Tuberculosis classification

Last updated

Tuberculosis classification system

The current clinical classification system for tuberculosis (TB) is based on the pathogenesis of the disease. [1]

Contents

Health care providers should comply with local laws and regulations requiring the reporting of TB. All persons with class 3 or class 5 TB should be reported promptly to the local health department. See list of notifiable diseases.[ citation needed ]

Classification System for TB
ClassTypeDescription
0No TB exposure
Not infected
No history of exposure
Negative reaction to tuberculin skin test
1TB exposure
No evidence of infection
History of exposure
Negative reaction to tuberculin skin test
2TB infection
No disease
Positive reaction to tuberculin skin test
Negative bacteriologic studies (if done)
No clinical, bacteriologic, or radiographic evidence of TB
3TB, clinically active M. tuberculosis cultured (if done)
Clinical, bacteriologic, or radiographic evidence of current disease
4TB
Not clinically active
History of episode(s) of TB
or
Abnormal but stable radiographic findings
Positive reaction to the tuberculin skin test
Negative bacteriologic studies (if done)
and
No clinical or radiographic evidence of current disease
5TB suspectDiagnosis pending
TB disease should be ruled in or out within 3 months

CDC TB classification for immigrants and refugees

The U.S. Citizenship and Immigration Services has an additional TB classification for immigrants and refugees developed by the Centers for Disease Control and Prevention (CDC). [2] The B notification program is an important screening strategy to identify new arrivals who have a high risk for TB. [3]

United States Immigrant/Refugee TB Classification - revised 2009
Class
No TB Classification (Normal)
Class A TB with waiver, infectious
Class B1 TB, Pulmonary
Class B1 TB, Extrapulmonary
Class B2 TB Latent TB Infection (LTBI) Evaluation
Class B3 TB, Contact Evaluation

See also

Related Research Articles

<span class="mw-page-title-main">Tuberculosis</span> Infectious disease

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but it can also affect other parts of the body. Most infections show no symptoms, in which case it is known as latent tuberculosis. Around 10% of latent infections progress to active disease which, if left untreated, kill about half of those affected. Typical symptoms of active TB are chronic cough with blood-containing mucus, fever, night sweats, and weight loss. It was historically referred to as consumption due to the weight loss associated with the disease. Infection of other organs can cause a wide range of symptoms.

<span class="mw-page-title-main">Mantoux test</span> Immunological method to test for tuberculosis

The Mantoux test or Mendel–Mantoux test is a tool for screening for tuberculosis (TB) and for tuberculosis diagnosis. It is one of the major tuberculin skin tests used around the world, largely replacing multiple-puncture tests such as the tine test. The Heaf test, a form of tine test, was used until 2005 in the UK, when it was replaced by the Mantoux test. The Mantoux test is endorsed by the American Thoracic Society and Centers for Disease Control and Prevention. It was also used in the USSR and is now prevalent in most of the post-Soviet states, although Soviet mantoux produced many false positives due to childrens' allergic reaction.

<span class="mw-page-title-main">Preventive healthcare</span> Prevent and minimize the occurrence of diseases

Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention.

Radiology (X-rays) is used in the diagnosis of tuberculosis. Abnormalities on chest radiographs may be suggestive of, but are never diagnostic of TB, but can be used to rule out pulmonary TB.

<span class="mw-page-title-main">Tropical medicine</span> Interdisciplinary branch of medicine

Tropical medicine is an interdisciplinary branch of medicine that deals with health issues that occur uniquely, are more widespread, or are more difficult to control in tropical and subtropical regions.

<span class="mw-page-title-main">Tuberculosis diagnosis</span>

Tuberculosis is diagnosed by finding Mycobacterium tuberculosis bacteria in a clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.

<span class="mw-page-title-main">Tuberculosis management</span>

Tuberculosis management describes the techniques and procedures utilized for treating tuberculosis (TB).

Latent tuberculosis (LTB), also called latent tuberculosis infection (LTBI) is when a person is infected with Mycobacterium tuberculosis, but does not have active tuberculosis. Active tuberculosis can be contagious while latent tuberculosis is not, and it is therefore not possible to get TB from someone with latent tuberculosis. The main risk is that approximately 10% of these people will go on to develop active tuberculosis. This is particularly true, and there is added risk, in particular situations such as medication that suppresses the immune system or advancing age.

<span class="mw-page-title-main">Berkeley Free Clinic</span>

The Berkeley Free Clinic is a non-profit community clinic located in Berkeley, California, US. It is operated as a worker-run collective by more than 100 volunteers. It has provided free medical care since opening in 1969.

A health professional, healthcare professional, or healthcare worker is a provider of health care treatment and advice based on formal training and experience. The field includes those who work as a nurse, physician, physician assistant, registered dietitian, veterinarian, veterinary technician, optometrist, pharmacist, pharmacy technician, medical assistant, physical therapist, occupational therapist, dentist, midwife, psychologist, or who perform services in allied health professions. Experts in public health and community health are also health professionals.

Interferon-gamma release assays (IGRAs) are diagnostic tools for latent tuberculosis infection (LTBI). They are surrogate markers of Mycobacterium tuberculosis infection and indicate a cellular immune response to M. tuberculosis if the latter is present.

