TB - General Information

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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.

TB 2016 Surveillance Report

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.

TB World TB Day Presentations

2019 Presentations 

World TB Day

Kathleen Ritger M.D., M.P.H. Natural History of Untreated Pulmonary Tuberculosis

Theodore Bonau, M.Ph. Epidemiology of Tuberculosis Cases in Chicago

Theodore Bonau, M.Ph. Using WGS to Establish Epi Links among Individuals with TB

C. Patricia Macias, M.D. The Marshall Islands TB Elimination Effort

Stefani Nixon, MPH, CPH, MCHES TB and Alcohol

Naeemah McMillon, BSN, RN, Charamonte Oladeji, MSN, RN and Angela Okafor, BSN, RN Day in the Life of a TB Nurse Case Manager

 

2018 Presentations 

David Ashkin, M.D., F.C.C.P.  It's World TB Day

Theodore Bonau, M.Ph.  Epidemiology of Tuberculosis Cases in Chicago

Janette Candido Tuberculosis in Illinois: Updates 2018

Elaine Darnall, R.N., B.S.N., C.I.C.  Latent TB, TB and The Role of the Helath Department

Dean E. Schraufnagel, M.D.  TB Update

 

2017 Presenations

Testing for TB Infection and Disease: Making Sense of Imperfect Tests

Dr. Kathy Ritger discusses the different TB screening tests and how to use them as a tool in public health TB control and prevention.

Essentials of TB Prevention: TB Infection

Janette Candido discusses the role of focusing on TB infection as a means for TB disease prevention and introduction on the new TB infection module in I-NEDSS.

Enhancing Immigrant Communication

Jenny Aguirre and Anne Bendelow identify best practices for communication between Refugee Health Programs and TB programs across the state and current refugee resettlement in the United States.

Interesting TB Cases in the Region

Physicians from Mayo Clinic Center for Tuberculosis present on a consultation for a dual infected HIV/TB case.

TB Contact

TB Program Contacts

For Clinical 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.

For Program Questions please contact:

Stephanie Atella, Program Manger

312-746-5987

TB Screening services

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.

If you are a provider who offers screening (TST, IGRA and/or X-Ray) and you would like to be added to the list (or your information is out of date), please contact Stephanie Atella, Program Director, at Stephanie.atella@cityofchicago.org

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

TB More Information

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 Clinicans 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

CDC Course “TB: What the Clinician Should Know”:  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.