The Department of Health supports the targeted screening approach advised by CDC in which groups at risk of TB are screened, but low-risk groups such as healthy, U.S. born children are not. Low-risk, healthy individuals should not be screened due to the increased likelihood of false positives leading to needless follow-up and care, in addition to associated anxiety and costs.
Treatment of Tuberculosis
The recommended treatment regimen for uncomplicated tuberculosis is a two-month induction phase of four drugs consisting of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and either ethambutol (EMB) or streptomycin (SM), followed by a four-month continuation phase with INH and RIF. For more complicated cases, e.g., co-existing HIV infection or drug resistance, treatment regimens vary. Consultation on such cases is available from the Communicable Diseases Program at 410-222-7256.
The Centers for Disease Control and Prevention recommend that a health care provider observe each dose as it is taken (i.e., Directly Observed Therapy – DOT). DOT is the standard of care for all active TB cases in Maryland and should be arranged by calling the local health department in the jurisdiction where the case resides. Other tuberculosis-related services available from all local health departments include medical consultation, laboratory studies, chest radiographs and medications. If the initial specimens submitted for mycobacterial culture are sent to a private laboratory, drug susceptibility testing should also be requested.
In Anne Arundel County, free and confidential TB treatment is available, along with public health follow-up with the contacts. Physicians should refer patients for treatment. Referring physicians will be included in developing the treatment plan that includes appropriate public health follow-up. Department of Health nursing staff will provide DOT to all County patients with tuberculosis. Call 410-222-7256 for more information.