Targeted Tuberculin Testing Infection

1 Inside: Continuing Medical Education for Physicians and NursesTargeted Tuberculin Testingand Treatment of Latent DEPARTMENT OF HEALTH & HUMAN SERVICESC enters for Disease Control and Prevention (CDC)Atlanta, GA 30333 June 9, 2000 / Vol. 49 / No. RR-6 RecommendationsandReportsInside: Continuing Medical Education for Physicians and NursesInside: Continuing Education Examination2 MMWRJune 9, 2000 Centers for Disease Control and Prevention .. Jeffrey P. Koplan, , material in this report was prepared for publication byNational Center for HIV, STD, and TB Prevention.

2 Helene D. Gayle, , of tuberculosis Elimination .. Kenneth G. Castro, production of this report as an MMWR serial publication was coordinated inEpidemiology Program Office .. Barbara R. Holloway, DirectorOffice of Scientific and Health Communications .. John W. Ward, , MMWR SeriesRecommendations and Reports ..Suzanne M. Hewitt, J. WilsonProject F. BoydVisual Information D. R. ShaverTechnical Information SpecialistsThe MMWR series of publications is published by the Epidemiology Program Office,Centers for Disease Control and Prevention (CDC), Department of Health andHuman Services, Atlanta, GA CITATIONC enters for Disease Control and Prevention.

3 Targeted Tuberculin Testing and treat-ment of latent tuberculosis Infection . MMWR 2000;49(No. RR-6):[inclusive pagenumbers].Vol. 49 / No. RR-6 MMWRiInside: Continuing Medical Education for Physicians and NursesContentsExecutive Summary .. 1 Targeted Tuberculin Testing .. 1 Treatment of Latent tuberculosis Infection .. 2 Clinical and Laboratory Monitoring .. 4 Introduction .. 5 History of Treatment of Latent tuberculosis Infectionand Relevance to tuberculosis Control .. 5 Relationship of Tuberculin Testing to Treatment of LatentTuberculosis Infection .

4 6 Change in Nomenclature .. 7 Scientific Rationale .. 7 Targeted Tuberculin Testing .. 7 Diagnosis of Latent tuberculosis Infection .. 10 Treatment of Latent tuberculosis Infection .. 12 Recommendations .. 22 Implementation of Targeted Tuberculin Testing .. 22 Diagnosis of Latent tuberculosis Infection .. 23 Treatment of Latent tuberculosis Infection .. 26 Priorities for Future Research .. 40 Diagnosis .. 40 Operational Research .. 40 Efficacy Studies of New Drugs .. 41 Studies of Immunomodulators and Vaccines .. 41 Decision/Cost-Effectiveness Analyses.

5 42 References .. 43iiMMWRJune 9, 2000 ATS/CDC Statement Committee on LatentTuberculosis InfectionMembership List, June 2000CO-CHAIRSD avid L. Cohn, Public HealthDenver, CORichard J. O Brien, for Disease Controland PreventionAtlanta, GAWRITING GROUPL awrence J. Geiter, Global TuberculosisFoundationRockville, MDFred M. Gordin, Medical CenterWashington, DCEarl Hershfield, of ManitobaWinnipeg, MB, CanadaC. Robert Horsburgh, Jr., University Schoolof MedicineAtlanta, GAJohn A. Jereb, for Disease Controland PreventionAtlanta, GATheresa J.

6 Jordan, York University, New York, NYNew Jersey Medical SchoolNational tuberculosis CenterNewark, NJJonathan E. Kaplan, for Disease Controland PreventionAtlanta, GACharles M. Nolan, County Departmentof HealthSeattle, WAJeffrey R. Starke, , Children s HospitalHouston, TXZachary Taylor, for Disease Controland PreventionAtlanta, GAM. Elsa Villarino, , for Disease Controland PreventionAtlanta, GAVol. 49 / No. RR-6 MMWRiiiATS/CDC Statement Committee on LatentTuberculosis InfectionMembership List, June 2000 ContinuedMEMBERSN ancy J. Binkin, , for Disease Controland PreventionAtlanta, GANaomi N.

7 Bock, University Schoolof MedicineAtlanta, GAKenneth G. Castro, for Disease Controland PreventionAtlanta, GARichard E. Chaisson, Hopkins UniversityBaltimore, MDGeorge W. Comstock, Hopkins UniversityHagerstown, MDMark S. Dworkin, for Disease Controland PreventionAtlanta, GAWafaa El-Sadr, , Hospital CenterNew York, NYPaula I. Fujiwara, , of tuberculosis ControlNew York, NYJeffrey C. Glassroth, of WisconsinMedical SchoolMadison, WIPeter Godfrey-Faussett, School of Hygieneand Tropical MedicineLondon, United KingdomMark J. Goldberger, , and Drug AdministrationRockville, MDJames L.

8 Hadler, , of Public HealthHartford, CTPhilip C. Hopewell, Francisco General HospitalSan Francisco, CAMichael D. Iseman, Jewish Medicaland Research CenterDenver, CORichard F. Jacobs, of ArkansasLittle Rock, ARMack A. Land, of TennesseeCollege of Medicine MemphisMemphis, TNMark N. Lobato, for Disease Controland PreventionAtlanta, GARichard I. Menzies, Chest HospitalMontreal, PQ, CanadaivMMWRJune 9, 2000 ATS/CDC Statement Committee on LatentTuberculosis InfectionMembership List, June 2000 ContinuedGiovanni B. Migliori, Salvadore MaugeriTradate, ItalyBess I.

9 Miller, , for Disease Controland PreventionAtlanta, GAAlwyn Mwinga, Teaching HospitalLukasa, ZambiaEdward A. Nardell, HospitalCambridge, MAJames Neaton, of MinnesotaSchool of Public HealthMinneapolis, MNNoreen L. Qualls, for Disease Controland PreventionAtlanta, GALee B. Reichman, , Jersey Medical SchoolNewark, NJDavid N. Rose, Island Jewish HospitalNew Hyde Park, NYShelley R. Salpeter, Clara Valley Medical CenterSan Jose, CAHolger Sawert, , of Public HealthNonthaburi, ThailandPatricia M. Simone, for Disease Controland PreventionAtlanta, GADixie E.

10 Snider, Jr., , for Disease Controland PreventionAtlanta, GAJoel Tsevat, , of CincinnatiMedical CenterCincinnati, OHAndrew A. Vernon, for Disease Controland PreventionAtlanta, GAChristopher C. Whalen, Western Reserve UniversityCleveland, OHTimothy C. Wilcosky, Triangle InstituteResearch Triangle Park, NCVol. 49 / No. RR-6 MMWRvNOTICEThis report is being published with the permission of the American ThoracicSociety and as a courtesy to the MMWR readership. It is an adaptation of areport published in the American Journal of Respiratory and Critical CareMedicine 2000;161:S221 9, 2000 Vol.