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

Swift, Melanie D., M.D., M.P.H. Swift.Melanie at mayo.edu
Thu Mar 9 06:41:57 PST 2023
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Also, check with your state TB control program. Ours requires that negative tests be no longer than 3 months before the start date.

Melanie

From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Thanassi, Wendy
Sent: Wednesday, March 8, 2023 9:59 PM
To: MCOH-EH <mcoh-eh at mylist.net>
Subject: [EXTERNAL] Re: [MCOH-EH] Re: TB screening question

In an ideal world it makes sense to base that a little on the risk factors of the applicant: with a grad student from India or a nurse from Philippines would be prudent to have a recent test; where someone with no risk factors could have one nearly a year old.

Many policies accept tests that are 3-6 months old (we use 6 months).

Best,
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 Anita McDowell via MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Date: Wednesday, March 8, 2023 at 6:18 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Anita McDowell <AMcdowell at echd.org<mailto:AMcdowell at echd.org>>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: TB screening question
[EXT]
Question? Are you requesting TB or QFT results within how many weeks month or year before they present to your facility
Anita McDowell RN BSN
Employee Health Coordinator
PH:432-640-4160
FAx:432-640-1166
Office: 432-640-1154
Today will never come again:
Be a Blessing, Be a Friend.
________________________________
From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> on behalf of Eisenhauer, Julie (TCRHCC) via MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Sent: Monday, March 6, 2023 3:52 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Eisenhauer, Julie (TCRHCC) <Julie.Eisenhauer at TCHEALTH.ORG<mailto:Julie.Eisenhauer at TCHEALTH.ORG>>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: TB screening question

*[EXTERNAL] This email originated outside of the MCHS organization. DO NOT CLICK links or attachments unless you recognize the sender and know the content is safe.*

We require this to be completed prior to starting their first day at our facility. We also require anyone with a past or new positive test to have completed or start treatment before the first day.



If it is a current employee and they need one for school or due to post-exposure etc.… they may ask for one and we foot the bill. It is not costly for us as we obtain it at cost with a government rate.



Sincerely Your Employee Health Nurse.



Julie A. Eisenhauer BSN, RN, CCM

HR/Employee Health

Tuba City Regional Health Care Corporation

PO Box 600

Tuba City, AZ. 86045

PH#: 928-283-1437; or Mitel ext. 41544

Email: Julie.eisenhauer at tchealth.org<mailto:Julie.eisenhauer at tchealth.org>

HR Email: TCRHCCHR at Tchealth.org<mailto:TCRHCCHR at Tchealth.org>



  *   THREE W’s -  WEAR a mask, WASH your hands, WATCH your distance 😊





From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> On Behalf Of ping gao via MCOH-EH
Sent: Thursday, February 16, 2023 4:54 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: ping gao <gaopg at yahoo.com<mailto:gaopg at yahoo.com>>
Subject: Re: [MCOH-EH] [EXTERNAL] Re: TB screening question



Caution: This email originated from outside of the organization. Do not click links or open attachments unless you recognize the sender and know the content is safe.



Our hospital covers the cost for its employee health services including TB testing and updating

/administering other immunizations.



Ping Gao, MD, MPH, FACOEM

Medical Director

Occupational Medicine & Employee Health

AnMed

Anderson, SC 29621

Please excuse typo



On Feb 16, 2023, at 1:19 PM, John Keogh <dr.jtkeogh at gmail.com<mailto:dr.jtkeogh at gmail.com>> wrote:



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://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.mayoclinic.org%2Fdepartments-centers%2Fpreventive-occupational-aerospace-medicine%2Fphysician-health-center%2Freferrals&data=05%7C01%7CSwift.Melanie%40mayo.edu%7C1921006cf419484f643008db2052dfa5%7Ca25fff9c3f634fb29a8ad9bdd0321f9a%7C0%7C0%7C638139312585302019%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=wEnk%2FYKkmSWZs%2Fxywml0Ac44eyf1HojQI%2FBQeAhxfY0%3D&reserved=0>

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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