Content Information
A. Purpose of Surveillance and Reporting
Prevention and control efforts should include three priority strategies:
- Identifying and treating all persons who have TB disease
- Finding and evaluating persons who have been in contact with TB patients to determine whether they have TB infection or disease, and treating them appropriately
- Testing high-risk groups for TB infection to identify candidates for treatment of latent infection and to ensure the completion of treatment.
B. Laboratory and Healthcare Provider Reporting Requirements
Iowa Administrative Code 641-1.3(139) stipulates that the laboratory and the healthcare provider must report suspected/confirmed M. tuberculosis.
What to report:
- Pulmonary and extrapulmonary sites of disease should be reported to IDPH within one working day. This includes laboratory confirmed or clinically suspected tuberculosis disease.
- Latent tuberculosis infection (LTBI) is not reportable.
- IDPH provides medication free of charge for anyone to treat both LTBI and TB disease.
How to report tuberculosis:
Call or FAX: Iowa Department of Public Health TB Control Program
(515) 281-8636 or (515) 281-7504
Fax (515) 281-4570.
IDPH TB Control Program requests that tuberculosis cases be reported by phone to help ensure timely public health follow-up measures. Specimens should be submitted to:
State Hygienic Laboratory
UI Research Park - Coralville
Iowa City, IA 52242-5002
319-335-4500 or 800-421-IOWA
Postage-paid disease reporting forms are available free of charge from the Iowa TB Control Program at (515) 281-8636 or (515) 281-7504.
Both outpatient and inpatient facilities that offer services for TB patients should have ready access to laboratory and diagnostic services. Access to radiological services includes radiography equipment, trained radiography technicians, and radiograph interpretation by a qualified person. Radiograph findings and reports should be available within 24 hours.
Laboratory services should be readily accessible to provide results of acid-fast bacilli smear examinations within 24 hours of specimen collection. The State Hygienic Lab is designated to process all isolates for TB in the state. Smear results are available within 24 hours from receipt of the specimen. All initial positive smears are telephoned to the submitting facility.
AMPLIFIED MYCOBACTERIUM TUBERCULOSIS Direct (MTD) Test
Description: Direct target-amplified nucleic acid probe test for the in vitro diagnostic detection of Mycobacterium tuberculosis complex rRNA in acid-fast bacilli (AFB) smear positive and negative concentrated sediments from sputum, bronchial specimens, or tracheal aspirates. For testing information, call the State Hygienic Laboratory at 319-335-4500 or the IDPH TB Control Program at 515-281-8636/515-281-7504.
The use of the BACTEC liquid culture system and DNA probes for M. tuberculosis continue to aid in rapidly and accurately isolating and identifying cultures of mycobacteria. All isolates are tested for drug susceptibilities.All M. tuberculosis identifications and susceptibility results are telephoned to the submitter immediately. The TB Control Program also receives these reports.
C. Local Public Health Agency Follow-up Responsibilities
Case Investigation
Contact Investigation
Prompt and thorough contact investigation is essential for the control of TB. The purpose of the investigation is to find contacts who (1) have TB disease so that they can be given treatment, and further transmission can be stopped, (2) have latent TB infection (LTBI) so they can be given treatment, and (3) are at high risk of developing TB disease and therefore require treatment until LTBI can be excluded.
The local health departments are legally responsible for ensuring that a complete and timely contact investigation is done for the TB cases reported in its area. Therefore, health departments should work closely with other agencies (e.g., managed care organizations, private providers) to ensure the prompt reporting of suspected TB cases. The health department should work closely with other agencies to plan the contact investigation and receive a report of the results. Occasionally, a contact investigation may be conducted by people outside of the health department, but under the supervision of the health department.
Contact investigations should be discussed with the TB Control Program Manager. The results of all contact investigations must be submitted to the Iowa TB Control Program. Forms used to document investigations are available by calling the program at (515) 281-7504 or (515) 281-8636.