Page 18 - Delaware Medical Journal - March/April 2020

WHAT TO DO IF YOU SUSPECT TB:
1. Implement AII precautions immediately.
2. Administer a TB test.
3. Obtain a chest x-ray.
4. Get a sputum sample for acid-fast bacilli (AFB) smear, nucleic acid amplification testing, and culture.
5. Consider consultation with an infectious disease expert.
6. Report confirmed or suspected cases of TB disease and LTBI to DPH within two working days. Contact the TB clinic in the county where the patient resides: in New Castle County, 302-283-7588; Kent County, 302-857-5130; and Sussex County, 302-515-3200.
TREATMENT
Treatment for LTBI can be completed in as little as 12 weeks, with a once-weekly dose of isoniazid (INH) and rifapentine, or 3HP, for most patients.11 Treatment for TB disease takes a little longer — six months for most, though for some it can take up
to nine months or longer depending on drug susceptibility and the characteristics of their disease. Most patients take a combination of INH, rifampin (RIF),
a week for eight weeks, followed by INH additional 18 weeks.12
CONCLUSION
Historical success at driving down TB rates domestically speaks largely to public health efforts, in which all Delaware health care providers play a part. To continue progress toward our end goal of eliminating TB, make TB part of the differential diagnosis when patients have TB disease symptoms and risk factors for exposure.
For more information, contact Crystal Vicidomini, DPH’s TB Elimination Program Manager, at 302-744-1053 or crystal.vicidomini@delaware.gov.
CONTRIBUTORS
■ CRYSTAL VICIDOMINI, MSN/MBA, RN, is the Program Manager for the Tuberculosis Elimination Program at the Division of Public Health, Delaware Department of Health and Social Services.
■ MARTIN LUTA, MD is the Chief of the Bureau of Communicable Diseases at the Division of Public Health, Delaware Department of Health and Social Services.
■ RICK HONG, MD is the Medical Director of the Division of Public Health, Delaware Department of Health and Social Services.
66 Del Med J | March/April 2020 | Vol. 92 | No. 2