Overview

Tuberculosis (TB) is an infectious disease caused by the organism Mycobacterium tuberculosis (MTB).

TB can occur in any part of the body (the brain, spine, lymph nodes, etc), but it most often causes infection in the lungs.

TB is spread from person to person through the air. This happens when a person with TB of the lungs sneezes, coughs, speaks, or sings and a person close by breathes in the MTB bacteria.

Not everyone with TB gets sick. A person can have TB disease or TB infection (“LTBI”), both of which are treatable with medication. If someone is not treated properly, TB can be a severe or deadly disease. People who have LTBI and are not treated properly can develop TB disease and become sick.

General information about TB and a variety of TB topics is available on US Centers for Disease Control and Prevention website.

Although TB is less common in the US now than in the past, there are still cases of TB in the Chicagoland area. For detailed information about TB in Chicago, please visit the following link here

 

The following links provide information for Clinicians regarding Tuberculosis

TB Treatment Guidelines :  This link provides information on general treatment, drug dosage and interactions as well as treatment of special populations.

Tools for Health Care Providers:  One-stop-shop for information, guidance & education.

Core Curriculum on TB | Guides & Toolkits | Publications & Products | TB | CDC:  This curriculum was designed to present basic information about TB for health care professionals in a web-based format. It is intended for clinicians caring for persons with or at high risk for TB disease or infection. This course offers free Continuing Education credits.

Testing/Specimen Collection

Screening Services for Tuberculosis in Chicago

CDPH does not provide routine TB screening services to the public. Recently, CDPH put together a list of places that provide screening in Chicago, which can be found here. CDPH recommends contacting these providers directly to verify availability and cost of TB screening.

To be added to the list (or your information is out of date), please contact Kathy Ritger at Kathleen.Ritger@cityofchicago.org.

For Update Recommendations for TB Screening, Testing and Treatment of Health Care Personnel click here.

Treatment


Both latent TB infection and active TB disease are treated with antibiotics. Treatment of active TB disease requires multiple antibiotics taken for 6-12 months. Treatment of LTBI is simpler and usually consists of a single antibiotic taken for 4 months. More information on TB treatment can be found via CDC resources here

Infection Prevention and Control

What are the reporting requirements around TB?

All patients with confirmed or suspected Tuberculosis (TB) must be reported as mandated by Illinois State Law. If the patient is residing in Chicago, the Local Health Department is the Chicago Department of Public Health (CDPH). This includes pulmonary and extrapulmonary TB cases.

All health care providers in attendance of a patient suspected to have or confirmed with active TB within seven calendar days.

Laboratory personnel must report laboratory evidence suggestive of TB within one calendar day after obtaining results.

How is a report submitted?

Reports of confirmed and suspected cases of TB should be submitted via the Illinois Department of Public Health’s web-based INEDSS system. The case report submitted will be routed to the appropriate Local Health Department based on the patient’s address of residence. Instructions for registering for access to INEDSS can be found here.

When a report of a TB case within the City of Chicago is entered in INEDSS by a disease, please fax supporting documents to CDPH at 312.746.5134:

  • Copy of patient’s medical record pertaining to TB
  • Narrative Summary
  • X-rays with report
  • Laboratory results

If providers or disease reporters do not have access to INEDSS or there are any questions or concerns about a case, CDPH’s TB program can be reached at 312.296.7394, Monday through Friday from 8am to 4pm.

CDPH as a public health authority reserves the right to request PHI as it pertains to TB diagnosis without individual authorization.

What is the role of the Chicago Department of Public Health in TB treatment?

TB is a communicable disease of public health significance, and under Illinois law the Local Health Department should be actively managing and/or monitoring treatment of each case of TB. TB is different than other illnesses; by law, the onus of completion of adequate therapy is on the healthcare provider and the Local Health Department, not the patient. While CDPH no longer has TB clinics, the TB program does conduct a number of services around TB treatment and prevention, including:

  • Case management by a public health nurse
  • Directly Observed Therapy (DOT)
  • Contact investigations
  • Follow-up TB screening for immigrants and refugees (Class B)
  • Epidemiological surveillance
  • TB education, outreach and research
  • Processing referrals
  • Housing linkage for TB patients experiencing homelessness
  • Technical Assistance: Infection control and medical consultations

CDPH provides TB treatment to all cases of active TB at no cost to the patient. TB clinical services are provided by the Cook County Health and Hospital System (by CDPH referral only).

Providers treating TB should adhere to the consensus TB treatment guidelines as published by the Centers for Disease Control and Prevention (CDC) and endorsed by the American Thoracic Society (ATS) and Infectious Disease Society of America (IDSA), which are available here.

Additional Resources

TB  Surveillance
CDPH’s Tuberculosis Annual Surveillance Reports are available here:

Additionally, here is an infographic that captures 2016 data on TB in Chicago.

National data, statistics and surveillance reports are available from the Centers for Disease Control’s Division of Tuberculosis Elimination here (link https://www.cdc.gov/tb/statistics/default.htm).

According to the CDC: A total of 9,105 TB cases (a rate of 2.8 cases per 100,000 persons) were reported in the United States in 2017. This is a decrease from the number of cases reported in 2016 and the lowest case count on record in the United States. The case rate of 2.8 per 100,000 persons is a 2.3% decrease from 2016. Ending TB requires maintaining and strengthening current TB control priorities while increasing efforts to identify and treat latent TB infection among high-risk populations.

CDC estimates that about 13% of U.S. TB cases with genotype data are attributed to recent transmission. Distinguishing the numbers of cases attributed to recent transmission from those likely due to reactivation of longstanding, untreated latent TB infection is one of many tools state and local TB programs can use to design and prioritize effective public health interventions.



World TB Day Presentations
2019 Presentations


2018 Presentations


Related Links
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Tuberculosis Reporting

For Questions Contact:

The CDPH Disease Reporting Hotline at
312-743-9000

Schools:  Please click here for reporting and TB management information.

*After hours, weekends, and holidays, call 311 and ask for the communicable disease physician on-call (or 312-744-5000 if outside the City of Chicago).

To Report Suspected or Confirmed Cases

Suspect or confirmed cases must be reported within 7 days.

Do not wait for laboratory confirmation.

If you have access to I-NEDSS (Illinois Notifiable Electronic Disease Surveillance System), please report via that electronic system. For all others, call the CDPH Disease Reporting Hotline at 312-743-9000 and fax pertinent patient records (e.g., admission and consultation notes, discharge summary, acid fast bacilli laboratory reports, chest imaging, and medication record showing anti-TB drugs) to 312-743-0243.

Asset Publisher

Tuberculosis Contact

For questions please contact:

Dr. Kathy Ritger, Medical Director
312-746-5992

For clinical questions during non-business hours, call 311 and ask for the communicable disease physician on-call.

To report cases call 312-743-9000 and fax pertinent patient records (e.g., admission and consultation notes, discharge summary, acid fast bacilli laboratory reports, chest imaging, and medication record showing anti-TB drugs) to 312-746-5134