Active TB investigations are a common, costly occurrence in the US
More than 13 million people in the US carry latent tuberculosis infection – and are at risk for progression to active TB disease (1).
People living in dense housing arrangements – such as college dormitories, prisons and hospitals – are at significantly increased risk of infection from airborne diseases, such as tuberculosis.
For these reasons, the CDC now recommends proactive testing for TB among patients at increased risk, such as college and university students (2, 3).
|People at increased risk for TB infection in the US|
|Close contacts of active TB cases|
|Persons in congregate settings|
|Persons in correctional and long-term care facilities|
On-demand webinar: Risk-based TB testing with Dr. Scott Lindquist
Watch our free on-demand webinar on TB testing guidelines from the CDC and USPSTF – and learn how these guidelines impact TB testing in a primary care setting. Dr. Scott Lindquist, MD, MPH describes how implementing comprehensive, risk-based TB screening programs can help primary care providers to lead US efforts to eliminate tuberculosis.
TB contact investigations – a 3-month snapshot
In the first three months of 2019, eight cases of active TB were reported at various schools across the country. Eight additional cases that were not previously reported were also disclosed by Minnesota State University. All but 200 of the 2,076 people directly impacted across 11 states were required to take a TB test (4–15*).
|Jan 11, California||A Riverside City College student was diagnosed, and 200 people were encouraged to get a TB test (4)|
|Jan 15, California||TB exposures from a student at Palomar College and an occupant of a men’s shelter in Carlsbad were reported (5)|
|Jan 16, Colorado||A student tested positive for contagious TB, prompting a contact investigation of 800 contacts (6–7)|
|Jan 23, Tennessee||A high school student tested positive for TB, prompting a contact investigation of 450 students and staff (8)|
|Jan 23, Minnessota||Minnesota State University reported 8 TB cases over the past two years, prompting calls for heightened TB awareness (9)|
|Feb 1, S. Carolina||A high schooler tested positive for contagious TB and an undisclosed number of contacts were encouraged to get tested (10)|
|Feb 11, Mississippi||A Jackson student tested positive for contagious TB, and over 200 classmates and staff were tested for exposure (11)|
|Feb 18, Missouri||An active TB case at the University of Missouri caused a temporary school closure for a deep, terminal clean (12).|
|Feb 28, Georgia||An active TB case was reported in a student who attended two schools before the infection was detected (13)|
|Mar 4, Georgia||A Gwinnet County student was diagnosed with active TB, prompting testing of 226 other students and staff (14)|
|Mar 13, Nevada||A student tested positive for contagious TB, prompting a contact investigation of more than 200 people using QFT kits (15)|
Improve your TB testing program with QuantiFERON-TB Gold Plus
One person with active TB can infect 10-15 others over a one year period (16). Proactive testing with QFT-Plus can help prevent the spread of TB:
- Single visit – skin test can require up to four visits
- Available through your current lab service provider
- Covered by insurance providers
- Unaffected by prior BCG vaccination
Find out more about QFT-Plus at our Provider Resources Portal
References and notes
1. Houben, R.M. and Dodd, P.J. (2016) The global burden of latent tuberculosis infection: a re-estimation using mathematical modelling. PLoS Med. 13, e1002152.
2. Centers for Disease Control and Prevention. (2010) Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection — United States. MMWR 59(RR05), 1.
3. Lewinsohn, D.M. et al. (2017) Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice Guidelines: Diagnosis of Tuberculosis in Adults and Children. Clin. Infect. Dis. 64, 111-115.
4. Sawyer, L. "TB outbreak tied to Minnesota State, Mankato under investigation". Star Tribune. Jan 25, 2019. http://www.startribune.com/tb-outbreak-under-investigation-in-mankato/504847552/
5. Schena, S.C. "Tuberculosis: 2 separate cases reported in San Diego County". Patch [Rancho Bernardo-4s Ranch]. Jan 15, 2019. https://patch.com/california/ranchobernardo-4sranch/tuberculosis-2-separate-cases-reported-san-diego-county
6. Health officials investigating possible tuberculosis exposure at Aurora Hills Middle School. The Denver Channel. Jan 16, 2019. https://www.thedenverchannel.com/news/local-news/health-officials-investigating-possible-tuberculosis-exposure-at-aurora-hills-middle-school
7. Tabachnik, S. "Health officials find no new active cases of Tuberculosis in Aurora middle school". The Denver Post. Mar 22, 2019. https://www.denverpost.com/2019/03/22/tuberculosis-testing-aurora-hills-middle-school/
8. Mojica, A. "450 to be tested after Wilson Central High School student with tuberculosis identified". Fox 17 Nashville. Jan 23, 2019. https://fox17.com/news/local/parents-notified-after-wilson-county-high-school-student-tests-positive-for-tuberculosis
9. Arola, B. "Blue Earth County, state investigate TB cases". The Free Press [South-Central Minnesota]. Jan 23, 2019.
10. WPSA staff. "Case of tuberculosis at Emerald H.S., DHEC says". 7 News WPSA. Feb 1, 2019. https://www.wspa.com/news/case-of-tuberculosis-at-emerald-hs-dhec-says/1745897601
11. Ducote, N. "JPS student contracts tuberculosis; Doctor explains symptoms, treatment for the disease". WLOX. Feb 11, 2019. http://www.wlox.com/2019/02/12/jps-student-contracts-tuberculosis-doctor-explains-symptoms-treatment-disease/
12. 41 Action News Staff. "Mizzou student contracts tuberculosis; others may need to get tested". KSHB Kansas City. Feb 18, 2019. https://www.kshb.com/news/local-news/mizzou-student-contracts-tuberculosis-others-may-need-to-get-tested
13. Popham, J. "Confirmed case of active tuberculosis at Model Elementary and Johnson Elementary". Rome News Tribune. Feb 28, 2019. http://www.northwestgeorgianews.com/rome/news/education/confirmed-case-of-active-tuberculosis-at-model-elementary-and-johnson/article_c7ff1510-3c50-11e9-bf55-8fc34c08e189.html#tncms-source=article-nav-next
14. Prince, C. " UPDATE: Case of tuberculosis confirmed at Gwinnett high school". Atlanta Journal Constitution. Mar 4, 2019. https://www.ajc.com/news/breaking-news/breaking-case-tuberculosis-confirmed-gwinnett-county-high-school/vY9qs2YwiERq10zjU2CmFL/
15. Associated Press. "Tuberculosis case sets off testing at Las Vegas high school". U.S. News and World Report. Mar 8, 2019. https://www.usnews.com/news/best-states/nevada/articles/2019-03-08/tuberculosis-case-sets-off-testing-at-las-vegas-high-school
16. World Health Organization. What is TB? How is it treated?". https://www.who.int/features/qa/08/en/
*Testing of 2,076 individuals for TB has been publicly disclosed. However, the number of people actually tested as mandated by the governing health officials, plus the number of people encouraged to get tested, is greater than 2,076 given that the exposure level was not publicly disclosed for all cases.
Disclaimer: The performance of the USA format of the QFT-Plus test has not been extensively evaluated with specimens from individuals younger than age 17 years.