<span class="mw-page-title-main">Tuberculosis in China</span>

Tuberculosis is a serious public health problem in China. China has the world's third largest cases of tuberculosis, but progress in tuberculosis control was slow during the 1990s. Detection of tuberculosis had stagnated at around 30% of the estimated total of new cases, and multidrug-resistant tuberculosis was a major problem. These signs of inadequate tuberculosis control can be linked to a malfunctioning health system. The spread of severe acute respiratory syndrome (SARS) in 2003, brought to light substantial weaknesses in the country's public health system. After the government realized the impact that the SARS outbreak had on the country, they increased leadership in their health department. After the SARS epidemic was brought under control, the government increased its commitment and leadership to tackle public health problems and, among other efforts, increased public health funding, revised laws that concerned the control of infectious diseases, implemented the world's largest internet-based disease reporting system to improve transparency, reach and speed, and started a program to rebuild local public health facilities and national infrastructure.

<span class="mw-page-title-main">Refugee health</span> Health effects experienced by people who have been displaced

Refugee health is the field of study on the health effects experienced by people who have been displaced into another country or even to another part of the world, as a result of unsafe circumstances such as war or persecution. Displaced populations' health is mainly affected by infectious disease, mental health, and chronic diseases that are uncommon in the country in which they eventually settle. Refugee health status is largely due to factors such as the migrant's geographic origin, conditions of refugee camps or urban settings where they lived, and personal, physical, and psychological conditions of the migrant, either pre-existing or acquired while traveling from their homeland to a camp or eventually to their new home.

<span class="mw-page-title-main">Tom Frieden</span> American physician

Thomas R. Frieden is an American infectious disease and public health physician. He serves as president and CEO of Resolve to Save Lives, a $225 million, five-year initiative to prevent epidemics and cardiovascular disease.

Infectious diseases within American correctional settings are a concern within the public health sector. The corrections population is susceptible to infectious diseases through exposure to blood and other bodily fluids, drug injection, poor health care, prison overcrowding, demographics, security issues, lack of community support for rehabilitation programs, and high-risk behaviors. The spread of infectious diseases, such as HIV and other sexually transmitted diseases, hepatitis C (HCV), hepatitis B (HBV), and tuberculosis, result largely from needle-sharing, drug use, and consensual and non-consensual sex among prisoners. HIV and hepatitis C need specific attention because of the specific public health concerns and issues they raise.

Applicants for immigration into the United States must meet certain medical standards, as assessed by the I-693, Report of Medical Examination and Vaccination Record. The purpose of the medical exam is to ensure that an applicant is “not inadmissible to the United States on public health grounds." Inadmissibility is defined in Act 212 of the Immigration and Nationality Act (INA). Accordingly, an alien is inadmissible if he or she has a communicable disease of public health significance, lacks the required vaccines, is a drug abuser or addict, or has a physical or mental disorder with a behavior, or history of a behavior, that is a threat to “the property, safety, or welfare of the alien or others”.

Migrant Clinicians Network (MCN) is a non-profit organization dedicated to health justice for the mobile poor and the creation of practical solutions at the intersection of vulnerability, migration, and health. It is headquartered in Austin, Texas with supporting offices in California, Maryland, and Puerto Rico. MCN engages in research, develops tools and resources, and advocates for migrants and underserved populations and the clinicians who serve them. MCN's goal is to improve health care for migrants by providing support, technical assistance, and professional development to clinicians at Federally Qualified Health Centers and other health care delivery sites, in order to ensure “quality health care that increases access and reduces disparities.” In 2019, MCN accounted for over 31,000 technical assistance encounters, 267 health center site visits, and 1,069 trained clinicians. MCN has 53 full-time and part-time staff members, with many of them being bilingual. MCN is featured as a Top Rated Non-Profit based on user reviews at Great Nonprofits as of 2021.

<span class="mw-page-title-main">Refugee health in the United States</span>

Refugee health in the United States focuses on the health, treatment, and healthcare barriers of migrants to the United States who have relocated from their country of origin, often because of factors such as political instability, war, or natural disaster. Special considerations are needed to provide appropriate medical treatment for these individuals, who often face extreme adversity, violent and/or traumatic experiences, and travel through perilous regions. Such considerations include screenings for communicable diseases, vaccinations, posttraumatic stress disorder, and depression.

<span class="mw-page-title-main">Division of Global Migration and Quarantine</span> U.S. government agency responsible for U.S. Quarantine Stations and issuing quarantine orders

The Division of Global Migration and Quarantine (DGMQ) is the part of the U.S. government responsible for U.S. Quarantine Stations and issuing quarantine orders. It is part of the National Center for Emerging and Zoonotic Infectious Diseases within the Centers for Disease Control and Prevention (CDC).

References

  1. Diagnostic Standards and Classification of Tuberculosis in Adults and Children. Am. J. Respir. Crit. Care Med., Volume 161, Number 4, April 2000, 1376-1395. This Official Statement of the American Thoracic Society and the Centers for Disease Control and Prevention was Adopted by the ATS Board of Directors, July 1999. This Statement was endorsed by the Council of the Infectious Disease Society of America, September 1999. Class 0-5 are explained on pages 1391-1392.
  2. CDC Immigration Requirements: Technical Instructions for Tuberculosis Screening and Treatment. October 1, 2009. Classifications, see pages 21-22.
  3. Revised CDC TB Classification system for overseas screening of immigrants and Refugees with Class B1/B2 TB Conditions Archived 2011-07-08 at the Wayback Machine . State of Wisconsin, Department of Health Services, Division of Public Health, International Health and Respiratory Disease Unit, Bureau of Communicable Diseases and Emergency Response. September 29, 2009. Accessed 2011-07-27.