S.C. Code Regs. § § 61-78.1300.1303

Current through Register Vol. 48, No. 10, October 25, 2024

Section 61-78.1300.1303 - Staff and Volunteer Tuberculosis Screening (I)

A. Tuberculosis Status. Prior to date of hire or initial patient contact, the tuberculosis status of direct care staff and volunteers shall be determined in the following manner in accordance with the applicable risk classification:

B. Low Risk:

1. 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 BAMT result during the previous twelve (12) months. If a newly employed staff member or volunteer has had a documented negative TST or BAMT result within the previous twelve (12) months, a single TST (or single BAMT) can be administered to serve as the baseline.

2. Periodic TST or BAMT is not required.

3. Post-exposure TST or BAMT for staff upon unprotected exposure to M. tuberculosis:

a. Perform a contact investigation when unprotected exposure is identified.

b. Administer one (1) TST or 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 BAMT result is negative, administer another TST or BAMT eight to ten (8 to 10) weeks after that exposure to M. tuberculosis ended.

C. Medium Risk:

1. 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 BAMT result during the previous twelve (12) months. If a newly employed staff member or volunteer has had a documented negative TST or BAMT result within the previous twelve (12) months, a single TST (or single BAMT) can be administered to serve as the baseline.

2. Periodic testing (with TST or BAMT):

a. All staff and volunteers who have risk of TB exposure and who have previously documented negative results shall have annual periodic testing.

b. Staff and volunteers with documented TB infection (positive TST or BAMT) shall receive a symptom screen annually instead of participating in periodic testing. This symptom screen shall be accomplished by educating the staff and volunteers about symptoms of TB disease (including the staff and/or direct care volunteers responses), documenting the questioning of the staff and volunteers about the presence of symptoms of TB disease, and instructing the staff and volunteers to report any such symptoms immediately to the administrator. Treatment for latent TB infection (LTBI) shall be considered in accordance with CDC and Department guidelines and, if recommended, treatment completion shall be encouraged.

3. Post-exposure TST or 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 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 BAMT result is negative, administer another TST or BAMT eight to ten (8 to 10) weeks after that exposure to M. tuberculosis ended.

D. Baseline Positive or Newly Positive Test Result:

1. Staff and volunteers with a baseline positive or newly positive test result for M. tuberculosis infection (TST or BAMT) or documentation of treatment for latent TB infection (LTBI) or TB disease or signs or symptoms of tuberculosis, such as 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). These staff members or volunteers shall be evaluated for the need for treatment of TB disease or latent TB infection (LTBI) and encouraged to follow the recommendations made by a physician with TB expertise (such as the Department's TB Control program).

2. Staff and volunteers known or suspected to have TB disease shall be excluded from work, required to undergo evaluation by a physician or legally authorized healthcare provider, and permitted to return to work only with approval by the Department TB Control program. Repeat chest radiographs are not required unless symptoms or signs of TB disease develop or unless recommended by a physician or legally authorized healthcare provider.

S.C. Code Regs. § 61-78.1300.1303

Replaced and amended by State Register Volume 40, Issue No. 04, eff. 4/22/2016.