UNF BUMEDINST 6224.8C

Question 1

WHAT IS BUMEDINST 6224.C?

Answer 1

TUBERCULOSIS SURVEILLANCE AND CONTROL PROGRAM

Question 2

WHEN WAS BUMEDINST 6224.8C PUBLISHED?

Answer 2

25-APR-2018

Question 3

WHO IS LISTED IN THE “FROM:” LINE OF BUMEDINST 6224.8C?

Answer 3

CHIEF, BUREAU OF MEDICINE AND SURGERY

Question 4

HOW MANY REFERENCES ARE LISTED FOR BUMEDINST 6224.8C?

Answer 4

TWO

Question 5

WHAT ARE THE REFERENCES FOR BUMEDINST 6224.8C?

Answer 5

(a) NMCPHC-TM OM 6260 AND (b) BUMEDINST 6220.12C

Question 6

WHAT IS LISTED IN THE “SUBJ:” LINE FOR BUMEDINST 6224.8C?

Answer 6

TUBERCULOSIS SURVEILLANCE AND CONTROL PROGRAM

Question 7

HOW MANY ITEMS ARE LISTED IN THE “ENCL:” LINE IN BUMEDINST 6224.8C AND WHAT ARE THEY?

Answer 7

FOUR AND:

(1) TUBERCULOSIS SCREENING AND TESTING
(2) EVALUATION MANAGEMENT OF NEW POSITIVE TESTS FOR LATENT TUBERCULOSIS INFECTION
(3) TUBERCULOSIS CONTACT INVESTIGATION, INITIAL TUBERCULOSIS PATIENT MANAGEMENT, AND REQUIRED REPORTS (4) LIST OF TUBERCULOSIS CONSULTANTS

Question 8

WHAT IS THE STATED PURPOSE FOR BUMEDINST 6224.8C?

Answer 8

TO PROVIDE POLICY AND PROCEDURES FOR SCREENING, TESTING, TREATING, DOCUMENTING, AND TRACKING DEPARTMENT OF THE NAVY (DON) MILITARY PERSONNEL AND MILITARY SEALIFT COMMAND CIVILIAN MARINERS (CIVMAR) AT RISK FOR TUBERCULOSIS (TB). TB CONTROL EFFORTS FOR OTHER POPULATIONS (E.G., HEALTHCARE WORKERS, DON CIVILIANS, DON CONTRACTORS, ELIGIBLE BENEFICIARIES, INMATES OF DETENTION AND CONFINEMENT FACILITIES, CHILD DEVELOPMENT CENTER WORKERS, ETC.) ARE TO BE GUIDED BY AND CONSISTENT WITH CURRENT CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) GUIDANCE, OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION (OSHA) REGULATIONS, APPLICABLE FEDERAL LAWS, AND REFERENCE (a)

Question 9

WHAT DOES BUMEDINST 6224.8C CANCEL?

Answer 9

BUMEDINST 6224.8B

Question 10

WHAT IS THE SCOPE OF BUMEDINST 6224.8C?

Answer 10

THIS INSTRUCTIONS APPLIES TO ALL SHIPS AND STATION WITH MEDICAL DEPARTMENT PERSONNEL.

Question 11

WHAT IS THE STATED BACKGROUND OF BUMEDINST 6224.8C?

Answer 11

ALTHOUGH THE CURRENT TB CASE BURDEN IS LOW, THE THREAT OF TB REMAINS A PUBLIC HEALTH CONCERN WITHIN THE DON. WHILE BEING A MILITARY MEMBER OR CIVMAR IS NOT IN ITSELF A RISK FACTOR FOR TB, PARTICULAR SITUATIONS IMPOSED BY MILITARY SERVICE MAY PRESENT AN INCREASED RISK OF INFECTION. CLOSE WORKING AND LIVING QUARTERS IN MILITARY AND SHIPBOARD OPERATIONS DEMAND VIGILANT PUBLIC HEALTH MEASURES TO PREVENT THE ACQUISITION, ACTIVATION, AND SPREAD OF TB. PROMPT RECOGNITION AND RESPIRATORY ISOLATION OF PERSONS WITH ACTIVE PULMONARY TB SIGNIFICANTLY REDUCES THE CHANCE THAT INFECTION WILL SPREAD TO OTHERS. EARLY DETECTION AND TREATMENT OF LATENT TB INFECTION (LTBI) REDUCES THE RISK OF PROGRESSION TO ACTIVE DISEASE.

