A TB screening test shall be used when screening persons for
latent TB infection (LTBI). Persons who have signs and symptoms of active TB
disease or a positive TB screening test result shall complete a diagnostic
evaluation for active TB disease in accordance with the Centers for Disease
Control and Prevention (CDC) guidelines, Targeted Tuberculin Testing and
Treatment of Latent Tuberculosis Infection and Guidelines for Health-Care
Settings.
a) Screening for Latent TB
Infection
1) Persons who are contacts to
suspected or confirmed cases of active TB disease shall be evaluated in
accordance with the CDC Guidelines for the Investigation of Contacts.
2) Workers and clients at health care
settings and other residential settings serving high-risk groups shall be
screened in accordance with this subsection (a)(2) and the following CDC
guidelines: Targeted Tuberculin Testing and Treatment of Latent Tuberculosis
Infection, Guidelines for Health-Care Settings, Prevention and Control of
Tuberculosis in Correctional and Detention Facilities: Recommendations from
CDC.
A) Health care workers and workers in
other residential care settings serving high-risk groups shall obtain a TB
screening test within seven days after being employed. If Mantoux skin testing
is used, two-step testing shall be done, with the first test placed within
seven days after employment. However, a second skin test is not needed if the
worker has a documented skin test result from any time during the previous 12
months. The need for routine periodic screening shall be determined by a risk
assessment.
B) All clients in
non-acute care residential health care settings serving high-risk groups shall
obtain a TB screening test within seven days after admission. If Mantoux skin
testing is used for clients with an anticipated stay longer than 30 days,
two-step testing shall be done, with the first test placed within seven days
after admission. Routine periodic screening shall be determined by a risk
assessment performed in cooperation with the local TB control
authority.
C) TB screening shall be
instituted in other residential care settings serving high-risk groups as
directed by the local TB control authority or the Department when a community
or residential care setting has a higher than expected incidence of active TB
disease or prevalence of LTBI.
D)
Inmates and employees in correctional and detention facilities shall be
screened in accordance with the CDC guideline Prevention and Control of
Tuberculosis in Correctional and Detention Facilities: Recommendations from
CDC.
3) Workers in child
day care and pre-school settings shall obtain a TB screening test within seven
days after being employed. If Mantoux skin testing is used, two-step testing
shall be done, with the first test administered within seven days after
employment. Routine, periodic screening of workers shall be determined by the
child day care or pre-school facility's TB risk assessment.
b) Screening for Active TB
Disease. The following persons shall be screened for active TB disease:
1) Persons with a documented positive TB
screening test result;
2) Clients
admitted to health care settings and residential care settings serving
high-risk groups; and
3) Inmates in
correctional and detention facilities, who shall be screened for active TB
disease in accordance with Prevention and Control of Tuberculosis in
Correctional and Detention Facilities: Recommendations from CDC.