In 1994, CDC published the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities, 1994. The guidelines were issued in response to 1) a resurgence of tuberculosis (TB) disease that occurred in the United States in the mid-1980s and early 1990s, 2) the documentation of several high-profile health-care–associated (previously termed “nosocomial”) outbreaks related to an increase in the prevalence of TB disease and human immunodeficiency virus (HIV) coinfection, 3) lapses in infection-control practices, 4) delays in the diagnosis and treatment of persons with infectious TB disease, and

5) the appearance and transmission of multidrug-resistant (MDR) TB strains. The 1994 guidelines, which followed statements issued in 1982 and 1990, presented recommendations for TB-infection control based on a risk assessment process that classified health-care facilities according to categories of TB risk, with a corresponding series of administrative, environmental, and respiratory-protection control measures.

Introduction -- Overview -- HCWs Who Should Be Included in a TB Surveillance Program -- Risk for Health-Care-Associated Transmission of M. tuberculosis -- Fundamentals of TB Infection Control -- Relevance to Biologic Terrorism Preparedness -- -- Recommendations for Preventing Transmission of M. tuberculosis in Health-Care Settings -- TB Infection-Control Program -- TB Risk Assessment -- Risk Classification Examples -- Managing Patients Who Have Suspected or Confirmed TB Disease: General Recommendations -- Managing Patients Who Have Suspected or Confirmed TB Disease: Considerations for Special Circumstances and Settings -- Training and Educating HCWs -- TB Infection-Control Surveillance -- Problem Evaluation -- Collaboration with the Local or State Health Department -- Environmental Controls -- Respiratory Protection -- Cough-Inducing and Aerosol-Generating Procedures -- -- Supplements -- Estimating the Infectiousness of a TB Patient -- Diagnostic Procedures for LTBI and TB Disease -- Treatment Procedures for LTBI and TB Disease -- Surveillance and Detection of M. tuberculosis Infections in Health-Care Settings -- Environmental Controls -- Respiratory Protection -- Cleaning, Disinfecting, and Sterilizing Patient-Care -- Equipment and Rooms -- Frequently Asked Questions (FAQs) -- -- Acknowledgments -- References -- Terms and Abbreviations Used in this Report -- Glossary of Definitions -- Appendices -- Continuing Education Activity