PHS-2936 (see fig. 5-4) is the most commonly used form in STD contact investigation. It should be completed on every sexual contact obtained in the interview. This form must be completed properly so that there is no doubt in the mind of the investigator as to the disease involved or the follow-up necessary. Instructions for completing and distributing this form are located in NAVMED P-5036. The routing of the form may vary in different locations. Individual commands should check with state and local health authorities for routing procedures in their jurisdiction. Most states and other civil jurisdictions have legal requirements that a patient morbidity card be completed on all patients diagnosed as having STD.
Personnel involved in STD control programs should continually evaluate the effectiveness of the efforts made in local STD control programs so that more effective measures may be instituted, as required, and high risk areas and personnel requiring more intensive attention can be identified.
Complete documentation of all STD diagnoses shall be made on the Chronological Record of Medical Care, SF 600. STD follow-ups are also entered on the SF 600.
Contact tracing is defined as the locating and bringing to therapy persons known or suspected to have been exposed to an infected person. These persons are identified and located on the basis of information obtained from the interview.
Few contact tracing investigations are carried out by military STD program managers except on certain military installations and in occupied areas. Civilian contacts are usually the responsibility of the local public health department. However, you should be aware of the methods and techniques used, since a patient might be concerned with how the investigation is to be conducted. The best method of acquiring this information is to meet with the contact investigators of the local health department, who can outline the method of operation for that area. TUBERCULOSIS CONTROL PROGRAM While the incidence of tuberculosis (TB) is slowly declining in the United States, substantial numbers of cases still occur in the Navy and Marine Corps, and the potential for epidemics remains. The purpose of the TB Control Program is to prevent its spread by early detection and treatment of personnel with active disease. Personnel who develop a reactive skin test are at risk of developing clinical TB and must be placed on isoniazid (INH) for 1 year and then be followed with annual clinical examinations to detect active diseases. With modern medical management most people who develop clinical TB maybe expected to return to duty; but early detection is still essential to reduce the impact of the disease on patients, their associates, and the service.
The Navy and Marine Corps TB Control Program consists of case finding and patient disposition.
Routine TB Screening Program. The purpose of this program is to detect as early as possible individuals who have been infected by tubercle bacilli or who have progressed and developed clinical TB.
The TB skin test (Mantoux method) is the basic method used for routine TB case finding and is used for individuals with previously recorded nonreactive or unrecorded skin tests.
An annual clinical evaluation is used for routine TB case finding in individuals who have previously recorded reactive skin tests and who have taken INH for 1 year, if they have remained reactors (most will revert to non-reactors).
Tuberculosis Contact Investigation Program. The purpose of this program is the early detection of TB in personnel who may have been exposed to an active TB case and who consequently may be at high risk of developing the disease.
Patients with reactive TB tests, abnormal clinical findings, or positive acid test Bacilli smears findings are further investigated. Those suspected to have or diagnosed as having the disease receive care or treatment.
When to test, how to test, and what to do with reactive and nonreactive personnel; responsibility and procedures for local program management; and reporting requirements are discussed at length in NAVMEDCOMINST 6224.1 series. All