TB Services at Local Health Offices: FAQs

Why would someone need to be tested for tuberculosis?

Testing by a skin or blood test is used to see if a person has been infected with Mycobacterium tuberculosis, this bacteria causes tuberculosis (TB). It may be required for school, work, change in immigration, to volunteer in certain facilities, or as part of a medical evaluation.

Note: A history of BCG vaccination does not exempt students or employees from the skin test.

What does a positive TB test result mean?

A positive skin or blood test means that a person may have been infected with TB bacteria sometime during their life. It does not indicate that a person has TB disease or is contagious.

What should a person do if they have positive TB test?

A person with a positive TB test needs a chest x-ray and/or other clinical exams to determine if the infection is active or in the sleeping phase (latent TB infection).

A person with a positive skin test and no symptoms and a normal chest X-ray has latent TB infection (LTBI). This is NOT contagious.

A person with a positive TB test who has symptoms of TB (such as a cough greater than 3 weeks, fever, fatigue, weight loss, night sweats) is potentially contagious. This person needs further evaluation by the New Mexico Department of Health (NMDOH) and a medical provider.

What TB services are available through the NM DOH?

The NM DOH TB Program through local health offices across the state provides a wide range of TB-related services.

Tuberculosis services to detect active TB and Latent TB Infection (LTBI) include:

TB skin testing (TST) OR blood test(IGRA)
Chest x-rays
Physical examination
Evaluation of symptoms
Collection of sputum for testing
Nurse Case Management
Treatment of active TB and LTBI
Monitoring side effects of TB medications, including laboratory tests
Monitoring of response to therapy
Referral to healthcare providers for other medical problems

Who will New Mexico Department of Health test for TB?

TB testing through the Department of Health is provided for any person who:

Has signs or symptoms of active TB disease;
Is a contact to an active TB case;
Is immunocompromised (e.g., HIV, organ transplants, or medications such as TNF-alpha blockers, etc.)

What TB services are NOT available through the NM DOH?

The NMDOH TB Program CANNOT provide:

Routine TB skin testing for work or school requirements
TB testing or chest X-rays for immigrants changing their status
- This is an elective activity and the services are provided through the civil surgeon (see the USCIS locator for New Mexico).
- If the immigrant is diagnosed with active TB or LTBI, then treatment and nurse case management is provided through the NM DOH

Where can I obtain a TB test?

o Your local health office can provide a TB test for people who need a test related to symptoms of TB or exposure to a case.
Your health care provider can offer testing for people that need a TST for school or work requirement.
Some pharmacists have the ability to place and read TB skin tests. Contact your local pharmacy for more information, including availability and cost.

What is the cost for TB services provided through the NM DOH?

There is no charge for any TB services for TB cases and suspects, their contacts, and persons with latent TB infection.

Do students in New Mexico schools need a tuberculin skin test?

No. The American Academy of Pediatrics (AAP) recommends that physicians routinely assess a child's risk of TB exposure with a questionnaire and offer TB testing only to at-risk children. The AAP does not recommend routine testing of children with no TB risk factors for school entry, day care attendance, WIC eligibility, or camp attendance.

Children who have a positive TB test but no symptoms of TB disease should not be kept out of school while they are being evaluated for treatment of latent TB infection.

Do all employees in New Mexico schools need a tuberculin skin test?

No. There is no statewide requirement for teachers or other school employees to have a TB screening test. The Centers for Disease Control (CDC) discourages the use of TB testing for persons who have no risk factors for TB exposure.

How often do health care workers need a tuberculin skin test?

Both paid and unpaid health care workers should receive a two-step tuberculin skin test when they start work in a health care setting unless they have documentation of a negative tuberculin skin test result within the last twelve months or documentation of a positive tuberculin skin test result at any time in the past. The frequency with which they receive additional tuberculin skin tests should be determined by the risk of exposure to persons with active TB disease in their work setting.

Are routine chest x-rays recommended for health care workers, patients, or institutional residents with a history of a positive tuberculin skin test result?

No. People who have a positive tuberculin skin test result should not have repeat chest radiographs performed routinely. Health care workers, patients, or institutional residents with a baseline positive or newly positive tuberculin skin test result should receive one chest radiograph to exclude a diagnosis of TB disease. Repeat radiographs are not needed unless signs or symptoms of TB develop, or a clinician recommends a repeat chest radiograph, or after a new exposure to M. tuberculosis. On a regular basis, the person in charge of infection control for their work area or facility should ask about any signs or symptoms of TB disease. The frequency of their symptom screen should be determined by the risk assessment for the facility.

Health care workers who have a previously positive TB screening test result and who change jobs should carry documentation of the results, chest radiograph, and documentation of treatment history for latent TB infection, if applicable, to their new employers.

Can I go to work with a positive TB test?

Yes, if your chest x-ray is normal and you do not have symptoms of TB.

Do I need to go through the Health Department to get TB clearance?

No, your private health care provider can give you clearance.

Do I need to get yearly chest x-rays if I have a positive TB test?

No, the CDC recommends chest x-rays only when:

You have your first positive TB skin test
You have symptoms of TB disease

What if I or one of my family members is diagnosed with TB?

Once a patient is referred to the New Mexico Department of Health (NM DOH) as a TB case or TB suspect, a nurse case manager is assigned to that patient. The patient is started on TB treatment as indicated per the NM DOH TB medical consultant. TB medications and follow up are provided at no charge to the patient. The best way to reduce the burden of TB in a community is to ensure that each TB case receives a full course of treatment. The CDC recommends treatment for active TB disease be administered via directly observed therapy (DOT) in which a health department worker observes the patient take each dose of TB medications. DOT is the standard of care for TB treatment and the DOT requirement applies to all TB patients.

What is the role of the health department in investigating TB transmission among contacts to TB cases?

The NM DOH nurse case manager will work with the patient to learn the names and contact information of persons who may have been exposed (e.g., those who live or work with the patient, spend a lot of leisure time with the patient, etc.). These people are called contacts. The nurse case manager will get in touch with the contacts while maintaining patient confidentiality and make arrangements for them to be evaluated, usually with a TB test, a symptom review, and if indicated, a chest x-ray, at the health department at no charge.

What is the role of the health department in managing treatment of TB cases?

TB is a communicable disease of public health significance. Department of Health staff are active in the management of each case of TB.

I am a contact of a TB patient. What do I need to do now?

Call a local health office to ask for an appointment for an evaluation as a TB contact. If you received a letter bring it with you to the health department. The NM DOH will determine what testing is needed.

I had a positive TB test after contact to a TB patient. What do I need to do now?

Discuss the result with your healthcare provider. Or, call a local health office to ask for an appointment for an evaluation. Bring the test results and a copy of any recent chest X-rays. The health department will determine what additional testing and treatment are needed.

What cases and information need to be reported to public health?

All confirmed and suspected cases of TB are reportable to the Department of Health by law in the State of New Mexico.

The law requires that all reports of confirmed or suspected TB must contain:

The disease or condition being reported;
Patient's name, date of birth/age, gender, race/ethnicity, address, telephone number, and occupation;
Physician or licensed healthcare professional (or laboratory) name and telephone number.

Report suspect or confirmed cases within 24 hours to Tuberculosis Program, by phone to NM DOH @ 505-827-2471 or 505-827-2473.

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