Canadian Tuberculosis Standards 5th Edition Table of Contents

PREFACE
ACKNOWLEDGEMENTS
I	EPIDEMIOLOGY
	I-A	The Epidemiology of Tuberculosis in Canada Howard Njoo and Richard Long
II	MEDICAL ASPECTS OF TUBERCULOSIS
	II-A	Bacteriologic Aspects of Tuberculosis and Mycobacterial Infection David Haldane
	II-B	Transmission and Pathogenesis of Tuberculosis Richard Long and Peter Jessamine
	II-C	Diagnosis of Tuberculosis Infection and Disease Dick Menzies and Louise Pourier
	II-D	Nonrespiratory (Extrapulmonary) Tuberculosis Richard Long
	II-E	Treatment of Tuberculosis Disease and Infection Vernon Hoeppner, Darcy Marciniuk and Earl Hershfield
	II-F	Drug-Resistant Tuberculosis Richard Long and Monica Avendano
	II-G	Pediatric Tuberculosis Mireille Lemay, Bruce Tapiero and Victor Chernick
	II-H	Tuberculosis and Human Immunodeficiency Virus Stanley Houston, Kevin Schwartzman, Paul Brassard, Monica Avendano and Richard Long
	II-I	Nontuberculous Mycobacteria Anne Fanning, Robert Cowie, Stephen Shafran and David Haldane
III	PUBLIC HEALTH ASPECTS OF TUBERCULOSIS
	III-A	The Role of Public Health in Tuberculosis Control Monika Naus and Donald Enarson
	III-B	Contact Follow-up and Outbreak Management in Tuberculosis Control Terry Nan Tannenbaum and Anne Fanning
	III-C	Surveillance and Screening in Tuberculosis Control Wendy Wobeser, Lilian Yuan and Barbara Yaffe
	III-D	Tuberculosis Control in Canadian Health Care Institutions Dick Menzies and John Conly
	III-E	Bacille Calmette-Guérin Vaccination Kevin Elwood
APPENDIX A
	National guidelines for the investigation and follow-up of individuals who were placed under surveillance for tuberculosis after arrival in Canada
APPENDIX B
	Definition of Terms
APPENDIX C
	The Canadian Tuberculosis Surveillance Systems
APPENDIX D
	Contributors
APPENDIX D
	INDEX

Editor:

Richard Long, MD, University of Alberta
Chairman, Tuberculosis Committee, Canadian Thoracic Society

Associate Editors:

Victor Chernick, MD, University of Manitoba
Kevin Elwood, MD, BC Centre for Disease Control Society
David Haldane, MD, Dalhousie University
Vernon Hoeppner, MD, University of Saskatchewan
Stanley Houston, MD, University of Alberta
Dick Menzies, MD, McGill University
Monika Naus, MD, Ontario Ministry of Health and Long Term Care
Howard Njoo, MD, Health Canada
Wendy Wobeser, MD, Queen's University

Project Coordinator:

Valoree McKay, Administrator,
Societies and Special Projects, Canadian Lung Association

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* A joint production of the Canadian Lung Association/Canadian Thoracic Society and Tuberculosis Prevention and Control, Centre for Infectious Disease Prevention and Control, Health Canada

Since the publication of the last edition of the Canadian Tuberculosis Standards of the Canadian Lung Association/Canadian Thoracic Society (CLA/CTS), there has been renewed interest in the global resurgence of tuberculosis. In Canada, the epidemiology of tuberculosis reflects the many important challenges facing tuberculosis control today: an increasing proportion, now 64%, of all patients with tuberculosis in Canada are foreign-born; there has been limited success in reducing the incidence of tuberculosis among Aboriginal Peoples, particularly in western Canada and the territories; TB-HIV co-infection and drug resistance are growing problems. As a result, there has been increasing collaboration between the various tuberculosis stakeholders in the country, including provincial/territorial tuberculosis control programs, Health Canada, Citizenship and Immigration Canada and the CLA/CTS. It is altogether fitting, therefore, that this, the 5^th edition of the Standards, has been co-produced by CLA/CTS and the Division of Tuberculosis Prevention and Control at the Centre for Infectious Disease Prevention and Control, Health Canada.

Some may ask, why a 5^th edition of the Standards in such close succession to the 4^th, published in 1996? Perhaps the best answer is the need to prepare ourselves in the new millennium to better respond to two major tuberculosis elimination initiatives: 1. A National Tuberculosis Elimination Strategy, issued by Medical Services Branch, Health Canada, in 1992 with the aim of eliminating TB in First Nations peoples by the year 2010, and 2. Proceedings of the National Consensus Conference on Tuberculosis, held in 1997 and sponsored by Health Canada, where an interim elimination goal of a 5% reduction in the number of TB cases in Canada each year was agreed on.

Historically, the Canadian medical and public health community has had a genuine interest in tuberculosis, and many notable persons and organizations have made significant regional, national and international contributions in the field. The present document draws upon a cross-section of current Canadian epidemiologic, medical microbiologic, respirologic, infectious disease and public health expertise in tuberculosis. Departures in content, layout and design from the last edition include the following:

As in previous editions of the Standards, the text is aimed primarily at the nonspecialist physician and public health nurse. More figures, tables, and flow charts have been added to facilitate comprehension. Provided in Appendix B are a list of definitions of those terms that require precise explanation, and in Appendix C, copies of the various forms used in the national tuberculosis surveillance systems. As recommended in the past, if specific concerns remain after review of the Standards, the reader is advised to seek the expertise of the appropriate public health agency.

Richard Long, BSc, MD, FRCPC, FCCP
Editor

The editor and associate editors of this 5^th edition of the Canadian Tuberculosis Standards would like to thank all those who contributed directly to the completion of this work — they are listed in Appendix D — as well as those who contributed indirectly, such as former authors and peer reviewers. Their input into the various chapters is greatly appreciated. We would also like to express our gratitude to Dr. Mark FitzGerald, editor of the 4^th edition of the Standards, for his helpful suggestions regarding the content and layout of this edition, and to Michele Zielinski and Susan Falconer of the University of Alberta for their tireless editorial assistance. Production of this edition was capably coordinated by Valoree McKay, Brian Graham and the staff of the Canadian Lung Association as well as Howard Njoo and Penny Nault of  Tuberculosis Prevention and Control, Centre for Infectious Disease Prevention and Control, and the staff of the Documents Dissemination Division, Management Planning and Operations Directorate, Population and Public Health Branch, Health Canada.