Skip Global navigation and goto content

It's a New Day in Public Health.

The Florida Department of Health works to protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

Skip MegaMenu and goto content
 

Providers and Professionals

TB Control Section

  •  850-245-4350
  •  

    Fax

    850-921-9906
  •  

    Mailing Address

    Florida Department of Health 

    4052 Bald Cypress Way, Bin A-20 

    Tallahassee, Florida 32399 

This page lists the tools of knowledge providers and professionals need to aid the Department of Health in its endeavor to control TB. If a resource you need cannot be found here, please contact us at 850-245-4350.

Special note: You will need Adobe Acrobat's FREE PDF Reader to view the pages labeled PDF. Get it for FREE from Adobe by visiting www.adobe.com

TB Screening, Diagnosis and Reporting

What is considered routine screening for TB infection and TB disease?

Routine screening for tuberculosis is recommended for certain targeted populations that are considered either high risk for recent TB exposure & infection or have medical conditions that place them at high risk for getting sick with TB disease more rapidly than an otherwise healthy individual, if infected. The following limited medical evaluations are recommended for routine tuberculosis screening, at a minimum. A TB skin test or blood test, alone, isn’t sufficient.

  • A limited medical history, inclusive of:
    • A TB symptom questionnaire to identify signs or symptoms of TB disease that present an immediate risk to the public health
    • A TB risk questionnaire to determine if the person is considered at risk for TB exposure and/or if they have any targeted medical conditions that place them at higher risk for progression to TB disease, if infected (e.g. Diabetes, HIV/AIDS, certain cancers and any other immune suppressive conditions or treatments like long-term corticosteroid use, use anti-rejection drugs after a transplant, rheumatoid arthritis drugs).
    • TB testing and treatment history
  • A limited physical examination, including,
    • Temperature, current weight, BMI
    • Testing for TB Infection (TB Blood Test or Tuberculin Skin Test [TST])
    • Chest X-ray (considered routine screening in persons with a positive TB test and for persons with immune compromising medical conditions).

What is the criteria for diagnosis of latent TB infection (LTBI)?

  • Positive TB skin Test or blood test (blood test preferred)
  • No symptoms or other signs of pulmonary or extra-pulmonary TB disease
  • Recent negative chest x-ray (i.e., performed within the last 8 weeks)

LTBI is not considered a reportable disease in Florida. Health care providers should offer and encourage treatment to low-risk individuals who are willing to commit to completing an entire course of treatment to cure. The health department is available for consultation for treatment recommendations, if needed.

Persons identified with latent TB infection who are considered high-risk for progression to disease and would benefit from treatment, who agree to complete treatment may be referred to the local health department for ongoing evaluation and treatment to cure.

Referral packets should include documentation of the medical evaluation and diagnosis of LTBI, as mentioned above, unless otherwise agreed to by the local health department.

*Please note, TB resources and services may vary from county to county depending on resources available. Please contact your local health department for additional information about the services offered in your area and the referral process.

Public health evaluation and treatment resources are prioritized to serve those that present the greatest risk to the public health, first. This includes persons who are ill with suspected or confirmed active TB disease (both pulmonary and extra-pulmonary), persons identified as contacts to an individual with potentially infectious TB disease, and other targeted high-risk populations.

For additional information on TB testing and diagnosis, including patient education materials, please visit https://www.cdc.gov/tb/topic/testing/default.htm

What do I do if my patient reports systemic or pulmonary TB symptoms or has an abnormal chest radiograph or other findings suggestive of TB?

Persons suspected of having TB disease should be referred for the following medical evaluations to rule out active TB disease, in addition to the routine screening evaluations:

  • Radiographic imaging studies (i.e. CXR, CT or other studies as clinically indicated, if not already done)
  • Diagnostic Microbiology
  • Any other specialized testing or procedures considered necessary to confirm or rule out a TB diagnosis.

A communicable disease report with the attached supporting medical records must be made to the local health department to report any persons with pulmonary or systemic TB symptoms or any other findings (e.g., + AFB without ID, radiographic imaging studies, pathology, etc.) suggestive of TB disease, regardless of the TB test result.

