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Testing health care workers for TB

On May 17, 2019 the Centers for Disease Control and Prevention (CDC) issued updated recommendations for TB testing of health care personnel. Key points include:

  1. The updated recommendations call for health care personnel to be screened for TB upon hire with an individual risk assessment, a symptom evaluation, and a TB test (either the interferon gamma-release assay, or IGRA, blood test or the tuberculin skin test). Thereafter, annual TB testing is not recommended unless there is a known exposure to a case of infectious TB disease or there is ongoing transmission in the health care setting where the individual works.
  2. A positive TB test indicates that a person has been infected with TB bacteria. It does not specify whether the person has latent TB infection (LTBI) or has progressed to TB disease. Anyone with a newly positive TB test should receive a symptom evaluation and chest x-ray to rule out TB disease. Additional workup may be needed based on these results.
  3. Treatment for latent TB infection is strongly encouraged for health care personnel diagnosed with LTBI. Shorter treatment regimens, such as once-weekly isoniazid and rifapentine for 3 months or daily rifampin for 4 months, should be used as they are more likely to be completed when compared to the traditional regimens of 6 or 9 months of isoniazid.
  4. Health care personnel that have been diagnosed with LTBI and declined treatment should receive an annual TB symptom screen to detect early evidence of TB disease and to reevaluate the risks and benefits of LTBI treatment. If the benefit of treatment is expected to exceed the risk, the health care worker should continue to be strongly encouraged to complete LTBI treatment.
  5. The CDC recommends that all health care personnel receive TB education annually. The PA TB program has prepared a presentation for health care personnel that reviews TB risk factors, the signs and symptoms of TB disease, and TB infection control policies and procedures. Consistent with CDC guidance, the presentation also emphasizes that health care personnel diagnosed with LTBI are strongly encouraged to complete preventive treatment..
  6. Lastly, the above information updates the recommendations for TB screening and testing of health care personnel from the 2005 CDC Guidelines on Preventing the Transmission of Mycobacterium tuberculosis in Health Care Settings. All other aspects of the 2005 guidelines, including infection control practices and facility risk assessments, remain in effect.  

For additional resources from the CDC, visit the TB Screening and Testing of Health Care Personnel page on the CDC website.

If you have any questions about TB testing call the PA TB program at 717-787-6267.