Question 12

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE FIRST STEP IN THE STRATEGY TO CONTROL TB?

Answer 12

a. TO PROMPTLY DETECT, ISOLATE, TREAT, AND REPORT PERSONS WHO HAVE DEVELOPED CLINICALLY ACTIVE (INFECTIOUS) TB.

Question 13

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE SECOND STEP IN THE STRATEGY TO CONTROL TB?

Answer 13

b. TO PROTECT PERSONS IN CLOSE CONTACT WITH PATIENTS DIAGNOSED WITH INFECTIOUS TB.

Question 14

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE THIRD STEP IN THE STRATEGY TO CONTROL TB?

Answer 14

c. TO PREVENT TB DISEASE IN MILITARY PERSONNEL AND CIVMARS THROUGH IMPLEMENTING ACCESSION TESTING FOLLOWED BY TARGETED TESTING AND EFFECTIVE TREATMENT FOR LTBI, AS DESCRIBED IN ENCLOSURES (1) THROUGH (3). ACTIVE AND RESERVE COMPONENT PERSONNEL AND CIVMARS WILL BE TESTED FOR LTBI ONLY WHEN THEY HAVE HIGH-RISK EXPOSURES, HIGH-RISK OCCUPATIONS, OR CLINICAL CONDITIONS THAT INCREASE THE RISK OF PROGRESSION FROM LTBI TO ACTIVE TB DISEASE.

Question 15

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE FOURTH STEP IN THE STRATEGY TO CONTROL TB?

Answer 15

d. TO CONDUCT TB SCREENING AND TARGETED TESTING IN NON-MILITARY OCCUPATIONAL POPULATIONS BASED ON THE MEDICAL CERTIFICATION GUIDANCE CONTAINED IN REFERENCE (a).

Question 16

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE FIFTH STEP IN THE STRATEGY TO CONTROL TB?

Answer 16

e. TO ASSURE THROUGH CONTRACTING OVERSIGHT THA TDON CONTRACTORS, ESPECIALLY IN THE DEPLOYMENT SETTING, ARE EVALUATED FOR TB INFECTION. CONTRACTS FOR HEALTHCARE WORKERS MUST CONTAIN LANGUAGE THAT SPECIFIES SCREENING FOR RISK OF EXPOSURE TO TB.

Question 17

ACCORDING TO BUMEDINST 6224.8C, HOW IS RECORD KEEPING DEFINED?

Answer 17

RECORD KEEPING. RELEVANT FORMS INCLUDE: NAVMED 6224/7 INITIAL TUBERCULOSIS EXPOSURE RISK ASSESSMENT; NAVMED 6224/8 TUBERCULOSIS EXPOSURE RISK ASSESSMENT; NAVMED 6224/9 MONTHLY EVALUATION FOR PAITENTS RECEIVING TREATMENT FOR LATENT TUBERCULOSIS INFECTION (LTBI); AND DD FORM 2766 ADULT PREVENTATIVE AND CHRONIC CARE FLOWSHEET. THESE FORMS WILL CONSTITUTE PAR FO THE PATIENT’S MEDICAL RECORD.

Question 18

ACCORDING TO BUMEDINST 6224.8C, HOW MANY RESPONSIBILITIES ARE LISTED FOR FLEET AND FLEET MARINE FORCE SURGEONS?

Answer 18

TWO

Question 19

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE FIRST LISTED RESPONSIBILITY OF FLEET AND FLEET MARINE FORCE SURGEONS?

Answer 19

(1) CONTROL TB IN THEIR SUPPORTED POPULATIONS BY MANAGING LOCAL CONTROL EFFORTS PER THIS INSTRUCTION AND CURRENT CDC GUIDELINES. OSHA GUIDANCE, FEDERAL LAW, STATE LAW, AND LOCAL ORDINANCE MAY BE CONSIDERED WHEN ESTABLISHING LOCAL CONTROL EFFORTS.

