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Education
Materials > Publications
> Effective TB Interviewing for Contact
Investigation > Facilitator Led Training Guide > Course Activities
Effective TB Interviewing for Contact Investigation:
Facilitator Led Training Guide
2006
10. Course Activities
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Activity 4: Infectious Period Exercise |
Objectives |
- To understand the considerations for determining infectiousness
- To formulate an infectious period
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Time Allotted |
30 minutes total
- 5 minutes for instructions and distributing exercises
- 10 minutes of group work
- 15-minute large group discussion of answers
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Materials Needed |
- Easel
- Markers
- Copies of the “Infectious Period Exercise”
on page 43 (one for each participant)
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Pre-Course Procedure |
The answers to this exercise will
vary based on your health department’s guidelines for
the calculation of an infectious period. Therefore, no
answers are provided to these questions. Copy the
exercise on page 43 and hand a copy to each participant.
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Procedure |
- Ask the participants how to calculate the infectious period
for their area. This should include a. beginning date,
b. end date, c. criteria for onset of symptoms.
- Ask the participants to work for about 10 minutes individually
to calculate the infectious period for each example.
- After 10 minutes, ask for volunteers to share with the
class the infectious period for each example. Whether correct
or incorrect, ask the participant the way in which this
period was calculated for each example. Correct any
incorrect answers.
- The participant should draw a diagram to visually explain
how the infectious period was calculated. The diagram
should look like Figure 7 with included dates as the answers.
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Figure 7. Diagram
of infectious period  |
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5. Answer any questions that may arise.
Be prepared to answer questions on topics such as
- Having multiple infectious periods for the same patient;
- Criteria for ending the infectious period;
- Varying an infectious period in the context of each contact
such as if the patient did not have contact with a close
contact at some point before being hospitalized for infectious
TB, i.e., the infectious period can end when contact is
broken; and
- Formulating the infectious period without the presence
of cough or any TB symptoms.
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Tip
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The infectious period brings focus to the
TB interview process. Here is a quick review of the
formulation of the infectious period. This is the time
frame during which potential exposure to others may have occurred
while the patient was infectious or able to transmit TB.
Often, the beginning of the infectious period is the date
of the onset of symptoms, especially coughing. Local
or state standards should be used to determine the beginning
of the infectious period. Some health department guidelines
denote a specified period prior to the patient’s recollection
of the onset of symptoms, particularly cough.
For the purpose of the contact investigation, the end of
the infectious period is determined by all of the following
criteria:
- Symptoms, such as frequency and intensity of cough, have
improved
- Patient has been receiving adequate treatment for at least
2 weeks
- Patient has shown some evidence of a bacteriological response,
such as the reduction of the grade of the AFB sputum smear
or conversion to negative sputum smears.
Or
- Exposure to contacts has ended
The infectious period should be stated in the form of start
date to end date. The infectious period provides a timeframe
for the patient when identifying information on contacts.
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Activity 4: Infectious Period Exercise
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Participant Handout |
Instructions |
Calculate the infectious period for the following cases.
It should include start and end dates. Base your answers on
your health department’s standards for calculating an
infectious period. Be prepared to discuss with the class
how you came up with your answer. You can use a diagram
like the one below to calculate the infectious period.
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- Joe was hospitalized on June 6 and started TB treatment
that day. He claimed he had been coughing since April
20. He had three consecutive negative smear results
as of July 10 and had improved symptoms. What is the
infectious period?
- Philip was hospitalized on December 4 with symptoms of
fever, night sweats, and cough. He was diagnosed with
TB on December 10 and started on TB treatment that day.
Philip states that he started coughing around November 6.
His symptoms resolved on January 27. Three consecutive
sputum smears were not negative until February 10.
What is the infectious period?
- Mary complained that she had been coughing since March
10. She started TB treatment on May 24. Mary
left the hospital against medical advice on June 7 but was
readmitted on July 8. She had three consecutive negative
smears as of August 1, during the second hospitalization.
What is the infectious period?
- David was diagnosed with TB on February 10, based on skin
test and chest X-ray results. He was asymptomatic
and treated on an outpatient basis. His sputum smears
were negative prior to treatment but sputum culture was
identified as M. tuberculosis. His treatment ended
on August 5. What is the infectious period?
- Carla was diagnosed with TB disease and had night sweats,
fever, and weight loss when admitted to the hospital on
May 19. She claims her symptoms began around April
3. She denies ever having had a cough. Carla
was admitted into the hospital and three consecutive induced
sputum smears were negative on June 21. What is the infectious
period?
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Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination - http://www.cdc.gov/tb
Please send comments/suggestions/requests
to: hsttbwebteam@cdc.gov,
or to
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333 |
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