Positive TB Test - How to Prove I'm Not Contageous

[thecrew74]

state of missouri
regarding latent TB not active tb
the county health nurse will not provide a letter to employer which must to state that i am not contagious and/or active
neither will the nurse practitioner that diagnosed me with latent tb but the nurse practitioner says the only reason she will not is because i am not under her care and i cant change from the county nurse to her either or so that is what they say. the state of missour does not require that i take any medication or follow any protocol for this condition, even so i am taking the medication so to protect myself and others for future reference but the county nurse says until she feels i am going to comply by coming to the monthly visits and taking the medication she will not write a letter for me. is this right? do i have any legal recourse here? i have already lost one job over refusing to take the medication. since then i have decided there is no other way around this mess so i decided to take the medicine but now i am facing this nurse that refuses to write out a letter that says i am not contagious which has absolutely nothing to do with complying with "her" rules. again the state does not say that i have to take the medicine so i am completely at a lose here and dont know what to do but i know i cant wait until this county health nurse decides she is ready to write a compliance letter. i have a job interview on monday and i know they are gonna want me to do a tb test what recourse do i have

[Mr. Knowitall]

If you're not under a medical professional's care, you're not under that medical professional's care.

If you would be under that medical professional's care if you agreed to follow a proper treatment regimen, but you are refusing to follow that treatment regimen, that's nobody's fault but your own.

The phone book is full of doctors. If you want a different treatment provider and a different treatment regimen, they await your call for an appointment.

[thecrew74]

also, i would like to make mention that i never stated that i have refused and regimen. quite the opposite. i am taking the medication please re-read my post if necessary.

[cbg]

No one is obligated to write a letter stating that you are not contagious. Particularly since you are only taking your medication under protest and she has no way of knowing whether you will stop taking it as soon as you get the letter you want.

[Mr. Knowitall]

also, i would like to make mention that i never stated that i have refused and regimen. quite the opposite. i am taking the medication please re-read my post if necessary.

No, you in fact stated that you have a history of refusing the regimen "i have already lost one job over refusing to take the medication". My comment is perfectly appropriate based upon the history of noncompliance that you provided. If you don't like being told the facts, or reminded of why you caused the nurse to doubt your word, so sorry.

Incidentally, if you want people to read, let alone re-read your posts, it would behoove you to learn and follow basic rules of grammar and spelling.

[Aesculapius]

I second the grammar and spelling comment.

But, back to your issue...

There has been a scary resurgence of tuberculosis across the globe; antibiotic resistant tuberculosis even. This resistance occurs due to noncompliance with prescribed antibiotic regimens. That being said, it is possible to have a false positive on a PPD. The best example are patients who have received the BCG vaccine in the past; they can sometimes test positive for years after the vaccine. If you haven't received the BCG and you've tested positive via a PPD with a negative chest x-ray, the next logical step would be the blood test. If you have already underwent the blood test for TB (QFT) and that was positive you should be treated as if you have TB.

Latent TB can become active.

Once you have tested positive for a PPD, it is almost useless to get another. Before injection, a questionnaire should be provided with a number of questions including, "Have you ever tested positive before?" If the answer is "yes," the health facility should have other steps to rule out active disease (X-Ray, QFT, sputum samples).

If you want to be thoroughly prepared, get a primary care physician... Yes, a personal doctor. He or she can guide you through the process, make recommendations, and provide documentation as to your work status. I do not blame an NP or some occupational health clinician for not wanting to provide some type of letter stating that it is okay for you to work despite a positive PPD.