Michelle Burton Ladna Farah · Michelle Burton Ladna Farah Objective: – Identify resources that will facilitate the successful care management of tuberculosis (TB) in active TB

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Public Health King County SeattleTuberculosis Resources

Michelle Burton

Ladna Farah

Objective:

– Identify resources that will facilitate the successful care management of tuberculosis (TB) in active TB and latent TB patients

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WhatYouNeedtoKnowAboutYourMedicinefor

LatentTuberculosis(TB)Infection

Rifampin(RIF)

TuberculosisControlProgramHarborviewMedicalCenterGroundFloorEastClinic3259thAvenue(Box359776)Seattle,WA98104Phone:206‐744‐4579Fax:206‐744‐4350www.kingcounty.gov/health/tb

Whotocallwithquestions:

Your Nurse:Funded by a grant from the

WhileonthisMedicine:

Tell your doctor or nurse if you have questions or concerns with the medicine.

Go to your planned clinic visits.

Discuss any alcohol use with your doctor. Alcohol may cause side effects.

Tell your doctor about all other medicines you are taking.

Be sure to tell your other doctors that you are being treated for latent TB infection.

Take all of your medicine as you were told by your TB doctor or nurse.

Some people find the medicine affects them less when taken with food.

TipstoHelpYouTakeYourMedicine

Take your medicine at the same time every day.

Set an alarm reminder for the time you should take your medicine.

Ask a family member or friend to remind you.

Use a pillbox. Put a reminder note on your mirror or refrigerator.

Use a calendar to check off the day when you take your medicine.

Rifampin

IfYouForgettoTakeYourMedicine:

If it is still the same day, take the dose as soon as you remember. Do not take 2 doses at the same time.

LatentTBInfectionMedicineSchedule

WatchforThesePossibleProblems:

STOP taking your medicine right away and CALL your TB doctor or nurse if you have any of the problems below:

Less appetite, or not appetite for food

An upset stomach or stomach cramps

Nausea or vomiting

Cola‐colored urine or light stools

Easy bruising or bleeding

Yellowing skin or eyes

Rash or itching

Severe weakness or tiredness

Fever

Head or body aches

Dizziness

NOTE: It is normal if your urine, saliva, or tears become orange‐colored. Soft contact lenses may become stained.

You have been given Rifampin to treat your latent TB infection. You do not have TB disease and cannot spread TB to others. This medicine will help you PREVENT getting TB disease.

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Isoniazid(INH)

TuberculosisControlProgram

HarborviewMedicalCenter,GroundFloorEastClinic3259thAvenue(Box359776)Seattle,WA98104Phone:206‐744‐4579Fax:206‐744‐4350www.kingcounty.gov/health/tb


Your Nurse:

DirectlyObservedPreventativeTherapy(DOPT)

When isoniazid is taken 2 times a week, it may be given by directly observed therapy. You will meet with a health care worker to take your medicine.

DOPT can help you in several ways:

The health care worker helps you to remember to take your medicine.

The health care worker will make sure you are not having problems with the medicine.

Funded by a grant from the

You have been given Isoniazid to treat your latent TB infection. You do not have TB disease and cannot spread TB to others. This medicine will help you PREVENT getting TB disease.

WhileonthisMedicine: Tell your doctor or nurse if you have questions or concerns with the medicine.

Go to your planned clinic visits.

Discuss any alcohol use with your doctor. Alcohol may cause side effects.



Take all of your medicine as you were told by your TB doctor or nurse.

Some people find the medicine affects them less when taken with food.

Isoniazid





Use a pillbox.

Put a reminder not on your mirror or refrigerator.


IfYouForgettoTakeYourMedicine: If it is still the same day, take the dose as soon as you remember. If the day has passed, skip the missed dose and take your next schedule dose—do not take 2 doses at the same time.

Your doctor may have you take Vitamin B6 with your medicine.


WatchforthesePossibleProblems:

STOP taking your medicine right away and CALL your TB doctor or nurse if you have any of the problems below:

Less appetite, or no appetite for food


Nausea or vomiting



Rash or itching

Tingling or numbness in your hands or feet

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IsoniazidandRifapentine(“3HP”)

TuberculosisControlProgram

HarborviewMedicalCenterGroundFloorEastClinic3259thAvenue(Box359776)Seattle,WA98104Phone:206‐744‐4579Fax:206‐744‐4350www.kingcounty.gov/health/tb


Your Nurse:

WatchforThesePossibleProblems:

STOP taking your medicine right away and CALL your TB nurse if you have any of the problems below:

Less appetite, or no appetite for food


Nausea or vomiting



Easy bruising or bleeding

Rash or itching

Severe weakness or tiredness

Fever

Head or body aches

Dizziness

Tingling or numbness in your hands or feet

NOTE: It is normal if your urine, saliva, or tears become orange‐colored. Soft contact lenses may become stained.

