CDC and the National Tuberculosis Controllers Association Releases Updated Recommendations for Tuberculosis Screening, Testing and Treatment for Health Care Personnel

Dear Colleagues,

The Centers for Disease Control and Prevention (CDC) and the National Tuberculosis Controllers Association (NTCA) have released “Tuberculosis Screening, Testing, and Treatment of U.S. Health-Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019”, published today in CDC’s Morbidity and Mortality Weekly Report (MMWR). The updated recommendations reflect the overall decrease of TB cases and the low incidence of TB among health care personnel in the United States due to occupational exposure.

Highlights from the updated recommendations include: Health care personnel should receive a baseline individual TB risk assessment, symptom screening, and TB testing (e.g., TB skin test or TB blood test) upon hire/pre-placement. CDC and NTCA do not recommend annual TB testing for health care personnel unless there is a known exposure or ongoing transmission in a health care setting. Health care personnel with a positive TB skin test or TB blood test result should receive a symptom evaluation and chest x-ray to rule out TB disease. Treatment for latent TB infection is strongly encouraged. Shorter course latent TB infection treatment regimens that are three to four months in duration are encouraged over the longer six- or nine-month treatment regimens because they are easier for people to complete. If health care personnel have untreated latent TB infection, they should be screened annually for symptoms of TB disease (e.g., a cough lasting longer than three weeks, unexplained weight loss, night sweats or a fever, and loss of appetite). All health care personnel should receive annual TB education. TB education should include information on TB risk factors, the signs and symptoms of TB disease, and TB infection control policies and procedures. These recommendations update the recommendations for TB screening and testing of health care personnel from the Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. The recommendations for facility risk assessments and infection-control practices are unchanged.

CDC has developed supporting resources and tools including: Frequently Asked Questions and a Baseline Individual TB Risk Assessment Form.

As state and local TB screening and testing regulations may differ based on local needs, the updated recommendations do not override or replace state regulations. CDC encourages facilities with questions about testing regulations in their state to contact their state TB control program. Thank you for your work and continued commitment to turn TB elimination into a reality. Please visit the CDC Division of Tuberculosis Elimination webpage for additional information and resources regarding these recommendations. /Philip LoBue/ Philip LoBue, MD, FACP, FCCP Director Division of Tuberculosis Elimination National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention www.cdc.gov/tb /Jonathan H. Mermin/ Jonathan H. Mermin, MD, MPH RADM and Assistant Surgeon General, USPHS Director National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Centers for Disease Control and Prevention www.cdc.gov/nchhstp