Question 20

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE SECOND LISTED RESPONSIBILITY OF FLEET AND FLEET MARINE FORCE SURGEONS?

Answer 20

(2) ASSIST NAVY ENVIRONMENTAL AND PREVENTATIVE MEDICINE UNITS (NAVENPVNTMEDU) IN THE CONDUCT, COMPLETION, AND REPORTING OF TB CONTACT INVESTIGATIONS.

Question 21

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE LISTED RESPONSIBILITY OF NAVY MEDICINE REGIONAL COMMANDERS?

Answer 21

NAVY MEDICINE REGIONAL COMMANDERS. MUST ENSURE SUBORDINATE MEDICAL TREATMENT FACILITIES (MTF) MAINTAIN AN EFFECTIVE TB SURVEILLANCE AND CONTROL PROGRAM AND CONDUCT ONGOING EVALUATIONS OF THE RISK FOR TB TRANSMISSION, PER THE CDC’S GUIDELINES FOR PREVENTING THE TRANSMISSION OF MYCOBACTERIUM TUBERCULOSIS IN HEALTH-CARE SETTINGS.

Question 22

ACCORDING TO BUMEDINST 6224.8C, HOW MANY LISTED RESPONSIBILITIES ARE THERE FOR COMMANDING OFFICERS AND OFFICERS IN CHARGRE OF MTF’S?

Answer 22

TWO

Question 23

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE FIRST LISTED RESPONSIBILITY OF COMMANDING OFFICERS AND OFFICERS IN CHARGE OF MTF’S?

Answer 23

(1) CONTROL TB IN THEIR SUPPORTED POPULATIONS BY MANAGING LOCAL CONTROL EFFORTS PER THIS INSTRUCTION AND CURRENT CDC GUIDELINES. OSHA GUIDANCE, FEDERAL LAW, STATE LAW, AND LOCAL ORDINANCE MAY BE CONSIDERED WHEN ESTABLISHING LOCAL CONTROL EFFORTS. AS AGENCIES OF THE FEDERAL GOVERNMENT, MTF’S ARE OBLIGED TO CONFORM TO FEDERAL LAW BUT ARE NOT OBLIGED TO COMPLY WITH STATE LAW OR LOCAL ORDINANCE IF THESE CONFLICT WITH FEDERAL LAW, DEPARTMENT FO DEFENSE (DOD) DIRECTIVES, OR NAVY MEDICINE DIRECTIVES.

Question 24

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE SECOND LISTED RESPONSIBILITY OF COMMANDING OFFICERS AND OFFICERS IN CHARGE OF MTF’S?

Answer 24

(2) ASSIST NAVENPVNTMEDU’S IN THE CONDUCT, COMPLETION, AND REPORTING OF TB CONTACT INVESTIGATIONS.

Question 25

ACCORDING TO BUMEDINST 6224.8C, HOW MANY LISTED RESPONSIBILITIES ARE THERE FOR COMMANDING OFFICER, NAVY AND MARINE CORPS PUBLIC HEALTH CENTER (NAVMCPUBHLTHCEN)?

Answer 25

TWO

Question 26

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE FIRST LISTED RESPONSIBILITY OF COMMANDING OFFICER, NAVY AND MARINE CORPS PUBLIC HEALTH CENTER (NAVMCPUBHLTHCEN)?

Answer 26

(1) ENSURE NAVENPVNTMEDU MEDU’S PROVIDE TB SURVEILLANCE AND CONTROL TECHNICAL SUPPORT AS NEEDED TO ALL NAVY AND MARINE CORP UNTIS IN THEIR GEOGRAPHIC AREA OF RESPONSIBILITY.

Question 27

ACCORDING TO BUMEDINST 6224.8C, WHAT IS THE SECOND LISTED RESPONSIBILITY OF COMMANDING OFFICER, NAVY AND MARINE CORPS PUBLIC HEALTH CENTER (NAVMCPUBHLTHCEN)?

Answer 27

(2) ENSURE NAVENPVNTMEDUS CONDUCT OR FACILITATE CONTACT INVESTIGATIONS OF ALL ACTIVE TB CASES WITHIN THE DON IN THEIR AREA OF RESPONSIBLITY.