Overhaul gets under way for old control guidelines

Changes abound in the landscape

Work has started on a new set of guidelines to govern the elements of TB control. The previous document on that subject dates all the way back to 1991 — so far back that the document is essentially out of print. The control guidelines are one of a TB "triad" of major documents that are either undergoing revision or else just emerging from the revision process.

The other two in the triad include recommendations on treatment and diagnosis. This year for the first time, a corollary set of guidelines on the prevention of latent TB infection — which might qualify as a fourth major set — was added.

Those charged with the revision will take a fresh look at case-finding, case-holding, contact investigation, and other basics of TB control, says Zack Taylor, field services branch chief at the Centers for Disease Control and Prevention’s Division of TB Elimination in Atlanta. As they do so, they’ll have to reframe these arenas in light of big changes in TB demographics and falling caseloads, he adds.

The team charged with the revision includes representatives from the American Thoracic Society, the CDC, and, for the first time, the Infectious Disease Society of America. Also contributing input will be the American Academy of Pediatrics and the National TB Controllers Association.

Last month, a committee met to hash out recommendations for a draft document. But don’t hold your breath; the new guidelines on control aren’t expected out until about this time next year.