The mission of the Suffolk County Department of Health Services, Division of Patient Care, Bureau of Chest Diseases (BCD) is to prevent, control and eliminate tuberculosis (TB) in Suffolk County.
The BCD will accomplish this mission through public health surveillance, nurse case management, contact tracing, policy development, health care professional consultation, technical assistance, supervision, regulation and education.
The BCD receives reports from hospitals, physicians and medical laboratories of persons with suspected and confirmed TB disease and ensures treatment for these persons. The BCD ensures that persons with TB disease of the respiratory tract are rendered non-infectious by completion of a course of recommended anti-TB medications. The BCD reduces TB transmission through contact tracing.
Bureau of Chest Diseases Programs
- Nurse Case Management
- Directly Observed Therapy
- Contact Investigations
- Source Case Investigations
- Health Care Professional Consultation Services
- Tuberculosis Registry
- Community and Professional Education Programs
Nurse Case Management
A registered nurse case manager follows each suspected or confirmed case of TB from initial report through completion of therapy to ensure that proper treatment protocols are followed. The registered nurse identifies high-priority contacts and ensures their evaluation.
Directly Observed Therapy (DOT)
DOT is the preferred means of ensuring adherence with TB treatment because it involves watching as the patient swallow their anti-TB medications. DOT is provided by appointment during normal weekday business hours, either daily or intermittently in the “field” (e.g., patient’s home, place of employment, school, or any other site that is mutually agreeable and deemed safe). DOT is administered by trained BCD personnel. DOT enables early identification of non-adherence with TB treatment, adverse medication effects, and possible worsening of TB.
TB contact investigations are an important part of TB control and are usually supervised by the local health department. TB contact investigations identify persons at risk of exposure to TB from a person with infectious TB disease. Since TB has a long incubation period of months or even years from exposure to development of disease, time is taken to carefully follow accepted medical and public health practices in identifying those persons at risk of exposure. Exposed contacts are usually persons who shared the same air space, in an enclosed environment, for a prolonged period of time (days or weeks, not minutes or hours) with a person with infectious TB disease. Exposed contacts are offered TB screening.
Source Case Investigations
Parents or guardians of children < 2 years of age diagnosed with latent TB infection (LTBI) are interviewed in an attempt to identify their child’s close contacts in order to determine, if possible, the source of the child’s TB infection.
Health Care Professional Consultation Services
A person with TB’s health care professional are encouraged to contact the BCD to discuss management issues.
The BCD maintains a registry of TB cases.
Community and Professional Education Programs
The BCD is available to participate in community or professional education programs to improve TB education and awareness.