Updated Tuberculosis Guidelines for Healthcare Workers

Sapna B. Morris, MD


June 12, 2019

Editorial Collaboration

Medscape &

The number of tuberculosis (TB) cases in the United States continues to decline, and the incidence of TB among healthcare personnel due to occupational exposure is low. In response, the Centers for Disease Control and Prevention (CDC) and the National Tuberculosis Controllers Association (NTCA) have developed updated guidelines.[1]

I'm Dr Sapna Bamrah Morris, a medical officer in the Division of Tuberculosis Elimination at the CDC. I'm delighted to speak with you about the key points in these new recommendations. The updated recommendations apply to TB screening, testing, and treatment of healthcare personnel only. It is important to note that the recommendations for facility risk assessments and infection control practices are unchanged.

On the basis of the new guidelines, which were developed after a thorough scientific review by CDC, NTCA, and other experts, we recommend conducting a TB risk assessment, symptom screen, and a TB blood or skin test for healthcare personnel upon hire or during the preplacement process.

Healthcare personnel who have a positive TB test should receive a symptom evaluation and chest x-ray to rule out TB disease. Those diagnosed with latent TB infection are strongly encouraged to prevent TB disease by taking treatment. Shorter-course treatment regimens that are 3-4 months in duration are encouraged rather than longer 6- or 9-month treatment regimens because they have higher rates of completion.

Healthcare personnel with untreated latent TB infection should be screened annually for symptoms of TB disease.

Annual testing for TB is not recommended for any healthcare personnel unless there is a known exposure or ongoing transmission in a healthcare setting. However, some institutions may decide that certain healthcare personnel should receive annual TB testing because of occupational risk.

All healthcare personnel should receive TB education annually. Education should include information on TB risk factors, the signs and symptoms of TB disease, and TB infection control policies and procedures.

These recommendations should be used for people who work or volunteer in all healthcare settings who might be exposed to TB, from hospitals to home-based healthcare, as well as nontraditional settings such as clinics in correctional facilities and homeless shelters.

State and local TB screening and testing regulations may differ based on local needs. The CDC and NTCA TB screening and testing recommendations do not override or replace state regulations. For TB regulations in your area, please contact your state or local TB control program.

For more information about TB screening, testing, and treatment for healthcare personnel, visit the CDC website. Thank you.