Please visit TB Professionals Reporting Requirements | Florida Department of Health (floridahealth.gov) and for additional information communicable disease reporting for health care practitioners and laboratories.

What does the health department do when they receive a communicable disease report for suspected or confirmed TB disease?

An individualized treatment plan must be prescribed by prescribers for each person in their care with who has suspected or confirmed active tuberculosis. The treatment plan must be consistent with current standards for medical practice and include information regarding provisions to for treatment to cure, provisions for follow-up, delivery of treatment, and a case management approach as defined by the Department.

The county health department director, administrator, or their designee (usually a TB Nurse Case Manager) must document the case management approach as defined in Department guidelines/Statewide Internal Operating Procedures. Private providers are required to collaborate with the Department on the treatment plan, regardless of who is treating the case. The Nurse Case Manager or their designee will follow-up to provide a complete explanation of tuberculosis, the medical risks associated with tuberculosis, the need to comply with the prescribed treatment plan and consequences of non-adherence to each patient, their legal guardian, or to the patient’s caregiver in accordance with Chapter 64D-3.043 Florida Administrative Code, Tuberculosis Treatment and Follow-up and continue to monitor the patient and document progress over the continuum of care to ensure timely diagnosis and/or treatment to cure.

The TB Nurse Case Manager will also make known and available to the patient and health care provider any additional TB services and resources offered by the department to support the treatment plan.

Please see the attached Technical Assistance Bulletin for additional information on ordering supplies and shipping microbiologic specimens or isolates to the TB Lab department of the Bureau of Public Health Laboratories.

 Bureau of Labs Services

Please note, prior authorization is required for NAA testing on multiple pulmonary samples, and for samples collected from any other (extra-pulmonary) sites being considered. Failure to request prior approval, and failure to appropriately label samples may result in this testing being canceled.

*Note to County Health Departments: forms for reporting to departmental headquarters can be found on the Department’s Tuberculosis Control Section SharePoint site.

What if a person is considered likely or threatens to leave “Against Medical Advice” (AMA), prior to completing a medical evaluation to rule out or confirm active TB disease?

Please notify Dr. David Ashkin, MD, Medical Director for the TB Control Section, Florida Department by calling 1-800-4TB-INFO and your local health department as soon as possible to discuss the case and determine if legal intervention is necessary for protection of the public health.

 What are the Laws and Rules for Tuberculosis Control and Prevention in Florida?

Florida State Statutes – Chapter 392, Tuberculosis Control Act

Florida Administrative Code – Chapter 64D-3, Control of Communicable Diseases and Conditions Which May Significantly Affect Public Health

TB Resources for Correctional Facilities

 MMWR- Prevention & Control of Tuberculosis in Correctional Facilities.

Correctional facilities should contact your local health department or the Corrections Liaison for the TB Control Section, Sherrie Arnwine, RN Consultant at Sherrie.Arnwine@FLHealth.gov for additional guidance or resources if needed.

Additional TB Resources

The educational materials we have for professionals are moderately extensive. A materials list may be found on our Professional Materials page.

TB Reporting

Florida law requires the Department of Health to periodically issue a list of diseases determined to be of public health significance and that are required to be reported to the county health departments.  Note some diseases have to be reported immediately by telephone as noted by a (T) next to their name in this Reportable Diseases List.

TB Reporting Requirements for Health Care Providers – by law health care providers are required to report TB cases and suspects within one business day of diagnosis, and must provide supporting documentation for the diagnosis within 24 hours. Learn more about who must report, what information must be reported, how to report, and follow-up reporting requirements…

TB Reporting Requirements for Laboratories – each person in charge of a laboratory which performs cultures for mycobacteria or refers specimens for mycobacterial cultures to other laboratories is required to report all specimens positive for Mycobacterium tuberculosis, M. bovis or M. africanum within 24 hours. For further details on what information must be reported, how to report and list of numbers in your area for reporting…

Note to County Health Departments: forms for reporting to departmental headquarters can be found on the department's Intranet.

Educational Materials

The educational materials we have for professionals are moderately extensive. A materials list may be found on our Professional Materials page.