Tuberculosis for Healthcare Providers

Complete an online TB referral 

Identifying Patients Who Need a TB Test

Healthcare providers should encourage patients who meet certain risk criteria to "Know their TB status" and test anyone who may be at risk for TB.

Those who are at higher risk for TB include:

• People who have spent time with someone who has TB disease
• People from a country where TB disease is common (most countries in Latin America, the Caribbean, Africa, Asia, Eastern Europe, and Russia)
• People who live or work in high-risk settings (for example correctional facilities, long-term care facilities or nursing homes, and homeless shelters)
• Healthcare workers who care for patients who are at increased risk for TB disease
• Infants, children, and adolescents exposed to adults who are at increased risk for latent TB infection or TB disease

Many people who have latent TB infection never develop TB disease. However, some people who have latent TB infection are more likely to develop TB disease than others. Those at high-risk for developing TB disease include:

• People with HIV infection
• People who have a TB infection that started in the last 2 years
• Babies and young children
• People who inject substances
• People who have other health conditions that weaken the immune system
• People who are older
• People who were not treated at all or treated correctly for TB in the past

TB tests are generally not needed for those who have a low risk for TB infection. 

TB Screening Resources

• Colorado Tuberculosis Risk Assessment

Reporting Suspected or Confirmed TB Disease

Healthcare providers are required to report known or suspected cases of active TB to their local public health department within 1 working day. Before beginning empiric treatment for TB disease, the local health department must be notified. For a list of reportable diseases and conditions in Colorado, click here. 

Once contacted, the Larimer County TB Program provides guidance and assistance with TB disease diagnosis. Cases of active or suspect active TB disease, who are not currently in the hospital, are required by state statute to receive treatment through the health department via directly observed therapy (DOT).

We can assist healthcare providers with:

• Finding and treating TB disease
  • Investigation of suspect and/or confirmed cases of TB disease
  • Resource navigation for sputum collection and testing, including use of hospital micro labs or the Colorado Department of Public Health and Environment (CDPHE) laboratory services. Rapid DNA-based, molecular testing (PCR or NAAT) for mycobacterium tuberculosis identification and evaluation of drug resistance should be ordered on all testing specimens, in addition to traditional tuberculosis smear and culture orders.
  • Resource navigation for chest x-rays, particularly for patients who meet certain criteria
  • Coordination for review of films, clinical and laboratory reports by the medical consultant with CDPHE
  • Case management of TB cases with oversight from CDPHE
  • Management of isolation requirements for the patient
  • Treatment for individuals with active TB disease using direct observation therapy (DOT)
• Conducting contact investigation
  • Conduct contact investigations to identify close contacts of a TB case
  • Screen and treat contacts who are at high risk of developing TB disease and those with latent TB infection. Medications can be provided to uninsured or underinsured individuals.
• TB screening for certain immigrants and refugees ("Class A or B TB")
  • Refugees, asylees, and certain immigrants are screened for tuberculosis prior to leaving their country of origin. Those who have been identified as needing additional screening upon arrival in the U.S. will be identified by the State TB Program and referred to local public health for follow-up. The local health department will make contact with these individuals and provide comprehensive screening and treatment if needed.
• Targeted TB testing and treatment of TB infections
  • Consultation with area health care providers, healthcare facilities, occupational health providers, infection prevention specialists, student health providers, correctional facilities, and shelter facilities with the goal of identifying and screening anyone at risk for TB infection.
  • Coordination with community providers by offering treatment recommendations for anyone found to have TB infection.
  • Supporting healthcare providers and health care facilities in developing and maintaining Tuberculosis Infection Control protocols for their healthcare workers

View the New Tricks for an Old Disease Presentation for Providers

Additional Information from the CDC

• TB Diagnosis and testing
• Health Care Providers and TB Program Materials by Topic