Effective TB Interviewing for Contact Investigation: Self-Study Modules
Outbreak Interviewing Skills
During outbreak interviewing, it is imperative for the interviewer to
- Clearly educate the index patient on the importance of describing exposure settings;
- Reiterate to the index patient that his or her confidentiality will be maintained by the health department personnel and those involved in the locations of investigation;
- Probe for nontraditional exposure settings in addition to the traditional ones; these should include living quarters, work (both paid and voluntary), school, social and recreational settings (e.g., bars, “hang-outs,” clubs, sporting events, areas of drug use, if substance abuse history is probable), and regular travel locations;
- Question the patient about who frequents exposure settings, and gain as much identifying information about the priority contacts as possible, even if this does not include names, but merely physical descriptions. Questions should also include inquiries about where the patient stays or sleeps, if not at the mailing address, sex partners, and people with whom drugs are used; and
- Ask the index case about who may provide further information about priority contacts.
RFLP analysis may also be part of the investigation. This is because TB bacteria have a unique genetic pattern that can be traced to the one or more persons who carry the same strain of bacteria. Access to this type of information is very helpful in finding related cases. These contacts may not know or identify each other in an interview, but may have a common link through a person or place.