TB screening information for medical providers
It is recommended to test people who are at increased risk for TB infection. Screening for TB should include a risk assessment, a symptom check, and a TB screening test (TST or IGRA).
Consider testing:
- People who travel in TB endemic areas.
- Migrant workers.
- People who experience homelessness.
- Contacts to a TB case.
- Foreign-born people from TB endemic areas.
- People who inject drugs.
- Immunosuppressed people (e.g., HIV positive or organ transplant).
- Residents or employees of healthcare, correctional, or long-term care facility.
- People with chronic medical problem (e.g., diabetes, ESRD, etc.).
Types of tests
- TB Skin Test (TST).
- A Mantoux test with Tubersol or Aplisol PPD material.
- Remember to date the vial and discard 30 days after opening.
- Tine tests are no longer recommended.
- Interferon Gamma Release Assay.
- Blood testing for TB infection with a QuantiFERON-TB Gold In-tube® (QFT)or T-SPOT.TB test.
- Available at most laboratories.
Who should I test?
You must screen patients who fit the criteria for testing:
- People have close contact to a person with active pulmonary TB.
- People with symptoms of active TB disease—cough for more than three weeks, weight loss, fatigue, night sweats, fever.
- Healthcare workers or healthcare students.*
- Residents of long-term care nursing facilities.
*Healthcare workers at entry and people admitted to nursing homes need two-step testing.
What if the test is positive?
- Verify that a symptom screen and risk assessment have been performed.
- Order a chest x-ray to assess for evidence of active TB in the lungs.
- Report any positive TB screening tests within 7 working days.
Report active TB cases, either confirmed or highly suspicious, within 24 hours
Visit our Report Notifiable Conditions page for reporting options, including the Positive tuberculosis screening form.
Testing documentation for work or school
Per Tacoma-Pierce County Health Department policy and Centers for Disease Control and Prevention (CDC), a verbal report of a positive skin test is unacceptable. There must be written documentation.
- If no documentation is available, apply and read a skin test. If it is positive, order a chest x-ray.