A tuberculosis control plan for ambulatory care centers.

Tuberculosis and a multidrug resistant form of TB have reemerged in epidemic proportions. Tuberculosis is more prevalent among HIV-infected individuals, the homeless, foreign-born individuals from countries with high rates of TB, prison inmates, individuals in long-term care facilities, individuals from low-socioeconomic backgrounds, and intravenous drug users. Urgent care centers, which have gained popularity as an easy access to medical care, are at risk for seeing undetected infectious patients. By developing a TB control plan for ambulatory care centers, specific triage criteria can be instituted to promote early identification of the potentially infectious patient and provide guidelines for identification, prevention, environmental controls, education, and follow-up of exposed health care workers. This article discusses the mandatory OSHA policy for occupational exposure to tuberculosis based on the 1993 CDC guidelines for TB transmission and how a TB control plan for ambulatory care centers can be developed from these guidelines.