mailto: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<mailto: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<mailto:sunnyside at dakotacom.net>
520 247 1397

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Dr. J. Thomas Keogh
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