Contact Investigations. WHO ?. WHERE ?. WHEN ?. HOW LONG ?. WHY ?. HOW ?. WHO ? IS RESPONSIBLE FOR CONTACT INVESTIGATION?. YOU ARE!!!!!!. ROLE OF HEALTH DEPARTMENT.
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TO ENSURE THAT ALL PERSONS WHO ARE SUSPECTED OF HAVING TUBERCULOSIS ARE IDENTIFIED AND EVALUATED PROMPTLY AND THAT AN APPROPERIATE COURSE OF TREATMENT IS PRESCRIBED AND COMPLETED SUCCESSFULLY
MMWR TREATMENT OF TB pg.15
TBCASES/TBSUSPECTS - the initial interview will be conducted within 3 days
At least 90% of newly reported AFB smear + cases will have contacts identified and at least 95% of the contacts will be evaluated for disease and/or infection
85% of contacts found to be infected with Mtb infection will complete a full coarse of recommended treatment
“Contact investigations are complicated undertakings that typically require hundreds of interdependent decisions, the majority of which are made on the basis of incomplete data, and dozens of time-consuming interventions…..”
Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis2005
Pulmonary, laryngeal, or pleural
AFB on sputum smear (1+ or 4+)
Cavitation on x-ray,
Adolescent or adult
Period of infectiousness
Inspect home, work and social environment
NOT EVERY TB CASE REQUIRES A CONTACT INVESTIGATION
Pulmonary, laryngeal or pleural TB
Consider contact investigation for TB case with extra pulmonary disease if there were procedures that generate aerosols (i.e. autopsy, embalming, wound irrigation or manipulation of a draining abscess)
Above is a starting point for estimating the period of likely infectiousness.
Interview the patient and/or review medical records to determine duration of symptoms.
If estimates vary, use the longer time.
December 16, 2005; Volume 54, # RR-15.
Volume 52, # RR-11.