Iowa Administrative Code › Agency 641 - Public Health Department › Chapter 155 - Licensure Standards for Substance Use Disorder and Problem Gambling Treatment Programs › Rule 641-155.37 - Definitions

Current through Register Vol. 47, No. 3, July 24, 2024
For the purpose of these rules, the following definitions
				shall apply:
"Bacille Calmette-Guerin (BCG) vaccination"
means a vaccine for TB. BCG is used in many countries with a high prevalence of
				TB to prevent childhood tuberculosis meningitis and military disease. BCG is
				not generally recommended for use in the United States because of the low risk
				of infection with
Mycobacterium tuberculosis,
the variable
				effectiveness of the vaccine against adult pulmonary TB, and the vaccine's
				potential interference with tuberculin skin test reactivity.
"Baseline TB screening "
means the screening
				of staff and residents for latent tuberculosis infection (LTBI) and TB disease
				at the beginning of employment or upon admission to a facility. Baseline TB
				screening includes a symptom screen for all staff and residents and tuberculin
				skin tests (TSTs) or interferon-gamma release assay (IGRA)
				for
Mycobacterium tuberculosis
for those staff and residents
				with previous negative test results for M.
tuberculosis
infection.
"Baseline TST"
or
"baseline IGRA
				"
means the TST or IGRA, respectively, that is administered at the
				beginning of employment to newly hired staff or upon admission to residents of
				facilities.
"Boosting"
means a phenomenon in which a
				person has a negative TST (i.e., false-negative) result years after infection
				withM
tuberculosis
and then a positive subsequent TST result.
				The positive TST result is caused by a boosted immune response of previous
				sensitivity rather than by a new infection (false-positive TST conversion).
				Two-step testing reduces the likelihood of mistaking a boosted reaction for a
				new infection.
"Extrapulmonary TB"
means TB disease in any
				part of the body other than the lungs (e.g., kidney, spine, or lymph
				nodes).
"Interferon-gamma release assay"
or
"IGRA "
means a whole-blood test that can aid in
				diagnosing
Mycobacterium tuberculosis
infection.
"laryngeal TB "
means a form of TB disease
				that involves the larynx and may be highly infectious.
"latent TB infection"
or
"ITBI"
means infection with
M. tuberculosis
without symptoms or signs of disease having manifested.
"Mantoux method"
means a skin test performed
				by intradermally injecting 0.1 mL of purified protein derivative (PPD)
				tuberculin solution into the volar or dorsal surface of the forearm.
"Pulmonary TB "
means TB disease that occurs
				in the lung parenchyma, usually producing a cough that lasts three weeks or
				longer. Pulmonary TB is usually infectious.
"Purifiedprotein derivative (PPD) tuberculin "
means a material used in diagnostic tests for detecting infection
				with
M. tuberculosis.
"Risk classification "
means the category on
				which the infection control team, or designated other, determines the setting's
				TB risk classification is based, as a result of the TB risk assessment.
"Serial screening"
refers to TB screening
				performed at regular intervals following baseline TB screening. Serial TB
				screening, also called annual or ongoing TB testing, consists of two
				components:
(1) assessing for current symptoms of active TB disease, and
				(2) testing for the presence of infection with M
tuberculosis
by administering either a TST or single IGRA.
"Symptom screen "
means a procedure used
				during a clinical evaluation in which patients are asked if they have
				experienced any departure from normal in function, appearance, or sensation
				related to TB disease (e.g., cough).
"TB patient"
means a person who had
				undiagnosed infectious pulmonary or laryngeal TB while in the facility during
				the preceding year. "TB patient" does not include persons with LTBI (treated or
				untreated), extrapulmonary TB disease, pulmonary, or laryngeal TB who have met
				criteria for noninfectiousness.
"TB risk assessment"
means an initial and
				ongoing evaluation of the risk for transmission of
M.
				tuberculosis
in a particular health care setting.
"TB screening"
means an administrative control
				measure in which evaluation for LTBI and TB disease is performed through
				baseline and serial screening of staff and residents of facilities.
"TB screening plan "
means a plan that
				facilities develop and implement that comprises four major components:
(1) baseline testing for
M. tuberculosis
infection, (2) serial testing for
M. tuberculosis
infection,
				(3) serial screening for signs or symptoms of TB disease, and (4) TB training
				and education.
"Treatment for LTBI"
means treatment that
				prevents the progression of
M. tuberculosis
infection into TB
				disease.
"Tuberculin skin test"
or
"TST"
means a diagnostic aid for finding
M.
				tuberculosis
infection. The Mantoux method is the recommended method
				to be used for the TST.
"Tuberculosis"
or
"TB"
means
				the namesake member organism of
M. tuberculosis
complex and the
				most common causative infectious agent of TB disease in humans. In certain
				instances, the species name refers to the entire
M.
				tuberculosis
complex, which includes
M. bovis
and
M. african, M. microti, M. canetti, M. caprae,
and
M. pinnipedii.
"Tuberculosis disease "
or
"TB disease
				"
means a condition caused by infection with a member of the
M.
				tuberculosis
complex that has progressed to causing clinical
				(manifesting symptoms or signs) or subclinical (early stage of disease in which
				signs or symptoms are not present, but other indications of disease activity
				are present) illness.
"Two-step tuberculin skin test"
or
"two-step TST"
means the procedure used for the baseline
				skin testing of persons who will receive serial TSTs to reduce the likelihood
				of mistaking a boosted reaction for a new infection.