- TB cases and suspects who have not been tested by PPD skin test - including newly arrived, non-US born individuals with Class A TB (active, infectious TB), Class B1 TB (active, non-infectious TB), and Class B2 TB (inactive TB)
Persons exposed to active TB in a communicable form:
- Close contacts
Persons in the categories below are at risk for latent TB infection because they:
- Are non-US born individuals from high prevalence countries* (especially, but not limited to those who arrived in the last 5 years)
*Africa, Asia except Japan, Central/South America, Mexico, Eastern Europe, Caribbean, Middle East
- Have worked or lived in a potentially high-risk congregate setting such as prison / jail, long-term care facility, homeless shelter, residential facility for persons with HIV/AIDS, drug treatment center, etc.
- Have lived or had extensive travel outside the USA within the past 5 years to countries with high prevalence of TB
- Have a history of substance abuse within the past year
- Have other high-risk factors, such as migrant/seasonal farm worker
- Are tuberculosis laboratory workers
- Are healthcare workers involved in high-risk procedures such as respiratory therapy, bronchoscopy, and autopsy
- Are over age 70 (Persons over age 70 have been exposed to more TB during life and are more likely to reactivate)
Persons who, if infected, are at increased risk for progression to active TB because of the following:
- Abnormal chest x-ray findings consistent with (but not necessarily specific for) old TB
- HIV+ or at-risk for HIV, but with unknown status
- Diabetes Mellitus
- Chronic Renal Disease/Hemodialysis
- Gastrectomy /Jejunoileal Bypass
- Steroid Therapy
- Organ Transplant
- Carcinoma of head or neck, and other neoplasms (e.g. lung cancer, lymphoma, leukemia)
- Underweight by 15 % of ideal weight
Special Considerations for Testing Children
- Children under age 5 are likely to be recently infected and are at high-risk for progression to active TB with a potential for disseminated TB.
- Testing of children should be based on the current TB Division approved guidelines. These guidelines include a risk assessment to determine those children who are at increased risk of latent TB infection because they have lived or spent time with adults who:
- Were homeless, living either on the street or in a shelter
- Have AIDS or are HIV infected
- Used intravenous drugs or other street drugs
- Lived in a correctional facility, nursing home or mental institution
- Came from a country with a high-prevalence of TB
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