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EROIGSA-15.0007 <br />(FDA) approved, method. Detainees who have symptoms suggestive of TB disease will <br />be immediately placed in an airborne infection isolation room and promptly evaluated for <br />suspected TB disease. Detainees who are initially tested using a test for TB infection [TB <br />skin test (TST) or interferon gamma release assay (IGRA)] and result with a TST <br />interpretation or IGRA positive for TB infection and no symptoms suggestive of TB <br />disease must be evaluated with a chest radiograph within 5 days after the TST is <br />interpreted or IGRA result is received, <br />Detainees who are identified with confirmed or suspected active TB (e,g„ symptoms <br />suggestive of TB or chest radiograph suggestive of TB) will be placed in a functional <br />airborne infection isolation room and managed in accordance with the PBNDS and all <br />applicable CDC guidelines; http,//www.cdc gov/tb/oublicapons/ uidol#u,esldefa'ul.t,htm. <br />It is not necessary to house detainees separately fiom the general population unless there <br />is clinical or radiographic evidence suggestive of TB disease, If chest x-rays are <br />performed on-site, they will be perfonned by a trained and qualified health care provider <br />and interpreted by a credentialed radiologist. There will be a non -punitive process m <br />place for detainees who refuse the screening assessment for TB. <br />The Service Provider will notify IHSC and the local health department of all detainees <br />with confinned or suspected TB disease, including detainees with clinical or radiographic <br />evidence suggestive of TB. Notification shall occur within one working day of <br />identifying a detainee with conf coned or suspected TB disease. Notification to local <br />health departments shall identify the detainee as being in ICL; custody and shall include <br />the alien number with other identifying information. For detainees with confirmed or <br />suspected TB disease, the Service provider will coordinate with IHSC and the local <br />health department prior to release to facilitate release planning and referrals for continuity <br />of care. <br />'The service provider will evaluate detainees annually for symptoms, consistent with TB, <br />within one year of the previously documented "IB evaluation. For detainees initially <br />screened with a TST or IGRA with a negative result, annual evaluation will include <br />testing with the same method as previously used, For detainees initially evaluated with a <br />chest radiograph interpreted as not suggestive of TB disease, routine annual chest <br />radiograph is not recommended. <br />R. Radiology Service Provider <br />If the service provider utilizes tele -radiology for Tuberculosis screening, the requirement <br />should be built into the established bed day rate for this IDSA. <br />S. Airborne precautions <br />In order to prevent the spread of airborne infectious disease or cross contamination of <br />zones within the facility, it is preferred that the HVAC system in the intake screening <br />area will be designed to exhaust to the exterior and prevent air exchange between the <br />11 <br />