Funded by a grant from the

You have been given medicine to treat your latent TB infection. You do not have TB disease and cannot spread TB to others. This medicine will help you PREVENT getting TB disease.

WhileonthisMedicine: Tell your doctor or nurse if you have questions or concerns with the medicine.

Go to weekly visits.

Discuss any alcohol use with your doctor. Alcohol use may cause side effects.



Some people find the medicines affect them less when taken with food.

Isoniazid+Rifapentine





Us a pillbox.

Put a reminder not on your mirror or refrigerator.



RemembertoKeepYourWeeklyVisits

You will meet with a health care worker weekly to take your medicines. This plan is called directly observed preventative therapy (DOPT).

DOT can help you in several ways:

The health care worker helps you to remember to take your medicine.

You will complete your treatment as soon as possible.

The health care worker will make sure you are not having problems with the medicine.

During your weekly meetings, this person can answer your questions. You can also talk about any concern you have.

Medicine Numberofpillseach

day

Schedule Day Lengthoftime

Isoniazid 3 Onceweekly

MTWThFSSun 3months(12weeks)

Rifapentine 6

Pyridoxine(vitaminB6)

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Languages Available– Amharic

– Arabic

– Burmese

– Chinese

– Dari

– English

– Farsi

– Khmer

– Kiro

– Laotina

– Marshallese

– Nepali

– Oromo

– Punjabi

– Russian

– Somali

– Spanish

– Swahili

– Tagalog

– Tigrinya

– Ukrainian

– Vietnamese

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Affordable QuantiFERON-Plus (QFT-PLUS)Testing for YourLocal Health Jurisdiction

(206) 790-9283

[email protected] 8/13/2018

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The King County Public Health Lab provides QFT-Plus testing for all Washington State Local Health Jurisdictions. Some benefits include: Low cost for QFT-Plus test ($50.00 per test) Generic tube; no processing at site required Single Tube New generation with higher sensitivity and

specificity

QFT-Plus Test

Setting up an Account is Easy! Contact Paul Swenson ([email protected]; 206.744.8050), Alfred Iqbal ([email protected]; 206.744.8957) or the lab with the following information: Name of account: Contact person and their address: Phone # and fax #: Billing contact person and their address: Method for delivering your hard copy lab reports:

Contact information for the King County Public Health Lab:

Harborview Medical CenterKing County Public Health Laboratory

Basement West Clinic Wing 325 9th Ave

Seattle, WA 98104 Phone:206-744-8950 Fax:206-744-8963

Open: Monday - Friday, 8:00 AM to 4:30 PMWebsite: www.kingcounty.gov/lab

. Fill a generic single lithium heparin blood collection tube with > 5 ml of blood. Mix by inverting the tube a few times. Label appropriately including the time of blood collection.

. Place tube in a zip-lock bag with completed laboratory form. Record the date and time of collection.

. Maintain tube at room temperature and deliver to the Seattle & King County Lab within 12 hours of collection.

OR

. Hold tube at room temperature between 15 min and 3 hours after collection and refrigerate until delivery to the Seattle & King County Public Health Lab within 48 hours. Do not freeze the blood sample. Be sure to indicate on the lab form the date and the time of refrigeration.

Steps for Blood Collection and Shipping

Resources I Use for Provider Questions

TC from a community provider:17 yo female who had a positive 2nd step PPD on 7/19/17 (testing for school). Her only risk factor was that she was born in Mexico (she did get the BCG vaccine). Chest Xray was neg. She was started on isoniazid on 7/17/17. She stopped isoniazid mid Sept 2017 due to cramping with medication. She was prescribed rifampin for 4 months starting 10/6/17. Pharmacy alerted PCP on 8/16/18 that she had been using rifampin sporadically. Her refill history is a follows: 10/6/17, 11/7/17, 6/19/18, 8/15/18.The provider’s question was, “Do we have to give her additional rifampin or do something different or let her complete the 4th month and leave as is?”‐https://www.doh.wa.gov/Portals/1/Documents/Pubs/343‐157‐LTBI%20Treatment%20Options%20One%20Pager.pdf

‐https://www.doh.wa.gov/YouandYourFamily/IllnessandDisease/Tuberculosis/TBProviderToolkit

‐https://www.cdc.gov/tb/topic/infectioncontrol/TBhealthCareSettings.htm

‐https://www.cdc.gov/tb/publications/ltbi/default.htm

‐https://www.currytbcenter.ucsf.edu/products

‐http://www.currytbcenter.ucsf.edu/consultation

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For more information please contact:Public Health-Seattle &King County,

TB Control Program, Mary Tuncil, RN

(Phone): 206-744-4579WTCN (Phone): [email protected]

Questions?

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