Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home
Share
Compartir

Menu of Suggested Provisions For State Tuberculosis Prevention and Control Laws

Definitions for Consideration

Descriptive Note: Defining TB, the measures for preventing and controlling it, and other relevant terms is a critical component of TB prevention and control statutes and regulations. As with state TB prevention and control laws in general, TB-related definitions found in statute or regulation vary considerably from state to state. Definitions listed in this section are not intended to define these terms appearing in other sections of the Menu; rather, they were selected from definitions currently found in some states’ laws based on the view that they may be particularly useful to jurisdictions contemplating changes to their legal TB-related definitions.

  • “Active tuberculosis” means a disease that is caused by Mycobacterium tuberculosis or other members of the Mycobacterium tuberculosis complex family in any part of the body and that is in an active state as determined by either:
    • 1) A smear or culture taken from any source in the person’s body tests positive for tuberculosis and the person has not completed the appropriate prescribed course of medication for active tuberculosis disease.
    • 2) Radiographic, current clinical, or laboratory evidence is sufficient to support a medical diagnosis of tuberculosis for which treatment is indicated.
  • “Case management” means the coordination of the necessary medical, nursing, outreach, and social service systems which ensure that all persons with confirmed [or] clinically suspected tuberculosis are started on appropriate therapy, and that all persons with confirmed tuberculosis complete an appropriate and effective course of treatment. 105 Mass. Code Regs. 365.200 (2010). [NOTE: “Or” in brackets replaced the word “and,” and the legal citation was retained].

  • “Case management services” can include, but are not limited to:
    • Patient education regarding the transmission of TB, how to prevent it, and the importance of keeping appointments for clinical assessments and completing treatment;
    • Facilitating the continuity of care for a patient with suspected or confirmed TB until treatment completion by scheduling diagnostic evaluations in a timely manner, monitoring adherence to prescribed therapy, and intervening as appropriate and necessary to address non-adherence;
    • Assessing adherence to community infection control precautions and intervening as appropriate and necessary to address non-adherence;
    • Coordination of TB care with the care of co-existing medical conditions among multiple medical providers;
    • Assessing the quality of care provided by both public and private health care providers with intervention as necessary;
    • Identification of psychosocial barriers to adherence and treatment completion, including, but not limited to: housing, food, transportation, communication, child care, parenting, incarceration, substance abuse and mental illness and intervention as necessary to promote the continuity of treatment;
    • Coordination of contact or source case investigation and care, including identification, evaluation and appropriate treatment of all identified contacts;
    • Coordination of investigations for all Class B1 and B2 referrals (defined as referrals from the CDC’s Division of Global Migration and Quarantine, which informs the Department of persons who are refugees, parolees, asylees, or recent legal immigrants to the United States, and who were screened overseas and classified as either B1 meaning TB, clinically active, not infectious or B2 meaning TB, not clinically active, not infectious) including location, evaluation, and initiation of appropriate treatment;
    • Coordination of all field services, including provision of directly observed therapy (DOT) as prescribed by a health care provider; and
    • Building and maintaining effective working relationships with infection control professionals at hospitals and private health care providers that identify and report tuberculosis in the designated coverage area.
  • “Communicable disease” means an illness caused by an infectious agent or its toxins that occurs through the direct or indirect transmission of the infectious agent or its products from an infected individual or via an animal, vector or the inanimate environment to a susceptible animal or human host. New York, N.Y., 24RCNY Health Code § 11.01 (2010).

  • “Confinement” means the restriction of an individual with TB to a specified place, including, but not limited to, a health facility or other public or private premises, in order to prevent transmission of the disease to others, to prevent the development of drug-resistance, or to ensure that the individual receives a complete court of treatment.

  • “Contact” means a person identified by the public health department who has had exposure to a patient with suspected or confirmed infectious or potentially infectious TB sufficient in both duration and proximity to make him or her at increased risk for recent transmission of latent TB infection. N.J. Admin. Code § 8:57-5.3 (2009).

  • “Cure” means a medically successful complete course of anti-tuberculosis treatment. Ariz. Rev. Stat. § 36-711 (LexisNexis 2009).
    • NOTE: “Medically successful complete course of antituberculosis treatment” means that a [person who has or who based upon reasonable grounds is suspected of having active tuberculosis] has successfully completed a prescribed course of antituberculosis treatment and has been medically discharged from further medical treatment for tuberculosis by a licensed physician. ARIZ. REV. STAT. § 36-711 (LexisNexis 2009).
  • “Cure” or “treatment to cure” means the completion of a course of antituberculosis treatment. Fla. Stat. Ann. § 392.52 (LexisNexis 2009).

  • “Directly observed therapy” means a course of treatment, or preventive treatment, for a contagious disease in which the prescribed medication is administered to the person or taken by the person under direct observation as specified by the Department. New York, N.Y., 24RCNY Health Code § 11.01 (2010).

  • “Examination” for tuberculosis infection or disease means conducting tests, including, but not limited to, Mantoux tuberculin skin tests, interferon gamma release assays or other tests for tuberculosis infection approved by the U.S. Food and Drug Administration, laboratory examination, and X-rays, as recommended by any of the following: 1) the local health officer, 2) the most recent guidelines of the state department, 3) the most recent guidelines of the Centers for Disease Control and Prevention, or 4) the most recent guidelines of the American Thoracic Society.

  • Extensively Drug-Resistant TB (XDR TB): TB that is resistant to isoniazid and rifampin, plus any fluoroquinolone and at least one of the three injectable second-line drugs. CDC definition (http://www.cdc.gov/tb/topic/drtb/default.htm).

