Frequency of Tuberculosis Screening and Testing for Health Care Personnel

Baseline TB Screening and Testing

All U.S. health care personnel should be screened for TB upon hire (i.e., preplacement). TB screening is a process that includes:

• A baseline individual TB risk assessment,
• TB symptom evaluation
• A TB test (e.g., TB blood test or a TB skin test), and
• Additional evaluation for TB disease as needed.

Annual TB Screening and Testing

Routine serial TB screening or testing at any interval after baseline (e.g., annually) of health care personnel is not recommended unless there is a known exposure or ongoing transmission at a healthcare facility.

If health care personnel diagnosed with latent TB infection do not receive treatment:

• Perform annual screening for symptoms of TB disease.
• Annually reevaluate the risk and benefits of treatment for latent TB infection
• Ensure health care personnel know the symptoms of TB disease that should prompt an immediate evaluation between screening

Treatment is strongly encouraged for health care personnel diagnosed with latent TB infection. Short course, rifamycin-based regimens are the preferred treatment options for latent TB infection because they have higher completion rates.

Health care facilities might consider using annual TB screening for:

• Certain groups at increased occupational risk for TB exposure (e.g., pulmonologists or respiratory therapists)
• Certain settings if transmission has occurred in the past (e.g., emergency departments)

State and local health departments can help facilities make these decisions.

Annual TB Education

All health care personnel should receive annual TB education.

TB education should include:

• Information on TB risk factors,
• Signs and symptoms of TB disease, and
• TB infection control policies and procedures.

TB education materials are available from:

• CDC
• TB Centers of Excellence for Training, Education, and Medical Consultation
• State TB Programs
• Find TB Resources
• National Tuberculosis Coalition of America

Post-Exposure Screening and Testing

All health care personnel with a known exposure to TB disease should receive a TB symptom screen and testing.

Health care personnel with a previous negative TB test result should be tested immediately and re-tested 8 to 10 weeks after the last known exposure. For consistency, use the same type of TB test (e.g., TB blood test or TB skin test) that was used upon hire (i.e., preplacement) and for any follow-up testing.

Health care personnel with a document history of a positive TB test result do not need to be re-tested after exposure to TB disease. They should receive a TB symptom screen. If they have symptoms of TB disease, they should be evaluated for TB disease.

Notify the local health department immediately if TB disease is presumed or confirmed.