The Employee with Positive PPD

Policy
 
It is the responsibility of this organization to protect its patients and employees from communicable disease. 
 
This organization is considered to be a low risk organization, however depending on the circumstance a PPD testing of employees involved with patient care may be conducted.
 
Procedure: 
 
Should an employee present with a positive PPD, A recent chest radiograph (within 6 months) must be presented/taken.  
This is to insure the absence of active TB infection. If the CXR is positive, then the employee must be given medical 
leave and referred immediately to an Infectious Disease or Pulmonary Physician.  Additionally, the NY Department of 
Health will be notified, as per local law.
 
If the CXR is negative, the employee will then be referred to an Infectious Disease Physician or Pulmonary Physician for 
further guidance/treatment. All information regarding the course of treatment followed will be documented in the 
employee health file and will remain confidential.
 
For further information the CDC states the following:In most people who breathe in TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. The bacteria become inactive, but they remain 
alive in the body and can become active later. This is called latent TB infection. People with latent TB infection: have no symptoms, don't feel sick, can't spread TB to others, usually have a positive skin test reaction, can develop active TB disease if they do not receive, treatment for latent TB infection 
 

Many people who have latent TB infection never develop active TB disease. In these people, the TB bacteria remain inactive for a lifetime without causing disease. But in other people, especially people who have weak immune systems, the bacteria become active and cause TB disease.
 
A negative chest x-ray is required before preventive therapy is initiated. In persons vaccinated with BCG, sensitivity to tuberculin is highly variable, depending upon the strain of BCG used and the group vaccinated. The presence or size of a post vaccination tuberculin skin-test reaction does not predict whether BCG will provide any protection against TB disease. 
 
Furthermore, the size of a tuberculin skin-test reaction in a BCG-vaccinated person is not a factor in determining whether 
the reaction is caused by M. tuberculosis infection or the prior BCG vaccination. See Volume 5, MC.14,  Guidelines for 
Preventing Transmission of TB in the Health-Care Setting.
 
Approved By Governing Board    
PP.6    
Control #334.4
GUPTA GASTRO