  • “Immediate or imminent public health risk” means a patient with suspected or confirmed infectious or potentially infectious TB disease and who does any of the following: 1) Threatens to leave an acute care facility against medical advice, 2) Leaves an acute care facility against medical advice, 3) States he or she will not adhere to infection control measures, 4) Does not adhere to infection control measures, 5) Refuses to take anti-tuberculosis medication as prescribed, or 6) Threatens to travel on a public conveyance. N.J. Admin. Code § 8:57-5.3 (2009).

  • “Isolates” means a population of Mycobacterium tuberculosis observed in cultures obtained from clinical specimens of persons with active tuberculosis. Ky. Rev. Stat. Ann. § 215.511 (LexisNexis 2009).

  • “Isolation” means the separation of ill persons who have a communicable disease from those who are healthy, and the restriction of their movement to stop the spread of that disease or illness.

  • “Latent TB infection” (LTBI) means the presence of Mycobacterium tuberculosis bacteria in the body as evidenced by a significant reaction to a Mantoux tuberculin skin test or positive interferon gamma release assay. A person with latent TB infection does not have an illness nor is he or she infectious. N.J. Admin. Code § 8:57-5.3 (2009).

  • “Least restrictive environment or manner” means the intervention that limits the patient's activities the least while providing protection for the public against the likelihood of TB transmission. N.J. Admin. Code § 8:57-5.3 (2009).

  • “Multidrug-Resistant Tuberculosis” (MDR TB) means TB that is resistant to at least isoniazid and rifampin. CDC definition (http://www.cdc.gov/tb/topic/drtb/default.htm).

  • Mycobacterium tuberculosis complex”: Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium africanum. (NOTE: This definition was suggested by the APHL TB Steering Committee for the purposes of the Menu.  There are actually seven organisms, but these are the three that are by far most clinically important).

  • “Suspected or confirmed infectious or potentially infectious TB disease” means any of the following: 1) A patient with a smear positive for AFB and/or nucleic acid amplification test positive for M.tb and/or a culture positive for M.tb or M.tb complex (this applies only to specimens from sputum, bronchioalveolar lavage, gastric aspirate, lung tissue or other tissue of the respiratory tract such as the larynx or epiglottis); 2) A patient with a chest radiograph, computed tomography scan, or clinical findings indicative of pulmonary tuberculosis sufficient to warrant treatment with anti-tuberculosis medications; 3) A patient whose chest radiograph or respiratory symptoms improve while taking anti-tuberculosis medication; or 4) A patient with respiratory symptoms indicative of pulmonary tuberculosis until a diagnostic evaluation is completed to rule out TB as a cause of these symptoms.

  • “Suspected or confirmed TB disease” means one or more of the following: 1) A patient meeting the definition of suspected or confirmed infectious or potentially infectious TB disease; 2) A patient with a smear positive for AFB and/or nucleic acid amplification test positive for M. tuberculosis and/or a culture positive for M. tuberculosis or M. tuberculosis complex from a location outside the respiratory tract; 3) A patient with extra-pulmonary clinical findings indicative of tuberculosis sufficient to prescribe treatment with anti-tuberculosis medications; 4) A patient whose extra-pulmonary symptoms improve on anti-tuberculosis medications; or 5) A patient with symptoms indicative of extra-pulmonary tuberculosis until a diagnostic evaluation is completed to rule out TB as the cause of these symptoms. N.J. Admin. Code § 8:57-5.3 (2009).

  • “Threat to the public health” means that a person has active tuberculosis and: 1) Is not taking medications as prescribed, 2) Is not following the recommendations of the treating physician, 3) Is not seeking treatment for signs and symptoms compatible with tuberculosis, or 4) Evidences a disregard for the health of the public.

  • “Treatment” means medication or medical therapy prescribed by a licensed physician to cure a person of active tuberculosis. Ariz. Rev. Stat. § 36-711 (LexisNexis 2009).

  • “Tuberculosis” means a disease caused by Mycobacterium tuberculosis, Mycobacterium bovis, or Mycobacterium africanum. Fla. Stat. Ann. § 392.52 (LexisNexis 2009).

  • “Tuberculosis”, as demonstrated by:
    • 1) Positive culture for Mycobacterium tuberculosis complex; or
    • 2) Positive DNA probe, polymerase chain reaction (PCR), or other technique for identifying Mycobacterium tuberculosis from a clinical or pathology specimen; or
    • 3) Positive smear for acid-fast bacillus, with final culture results pending or not available, on either a microbacteriology or a pathology specimen; or
    • 4) Clinically suspected pulmonary or extrapulmonary (meningeal, bone, kidney, etc.) tuberculosis, such that the physician or other health care professional attending the case has initiated or intends to initiate isolation or treatment for tuberculosis, or to continue or resume treatment for previously incompletely treated disease, or, if the patient is not available, that the physician or other health care professional would initiate isolation or treatment if the patient were available; or
    • 5) Biopsy, pathology, or autopsy findings in lung, lymph nodes or other tissue specimens, consistent with active tuberculosis disease including, but not limited to presence of acid-fast bacilli, caseating and non-caseating granulomas, caseous matter, tubercles and fibro-caseous lesions.
 
Contact Us:
  • Centers for Disease Control and Prevention
    Division of Tuberculosis Elimination (DTBE)
    1600 Clifton Rd., NE
    MS E10
    Atlanta, GA 30333
  • 800-CDC-INFO
    (800-232-4636)
    TTY: (888) 232-6348
  • Contact CDC–INFO
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #