| Situation |
Recommended Testing |
| No previous TST result |
Two-step baseline TST's |
| Previous negative TST result (documented or not) > 12 months before new employment |
Two-step baseline TST's |
| Previous documented negative TST result < 12 months before new employment |
Single TST needed for baseline testing |
| > 2 Previous documented negative TST's but most recent TST > 12 months before new employment |
Single TST; two-step testing is not necessary |
| Previous documented positive TST result |
No TST |
| Previous undocumented positive TST results |
Two-step baseline TST's |
| Previous BCG vaccination |
Two-step baseline TST's |
Recommendations
1. Develop a comprehensive post-exposure management and medical follow-up program
a. Include policies and procedures for prompt reporting, evaluation, counseling, treatment and medical follow-up of occupational exposures.
b. Establish mechanisms for referral to a qualified healthcare professional for medical evaluation and follow-up.
c. Conduct a bseline TST, preferably by using a two-step test, for all DHCP who might have contact with persons with suspected or confirmed infectious TB, regardless of the risk classification of the setting.