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B. TUBERCULOSIS SCREENING All inmates will be screened for tuberculosis (TB) within four (4) days of admission into the Jail. The nursing staff will begin by interviewing the inmate to determine his /her reactivity to the tuberculin skin test (TST). Inmates who do not have a verifiable positive test result history will have the TST administered at this time, according to the Mantoux method, with readings taken in 48 to 72 hours. Immune compromised inmates will be anergy tested at the time of the skin test to minimize the risk of a false negative result. Positive TST results will trigger a more extensive examination to determine the likelihood of active disease. Individuals considered positive reactors (by history or skin test) would receive a chest x -ray. The physician, regardless of the skin test result, will examine HIV positive or possible positive, individuals whose chest x -rays are abnormal or whose symptoms are suggestive of active tuberculosis. Sputurn stains and cultures will be performed on those individuals suspected of being positive for active tuberculosis. While cultures are pending, the inmate will be housed in respiratory isolation. Confirmed cases of TB will be reported to the proper authorities including the Jail Administrator and the Orange County Department of Public Health. Inmates with inactive tuberculosis will be given future TB testing instructions and education. Screening results will be placed in the inmate's medical record and reviewed and approved by the physician or NP during the health appraisal. C. HEALTH APPRAISAL All inmates will receive a comprehensive medical history and physical examination within fourteen (14) days after admission. The history and exam will be performed by qualified and trained health professionals (if City of Sa as Ma Jail - L 5- Proposal rot hunate Medical Services RPPN 07 -062 25J -31