Tuberculosis and Public Health Emergencies
- If you are currently taking treatment for TB disease and your medical visits have been affected by the COVID-19 pandemic, contact your state or local TB program.
For TB Control Professionals
- CDC published Interim CDC Guidance on Handling Non-COVID-19 Public Health Activities that Require Face-to-Face Interaction with Clients in the Clinic and Field in the Current COVID-19 Pandemic to provide guidance for the management of public health workers engaged in public health activities that require face-to-face interaction with clients in clinic and field settings, such as TB control programs.
The Importance of TB Treatment
It is very important that people who have tuberculosis (TB) disease are treated, take the drugs exactly as prescribed, and finish the medicine. If they stop taking the drugs too soon, they can become sick again. If they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat.
Tuberculosis Information for Public Health Emergencies
A public health emergency can make efforts to help TB patients continue their treatment difficult. TB programs’ work ensures that people who are receiving treatment for TB disease can continue their treatment, even if routine health care services are affected.
In the event of a public health emergency, TB programs can help to mitigate potential shifts in staff assignments and resources.
- Make sure contact information for patients is current, and staff can reach patients with updates and information.
- Provide contact numbers of TB program personnel to patients.
- Communicate any changes or updates in service to community partners.
- Consider providing additional medications to patients if health department operations are likely to be affected.
- If policies and procedures are in place, consider alternative treatment delivery methods, such as electronic directly observed therapy (eDOT).
People with COVID-19 infection might seek care at tuberculosis (TB) clinics because the primary symptoms of this disease are similar to those of TB (e.g., fever, cough, and shortness of breath). Patients with TB can become infected with COVID-19, which could result in an unexpected deterioration of a patient’s condition (e.g., was responding well to treatment and develops new acute cough, fever, or shortness of breath). TB patients who are at least 65 years old; have respiratory compromise from their TB; or other medical conditions, including HIV and other immunocompromising conditions, are at greater risk for severe COVID-19 infection. Therefore, respiratory infection control precautions, with which TB programs are familiar, are of even greater importance now as are general precautions, such as frequent hand washing, disinfecting surfaces, and avoiding touching one’s face.
COVID-19 guidance for healthcare facilities, including outpatient facilities, is available at the CDC COVID-19 website.
COVID-19 Information for TB Laboratories:
CDC is providing updates on the current status of national TB laboratory services during the ongoing COVID-19 response efforts.
- CDC’s Molecular Detection of Drug Resistance (MDDR) Service is operational, and we are working diligently to ensure sufficient staffing and resources to provide both molecular and growth-based drug-susceptibility testing (DST). Turnaround times for issuance of reports back to submitters could be delayed. If you need additional information or have questions, please feel free to contact TBLab@cdc.gov or 404-639-2455.
- The National DST Reference Center for Mycobacterium tuberculosisexternal icon at the California Microbial Diseases Laboratory is operational. For enrolled laboratories, please continue to refer specimens and isolates for pyrosequencing or MGIT DST as per your usual procedure. For additional information, please contact CDPHTBDST@cdph.ca.gov or 510-412-3949.
- The National TB Molecular Surveillance Center at the Michigan Department of Health and Human Services Bureau of Laboratories is operational, and referral of M. tuberculosis isolates should continue. CDC is continuing to provide conventional genotyping results and conducting analysis of whole genome sequencing data, as applicable. For additional information, please contact Angie Schooley at email@example.com or 517-335-9637.
The response to COVID-19 is an unprecedented event and could impact public health laboratory testing for TB. CDC has received reports of shifting or rotating mycobacteriology staff to support COVID-19 testing and also has received notification that some public health laboratories are implementing continuity of operations plans. As always, CDC encourages regular communication between TB programs and public health laboratories to understand any impacts to TB testing capacity.
COVID-19 vaccination is an important tool to help stop the pandemic, and CDC recommends healthcare personnel be among those offered the first doses of COVID-19 vaccines. As the U.S. COVID-19 vaccination program continues, some may have questions about the interaction between COVID-19 mRNA vaccines and tests used for tuberculosis (TB) infection.
Currently, there are no data to inform the impact of the COVID-19 mRNA vaccines on either the tuberculin skin test (TST) (administered by intradermal placement of 0.1 cc of purified protein derivative) or the interferon gamma release assay (IGRA). There is no immunologic reason to believe that a TST or blood draw for IGRA will impact the effectiveness of COVID-19 mRNA vaccines. See CDC’s Dear Colleague Letter for more information.
- TB Electronic Directly Observed Therapy (eDOT) Toolkit https://www.cdc.gov/tb/publications/guidestoolkits/tbedottoolkit.htm
- TB infection control guidelines https://www.cdc.gov/tb/publications/guidelines/infectioncontrol.htm
- TB laws and policies: https://www.cdc.gov/tb/programs/laws/default.htm
- Interim Guidance on Management of Coronavirus Disease 2019 (COVID-19) in Correctional and Detention Facilities