Tuberculosis Control Program BUMEDINST 6224'8

1
Tuberculosis Control Program BUMEDINST 6224.8

• HM1(FMF/SW/AW) RACUYA, O.P. PMT OF MARINES

2
INSTRUCTION

• BUMEDINST 6224.8

3
DEFINITIONS
4
TUBERCULOSIS

• A disease produced by infection with M.
  tuberculosis.

5
TUBERCULOSIS

• Active
• S/S, radiographic, or laboratory evidence of
  pulmonary, meningeal, miliary, or extrapulmonary
  tuberculosis
• It causes the most concern because of the
  potential to transmit the infection via airborne
  route

6
TUBERCULOSIS

• Tuberculosis Infection
• Person has no S/S or radiographic evidence of
  active disease but does show evidence of
  infection
• Positive TB skin test

7
TB SKIN TEST

• Mantoux method
• Measured by induration

8
TB REACTOR

• Person with a an area of induration to a 5 TU TB
  skin test when read 48-72 hours after
  administration

9
TB NON-REACTOR

• A person with an area of induration of less than
  5mm

10
BCG

• Bacillus Calmette-Guerin vaccines
• Made from live attenuated mycobacteria strains
• Foreign countries use in the attempt to prevent
  becoming infected with TB

11
PPD

• Purified Protein Derivate
• Normal dose 5 TU

12
TB SCREENING
13
YEARLY

• All shipboard personnel, both active duty and
  civil service, will receive TB screening yearly

14
EVERY 3 YEARS

• Personnel stationed in low-risk areas are
  screened every 3 years.

15
12 MONTHS OUT

• Naval personnel must a documented TB skin test
  within 12 months prior to separating.

16
READING AND RECORDING
17
READING

• After performing a TB skin test, inform him/her
  to return to medical 48-72 hours

18
RECORDING

• Always record results into the medical record
  using mm induration

19
RECORDING

• If a PT returns to medical and no reaction has
  taken place, mark as Zero mm

20
RECORDING

• If a PT returns to medical after the recommended
  time frame and lt14mm
• Make an entry of Not Read
• Immediately apply a PPD test on the opposite arm

21
INH THERAPY

• Oral doses of INH 300mg
• The antibiotic regimen of choice
• Oral doses of Pyridoxine 50mg (Vitamin B6)

22
INH THERAPY

• Except in unusual circumstances, you should only
  dispense INH in 1 month increments

23
INH THERAPY

• All TB reactors who have completed a course of
  preventive therapy and month evaluations, as well
  as previously-known reactors, must receive a
  brief clinical evaluation every year

24
QUESTIONS??