5 Questions on TB Screening in Healthcare Workers

In May 2019, the Centers for Disease Control and Prevention (CDC) issued updated recommendations on tuberculosis (TB) screening in healthcare workers. Test your knowledge on how to keep yourself, staff, and patients safe with this quick 5-question quiz regarding the new guidelines.

1. Baseline TB screening is not needed in healthcare workers who are considered low risk.A. True

B. False

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Answer B: False. According to the 2019 CDC recommendations, all healthcare workers should receive baseline TB screening, which provides a comparison in cases of potential or known exposure to TB. Baseline screening can also detect latent or active TB and enable treatment when necessary, which can protect patients and other healthcare workers. Screening should include risk assessment.

2. Healthcare workers may be at increased risk for TB if they have which of the following?

A. HIV

B. Diabetes

C. Past organ transplant

D. A and C

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Answer: D. A (HIV) and C (past organ transplant). The CDC guidelines recommend baseline risk assessment for TB in healthcare workers. Healthcare workers may have increased risk for TB if they are immunosuppressed (eg, from HIV or treatment with immunosuppressive medication for a medical condition such as organ transplant); lived for ≥1 months in a country with a high rate of TB; and/or have had close contact with someone with active TB.

3. A healthcare worker is NOT considered at risk for TB if the person has lived in which of the following countries?A. Mexico

B. China

C. Australia

D. Poland

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Answer: C. Australia. Healthcare personnel are considered to be at increased risk for TB if they have lived for ≥1 months in countries with high rates of TB. These countries do NOT include Australia, Canada, New Zealand, US, and countries in western or northern Europe.

4. How many weeks after exposure should healthcare workers with a negative postexposure TB test be retested?A. 4-6 weeks

B. 6-8 weeks

C. 8-10 weeks

D. 10-12 weeks

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Answer: C. 8-10 weeks. Healthcare workers who have had a TB exposure and no past evidence of infection should receive a TB test. If the initial test is negative, they should be retested in 8-10 weeks after exposure. Healthcare workers with past documented latent or active TB do not need testing after exposure, but should be evaluated if there is concern for active TB. Healthcare workers with initial positive results should receive a symptom evaluation and chest radiograph.

5. Healthcare workers without known TB exposure should be screened for TB:A. At baseline only

B. Annually

C. Every 2 years

D. Every 5 years

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Answer: A. At baseline only. Healthcare workers without latent TB and no known exposure to TB only require screening at baseline. Serial screening may be considered in certain high-risk groups, such as pulmonologists, respiratory therapists, or providers who work in emergency departments.

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(Image ©Sebastian Kaulitzki/adobe.stock.com)

Source

Sosa LE, Njie GJ, Lobato MN, et al. Tuberculosis screening, testing, and treatment of U.S. health care personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. Morb Mortal Wkly Rep 2019;68:439–443.

Additional information for healthcare professionals

The recommendations released on May 17, 2019 by the CDC and the National TB Controllers Association, update the health care personnel screening and testing section of the 2005 CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings. CDC has developed supporting resources and tools including: Frequently Asked Questions and a Baseline Individual TB Risk Assessment Form.