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Guide to the Application of Genotyping to Tuberculosis Prevention
and Control
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Applying Genotyping Results to Tuberculosis
Control Practices
Expanded Contact Investigation
Goal
The goal of an expanded contact investigation is to ensure that
all contacts of an infectious TB patient have been identified, evaluated,
and treated appropriately. Although the goals of a regular contact
investigation and an expanded contact investigation are the same,
an expanded contact investigation involves applying greater resources
to identifying and evaluating contacts, since the possibility of
recent transmission to contacts has been confirmed.
Steps
Although the details of conducting an expanded contact investigation
are beyond the scope of this guide, the key steps are described
in this section. CDC and NTCA are developing revised guidelines
for conducting contact investigations, which should be available
in 2005. An additional source of information is CDC’s Self-Study
Module 6, Contact Investigation for Tuberculosis, which can
be ordered from CDC.
The first step in an expanded contact investigation is to ensure
the completeness of the initial contact investigation of close contacts.
This is most easily done by creating a database of contacts to facilitate
their management. For each contact, information should be entered
into the database to designate completion of each of the key components
of a contact investigation: contact interview, symptom screening,
tuberculin skin testing, evaluation for active TB for contacts with
positive TSTs or symptoms, and treatment for LTBI, for those who
require treatment. The second step in an expanded contact investigation
is to include second- and third-tier contacts. These are often leisure
contacts and work contacts who were not included in the initial
contact investigation. The same information should be gathered for
second- and third-tier contacts as was described above for close
contacts identified during the routine contact investigation.
Outcome
The expected outcome of an expanded contact investigation is the
complete processing of all contacts of an infectious TB patient,
the identification of any active cases among those contacts, and
the treatment to completion, when indicated, of contacts with LTBI.
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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