BOP Program Statement 6190.05 § 17

INFECTION

a. Medical Isolation. Inmates with suspected active pulmonary TB must be medically isolated

alone in an AIIR. For more information on AIIRs, see the Airborne Infection Isolation Rooms

subsection in Section 12. Medical Isolation and Quarantine.

 Only institutions with a functional and validated AIIR can medically isolate and treat

inmates with suspected active TB within the institution. While an inmate is in an AIIR,

staff or inmates entering the room must wear a respirator (N-95 efficiency or better) for

which they have been trained and fit tested. For additional information, see Section 6c.

Respirators.

b. Transport. Facilities without an AIIR must transport inmates with suspected active TB to a

local hospital or another Bureau institution with the capability of isolating and treating the

inmate. The following precautions are followed while awaiting transport and during transport:

 The inmate must wear a standard, surgical type mask without an exhalation valve.

 The inmate must be removed from the general population and placed in a low traffic area.

 Escort personnel must wear a fit tested respirator (N-95 efficiency or better). For

additional information, see Section 6c. Respirators.

 No other inmate may be transported with an inmate who has suspected active TB.

 The vehicle ventilation system must bring in as much outdoor air as possible and not be

placed in recirculation mode.

 The vehicle fan must be set to high.

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 Front seat windows may be rolled down in transport vehicles to increase fresh air

ventilation, if weather permits.

 After transporting an inmate with suspected or confirmed active TB, the vehicle must be

aired out for at least one hour before entering it without a respirator.

c. Hospital Escort. Staff assigned to provide hospital escort for inmates who are housed in

AIIRs must wear an approved respirator (N-95 efficiency or better) for which they are currently

enrolled in the Respiratory Protection Program whenever they are in the inmate’s room or

anteroom.

 The Bureau institution will provide staff with the size and type of respirators for which

they were fit tested.

 Staff must not wear N-95 respirators provided by the hospital or other entities unless they

have been fit tested for that specific N-95 respirator size and type.

d. Discontinuation of Medical Isolation. Prior to discontinuing medical isolation and returning

an inmate to the general population, the inmate must meet the criteria for discontinuing medical

isolation as defined in guidance from the Medical Director.

e. Monitoring. While in medical isolation, a daily clinical assessment must be completed and

documented in the medical record by a healthcare provider. Inmates with suspected or confirmed

active TB are monitored to ensure they are receiving an appropriate workup or treatment for TB

in accordance with guidance from the Medical Director. Monitoring assures the workup is

proceeding in a timely fashion and ensures compliance with treatment. It also assesses clinical

improvement, bacteriologic response to treatment, and signs and symptoms of adverse reactions

to medication(s).

Inmates with latent TB infection who agree to take treatment are also monitored. This ensures

treatment and follow-up, including assessment of potentially adverse reactions to medications, is

appropriate and in accordance with guidance from the Medical Director.

f. Release Planning. If an inmate will be released without having completed treatment for

active TB or latent TB infection, planning for continuity of TB treatment must begin as soon as

the inmate is diagnosed with the condition.

 The projected release date is researched in the applicable Bureau inmate management

system.

 If the projected release date falls before the anticipated treatment completion date or the

projected release date is unknown, release planning must begin immediately in

accordance with the Bureau’s TB clinical guidance.

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g. Refusal of Treatment. If an inmate refuses clinically indicated treatment for active TB and

poses a risk to others by continuing to refuse treatment, they must be medically isolated in an

AIIR until they meet criteria for discontinuation of medical isolation, adhere to treatment, and/or

are determined to be noninfectious. Consult with HSD Population and Correctional Health

Branch staff for further directions, if needed.