December 16, 2005 / Vol. 54 / No. RR–15
Guidelines for the Investigation of Contacts of Persons with Infectious Tuberculosis: Recommendations from the National Tuberculosis Controllers Association and CDC

In 1976, the American Thoracic Society published brief guidelines for the investigation, diagnostic evaluation, and medical treatment of TB contacts. Although investigation of contacts and treatment of infected contacts is an important component of the U.S. strategy for TB elimination, second in priority to treatment of persons with TB disease, national guidelines have not been updated since 1976. This statement, the first issued jointly by the National Tuberculosis Controllers Association and CDC, provides expanded guidelines concerning investigation of TB exposure and transmission and prevention of future cases of TB through contact investigations and discusses multiple related topics (e.g., data management, confidentiality and consent, and human resources). These guidelines are intended for use by public health officials but also are relevant to others who contribute to TB control efforts.

Guidelines for Using the QuantiFERON®-TB Gold Test for Detecting Mycobacterium tuberculosis Infection, United States

On May 2, 2005, a new in vitro test, QuantiFERON^®-TB Gold (QFT-G), received final approval from the U.S. Food and Drug Administration as an aid for diagnosing Mycobacterium tuberculosis infection. This test detects the release of interferon-gamma (IFN-γ) in fresh heparinized whole blood from sensitized persons when it is incubated with mixtures of synthetic peptides representing two proteins present in M. tuberculosis: early secretory antigenic target–6 (ESAT-6) and culture filtrate protein–10 (CFP-10). These antigens impart greater specificity than is possible with tests using purified protein derivative as the tuberculosis (TB) antigen. In direct comparisons, the sensitivity of QFT-G was statistically similar to that of the tuberculin skin test (TST) for detecting infection in persons with untreated culture-confirmed tuberculosis. CDC recommends that QFT-G may be used in all circumstances in which the TST is currently used, including contact investigations, evaluation of recent immigrants, and sequential-testing surveillance programs for infection control (e.g., those for health-care workers). Specific cautions are provided for interpreting negative QFT-G results in persons from selected populations.

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December 2, 2005 / Vol. 54 / No. SS–8
Surveillance for Certain Health Behaviors Among States and Selected Local Areas --- Behavioral Risk Factor Surveillance System, United States, 2003

Data on health risk behaviors for chronic diseases and use of preventive practices are essential for developing effective health education and intervention programs and policies to prevent morbidity and mortality. This report summarizes data for states/territories, selected metropolitan and micropolitan statistical areas (MMSAs), and their counties from the 2003 Behavioral Risk Factor Surveillance System. Findings demonstrate that prevalence of high-risk behaviors for chronic diseases, awareness of certain medical conditions, and use of preventive health-care services varied substantially by state/territory, MMSA, and county, indicating a need for appropriate public health interventions and continued efforts to evaluate public health programs and policies and health-care–related efforts designed to reduce morbidity and mortality.

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