Please note:   This information has been provided by University Health Services (UHS). Please contact UHS with any questions you may have, (312-996-7420).
University Health Services (MC 684)
835 South Wolcott Avenue, Room E-144
Chicago, Illinois 60612-7338
T 312-996-7420
F 312-413-8485
DATE: February 27, 2008
TO: INCOMING UIC RESIDENTS
FROM: David C. Marder, MD, MPH
Director, University Health Services
RE: University of Illinois Medical Center at Chicago (UIMCC)
Mandatory Health Evaluations
June 18th and June 24th
University Health Services has scheduled 2 days in June for New House Staff mandatory pre-placement health assessments. The pre-placement assessment will include a brief history, vital signs, vision test, blood screen for hepatitis B (HBV), measles, mumps, rubella and varicella (MMRV) immunity, blood assay for Mycobacterium Tuberculosis (BAMT), and a drug test. You will also complete a fit test for the N95 respirator [see below] used for suspect or active Tuberculosis patients, etc.
If you have documented titers for MMRV or HBV, please bring with you to avoid repeat testing. The Tuberculosis screen, BAMT, is a highly sensitive test for Tb surveillance and is the preferred method of testing at UIMCC. Please refer to the "Frequently Asked Questions" information sheet provided [below]. If you have a history of a positive TB skin test, you are still required to have the baseline BAMT test to confirm the result. If the BAMT confirms your positive test, you will be required to complete a TB Surveillance Program Questionnaire and you will also be required to have a CXR (a CXR report less than one year old will be accepted unless a new CXR is clinically indicated).
It is the UIMCC policy in accordance with OSHA and JACHO requirements, that all health care workers must successfully complete this MANDATORY evaluation prior to working in the Medical Center. You will not be placed on the payroll and will not be allowed to work if this is not completed. Completion includes the above and vaccination for susceptible/equivocal MMRV and HBV titers, and CXR if confirmed positive BAMT.
  
MANDATORY HEALTH EVALUATION DATES AND TIMES:
Wednesday, June 18, 2008   -   8:00am -  3:00pm
Tuesday, June 24, 2008   -   8:00am -  3:00pm
LOCATION:
University Health Services
835 South Wolcott Avenue, Room E-144
Chicago, Illinois 60612-7338
(Directly across from the Student Center West)
(312) 996-7420
  
BRING:
•   Vaccination titers as listed above, if available
  
RETURN VISIT:
You may also be required to return for vaccination boosters, or CXR as indicated.
University Health Services Clinic hours are Monday, Tuesday, Thursday, Friday 7:00am - 4:00pm and Wednesday 7:00am - 3:00pm.
We look forward to meeting you and helping you complete the mandatory pre-placement health evaluation requirements as efficiently as possible. If you have any questions, please call the University Health Services at (312) 996-7420 and ask to speak with a nurse.

  
University Health Services
UIC
QuantiFERON-TB Gold
FAQs - Frequently Asked Questions
What is it?
The QuantiFERON-Gold test (QFT) is a whole-blood test for screening for active tuberculosis (TB) or latent tuberculosis infection (LTBI). If not detected and treated, LTBI may later develop into TB disease. The QFT measures the patient's immune reactivity to M. Tuberculosis, the bacterium that causes TB. This test was approved by the U.S. Food and Drug Administration (FDA) in 2004. QuantiFERON-GOLD represents a significant advance over the first- generation QuantiFERON-TB previously used by SFDPH TB Control.
How does it work?
Blood samples are mixed with antigens and incubated for 16 to 24 hours. The antigens include ESAT-6 and CFP-10, proteins specific to M. tuberculosis complex. These antigens are not found in BCG strains or M. avium. If the patient is infected with M. tuberculosis, the patient's lymphocytes will recognize the antigens and release interferon-gamma (IFN-g) in response. The QFT results are based on the amount of IFN-g that is released.  Additional tests (such as chest radiograph) are needed to exclude TB disease and confirm the diagnosis of LTBI.
What are the advantages?
•   Higher sensitivity and specificity than the tuberculin skin test (TST)
•   More likely to be positive with active TB  disease than the TST (more sensitive)
•   Less likely to be falsely -positive in  patients with past exposure to BCG or atypical mycobacteria (more specific)
•   Only needs a single patient visit - does not require return visit to determine results
•   Does not cause the booster phenomenon, which can happen with repeat tuberculin skin tests (TST)
•   Is less subject to reader bias and error when compared to the TST
•   Results are not affected by past TST
What are the disadvantages?
•   As with the TST, additional  tests are needed to exclude TB  disease and confirm LTBI
•   Blood samples must be processed  within 12 hours of blood draw
Who should get the QFT blood test?
•   High-risk populations to screen include: Immunocompromised individuals (HIV+ persons or those receiving immunosuppressive medications, including TNF-alpha antagonists)
•   Individuals with medical risk factors  for TB reactivation (diabetes, chronic renal failure, renal dialysis, silicosis, malnutrition)
•   Newcomers (<5 years) to the U.S.  from TB endemic areas regardless of  age
•   Foreign born <35 years of age, from TB endemic areas
•   Homeless individuals
•   Injection drug users
•   Patients with abnormal CXR consistent with old or active TB
•   Residents of high-risk congregate settings shelters, nursing homes, jails,  substance abuse treatment facilities)
•   Organ transplant patients (before transplant)  Staff members of TB surveillance    programs (e.g., health care workers)
•   Staff members of TB surveillance program (e.g.; health care workers)
When not to use the QFT?
•   Patients currently receiving anti-TB drugs for active TB
How do you interpret test results?
Like the TST, the QFT is a useful but imperfect diagnostic aide.  It should not  
replace clinical judgment.
•   Negative: Same interpretation as negative TST - no further TB evaluation unless indicated by clinical judgment
•   Positive:  Same interpretation as positive TST. Radiograph and medical evaluation indicated
•   Indeterminate: Test failure.  Administer TST as diagnostic aide for TB or LTBI. QFT results may be indeterminate due to laboratory error or patient allergy.
Additional information:
Food and Drug Administration, “QuantiFERON: Summary of Safety and Effectiveness Data,” http://www.fda.gov/cdrh/pdf/p010033.html
[CDC guidelines pending. www.cdc.gov/tb/]
Mori et al. Specific detection of tuberculosis infection. Am J Resp Crit Care Med 2004:170:59-64.   

  
Environmental Health and Safety Office
University of Illinois at Chicago
MANDATORY N95 RESPIRATOR FIT-TESTING
NOTE:
1. Residents/Fellows MUST HAVE A COMPLETED University Health Services form WITH THEM in order to participate in their MANDATORY N95 Respirator Fit-Testing.
2. Gentlemen must NOT have more than a 24-hour growth of facial hair (beard.)
3. Gentlemen with facial hair for a religious or medical reason may address this issue with personnel from Environmental Health and Safety AT THE FIT-TESTING.