South Carolina Code of Regulations › Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL › Subchapter 61-125 - Consumer Electronic Equipment Collection and Recovery › Section 61-125.1700 - INFECTION CONTROL › Subsection 61-125.1702 - Tuberculosis Risk Assessment and Screening. (I)

Current through Register Vol. 48, No. 6, June 28, 2024
A. All facilities shall conduct an annual
				  tuberculosis risk assessment (see Section 101.SS) in accordance with CDC
				  guidelines to determine the appropriateness and frequency of tuberculosis
				  screening and other tuberculosis related measures to be taken.
B. The risk classification, for example, low
				  risk, medium risk, shall be used as part of the risk assessment to determine
				  the need for an ongoing TB screening program for staff and volunteers and
				  patients and the frequency of screening. A risk classification shall be
				  determined for the entire facility. In certain settings, for example,
				  healthcare organizations that encompass multiple sites or types of services,
				  specific areas defined by geography, functional units, patient population, job
				  type, or location within the setting may have separate risk classifications.
C. Staff and Volunteers
				  Tuberculosis Screening.
1. Tuberculosis
				  Status. Prior to date of hire or initial patient contact, the tuberculosis
				  status of staff and volunteers shall be determined in the following manner in
				  accordance with the applicable risk classification:
2. Low Risk:
a. Baseline two-step Tuberculin Skin Test
				  ("TST") or a single Blood Assay for
Mycobacterium tuberculosis
("BAMT"): All staff and volunteers (within three (3) months prior to
				  contact with patients) unless there is a documented TST or a BAMT result during
				  the previous twelve (12) months. If a newly employed staff or volunteer has had
				  a documented negative TST or a BAMT result within the previous twelve (12)
				  months, a single TST (or the single BAMT) can be administered and read to serve
				  as the baseline prior to patient contact.
b. Periodic TST or BAMT is not
				  required.
c. Post-exposure TST or a
				  BAMT for staff and volunteers upon unprotected exposure to
M.
				  tuberculosis
: Perform a contact investigation when unprotected
				  exposure is identified. Administer one (1) TST or a BAMT as soon as possible to
				  all staff who have had unprotected exposure to an infectious TB case or
				  suspect. If the TST or the BAMT result is negative, administer another TST or a
				  BAMT eight to ten (8 to 10) weeks after that exposure to
M.
				  tuberculosis
ended.
d.
				  Baseline positive with or without documentation of treatment for latent TB
				  infection ("LTBI") (see Section 101.Z) or TB disease shall have a symptoms
				  screen prior to employment and annually thereafter.
e. Upon hire, staff and volunteers with a
				  newly positive test result for
M. tuberculosis
infection (for
				  example, TST or BAMT) or signs or symptoms of tuberculosis, for example, cough,
				  weight loss, night sweats, fever, shall have a chest radiograph performed
				  immediately to exclude TB disease (or evaluate an interpretable copy taken
				  within the previous three (3) months). Repeat radiographs are not needed unless
				  symptoms or signs of TB disease develop or unless recommended by a physician.
				  These staff members and volunteers will be evaluated for the need for treatment
				  of TB disease or LTBI and will be encouraged to follow the recommendations made
				  by a physician with TB expertise (for example, the Department's TB Control
				  program).
3. Medium
				  Risk:
a. Baseline two-step TST or a single
				  BAMT: All staff and volunteers (within three (3) months prior to contact with
				  patients) unless there is a documented TST or a BAMT result during the previous
				  twelve (12) months. If a newly employed staff member or volunteer has had a
				  documented negative TST or a BAMT result within the previous twelve (12)
				  months, a single TST (or the single BAMT) can be administered to serve as the
				  baseline prior to patient contact.
b. Periodic testing (with TST or BAMT):
				  Annually, of all staff and volunteers who have risk of TB exposure and who have
				  previous documented negative results. Instead of participating in periodic
				  testing, staff and volunteers with documented TB infection (positive TST or
				  BAMT) shall receive a symptom screen annually. This screen shall be
				  accomplished by educating the staff or volunteer who have documented TB
				  infection about symptoms of TB disease (including the staff's and/or
				  volunteers' responses concerning symptoms of TB disease), documenting the
				  questioning of the staff or volunteers about the presence of symptoms of TB
				  disease, and instructing the staff or volunteers to report any such symptoms
				  immediately to the administrator. Treatment for LTBI shall be considered in
				  accordance with CDC and Department guidelines and, if recommended, treatment
				  completion shall be encouraged.
c.
				  Post-exposure TST or a BAMT for staff or volunteers upon unprotected exposure
				  to
M. tuberculosis
: Perform a contact investigation (see
				  Section 101.I) when unprotected exposure is identified. Administer one (1) TST
				  or a BAMT as soon as possible to all staff and volunteers who have had
				  unprotected exposure to an infectious TB case or suspect. If the TST or the
				  BAMT result is negative, administer another TST or BAMT eight to ten (8 to 10)
				  weeks after that exposure to
M. tuberculosis
ended.
4. Baseline Positive or Newly
				  Positive Test Result:
a. Baseline positive
				  with or without documentation of treatment for LTBI or TB disease shall have a
				  symptoms screen prior to employment and annually thereafter.
b. Upon hire, staff and volunteers with a
				  newly positive test result for
M.tuberculosis
infection (for
				  example
,
TST or BAMT) or signs or symptoms of tuberculosis,
				  for example
,
cough, weight loss, night sweats, fever, shall
				  have a chest radiograph performed immediately to exclude TB disease (or
				  evaluate an interpretable copy taken within the previous three (3) months).
				  Repeat chest radiographs are not required unless symptoms or signs of TB
				  disease develop or unless recommended by a physician. These staff members and
				  volunteers will be evaluated for the need for treatment of TB disease or LTBI
				  and will be encouraged to follow the recommendations made by a physician with
				  TB expertise (for example
,
the Department's TB Control
				  program).
c. Staff and volunteers
				  who are known or suspected to have TB disease shall be excluded from work,
				  required to undergo evaluation by a physician, and permitted to return to work
				  only with written approval by the Department's TB Control program. Repeat chest
				  radiographs are not required unless symptoms or signs of TB disease develop or
				  unless recommended by a physician.