Screening for Latent Tuberculosis Infection (LTBI) and Active Tuberculosis (TB) Disease

Section 696 Section 696.140  Screening for Latent Tuberculosis Infection (LTBI) and Active Tuberculosis (TB) Disease A TB screening test shall be used when screening persons for latent TB infection (LTBI).  Persons who have signs and symptoms of active TB disease or a positive TB screening test result shall complete a diagnostic evaluation for active TB disease in accordance with the Centers for Disease Control and Prevention (CDC) guidelines, Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection and Guidelines for Health-Care Settings. a)         Screening for Latent TB Infection 1)         Persons who are contacts to suspected or confirmed cases of active TB disease shall be evaluated in accordance with the CDC Guidelines for the Investigation of Contacts. 2)         Workers and clients at health care settings and other residential settings serving high-risk groups shall be screened in accordance with this subsection (a)(2) and the following CDC guidelines:  Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection; Guidelines for Health-Care Settings; Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC. A)        Health care workers and workers in other residential care settings shall have baseline (preplacement) TB symptom evaluation, TB test (Interferon Gamma Release Assay (IGRA) blood test or Mantoux Tuberculin Skin Test (TST)), and an individual risk assessment. B)        Evaluate symptoms for all healthcare workers when an exposure is recognized and perform a test (IGRA or Mantoux TST) for those with a baseline (preplacement) negative TB test, and no prior TB disease or LTBI. A negative IGRA or Mantoux TST shall be repeated 8-10 weeks after the most recent exposure. C)        All clients in non-acute care residential health care settings serving high-risk groups shall obtain an entry TB screening according to the healthcare facility written protocol.  Routine periodic screening shall be determined by completing a Department approved a risk assessment tool performed in cooperation with the local TB control authority.  The TB Risk Assessment Form is available on the Department's website at  https://dph.illinois.gov/content/dam/soi/en/web/idph/files/forms/tuberculosis-risk-assessment.pdf. D)        TB screening shall be instituted in other residential care settings serving high-risk groups as directed by the local TB control authority or the Department when a community or residential care setting has a higher than expected incidence of active TB disease or prevalence of LTBI. E)        Inmates and employees in correctional and detention facilities shall be screened in accordance with the CDC guideline Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC. 3)         Workers in child day care and pre-school settings shall obtain a baseline risk assessment, TB screening test and symptom evaluation upon hiring.  Routine, periodic screening of workers shall be determined by the child day care or pre-school facility's TB risk assessment performed in cooperation with the local TB control authority. b)         Screening for Active TB Disease.  The following persons shall be screened for active TB disease: 1)         Persons with a documented positive TB screening test result; 2)         Clients admitted to health care settings and residential care settings serving high-risk groups; and 3)         Inmates in correctional and detention facilities, who shall be screened for active TB disease in accordance with Prevention and Control of Tuberculosis in Correctional and Detention Facilities: Recommendations from CDC.