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CLINICAL POLICIES AND PROTOCOLS - Bureau of Tuberculosis Control New York City Department of Health and Mental Hygiene

This manual describes policies, protocols and recommendations for the prevention, treatment and control of tuberculosis from the New York City Department of Health and Mental Hygiene (NYC DOHMH). It was written primarily for the medical providers of the New York City Bureau of Tuberculosis Control (BTBC) as a reference guide on tuberculosis diagnosis, treatment and prevention. Originally published in 1993, with subsequent editions in 1997 and 1999, the 4th edition of the manual has been updated to reflect changes in national recommendations and BTBC protocols. We continue to use our modified version of the International Classification of Tuberculosis (see inside back cover) for patient classification | 4th Edition March 2008 Tuberculosis Verem ConsumpflonTibekiloz a 3 Gruzlica Tuberkulozi Kgotlota Ethuna g wsil I ij Phthisis ộaaxo 5 zTuberculose . Bureau of Tuberculosis Control New York City Department of Health and Mental Hygiene Abbreviations AAP American Academy of Pediatrics ACH air changes per hour AFB acid-fast bacilli AII airborne infection isolation ALT alanine transaminase AMA against medical advice ANA antinuclear antibody ATS American Thoracic Society BCG Bacille Calmette-Guérin BP base pairs BTBC Bureau of Tuberculosis Control CBC complete blood count CDC Centers for Disease Control and Prevention CDC DGMQ CDC Division of Global Migration and Quarantine CFM cubic feet per minute CFP-10 culture filtrate protein-10 CI contact investigation CNS central nervous system CSF cerebrospinal fluid CT computed tomography CXR chest X-ray DOS Department of State DOT directly observed therapy DR direct repeat DRTB drug resistant tuberculosis ECLRS Electronic Clinical Laboratory Reporting System EDN Electronic Disease Notification EDTA ethylenediaminetetraacetic acid ELISA enzyme-linked immunosorbent assay ESAT-6 Early Secretory Antigenic Target-6 FP false-positive HAART highly active antiretroviral therapy HEPA high-efficiency particulate air HHS U.S. Department of Health and Human Services HIPAA The Health Insurance Portability and Accountability Act of 1966 HIV Human Immunodeficiency Virus IDPL Infectious Diseases Pharmacokinetics Laboratory IDSA Infectious Diseases Society of America INA Immigration and Naturalization Act IND investigational new drug IFN-g interferon-gamma IRIS immune reconstitution syndrome IRU Immigration and Refugee Unit LFTs liver function tests LTBI latent tuberculosis infection MAC mycobacterium avium complex MAI mycobacterium avium intracellulare M. bovis mycobacterium bovis MDRTB multidrug-resistant tuberculosis MGIT Mycobacterial Growth Indicator Tube MIRU mycobacterial interspersal repetitive units MOTT mycobacterium other than .