(1) Private providers and local health
departments shall screen individuals considered to be at high risk for
tuberculosis disease and infection before screening is conducted in the general
population. Priorities shall be established based on those at greatest risk for
disease and in consideration of the resources available.
(2) Individuals considered at high risk for
tuberculosis include the following:
(a) Close
contacts of those with infectious tuberculosis;
(b) Persons infected with human
immunodeficiency virus;
(c)
Individuals who inject illicit drugs;
(d) Inmates of adult and youth correctional
facilities;
(e) Residents of
nursing homes, mental institutions, other long term residential facilities and
homeless shelters;
(f) Temporary or
permanent residence (>= 1 month) in a country with a high TB rate (any
country except the U.S., Canada, Australia, New Zealand, countries in western
and northern Europe);
(g) Low
income or traditionally under-served groups with poor access to health care,
e.g., migrant farm workers and homeless persons;
(h) Individuals who are substance abusers and
members of traditionally under-served groups;
(i) Individuals with certain medical
conditions that may predispose them to tuberculosis infection and disease,
e.g., diabetes, cancer, silicosis, and immune-suppressive disorders;
(j) Individuals who have travelled for >=
1 month in a country with a high TB rate (any country except the U.S., Canada,
Australia, New Zealand, countries in western and northern Europe);
(k) Other groups may be identified by order
of the Department, as needed to protect public health.
(3) Employers who are required to follow
Occupational Safety and Health Administration guidelines for the prevention of
tuberculosis transmission disease shall develop and implement an employee
screening program.
(4) Tuberculosis
screening shall be completed using either the Mantoux tuberculin skin test
method or an FDA approved in-vitro serologic test, e.g. IGRA.
(a) Screening for tuberculosis with chest
radiographs or sputum smears to identify individuals with tuberculosis disease
is acceptable in places where the risk of transmission is high and the time
required to give the skin test makes the method impractical.
(b) If the skin test or serologic test yields
results indicating tuberculosis exposure, the individual shall be referred for
further medical evaluation.
