Tuberculosis Prevention Program
The Tuberculosis (TB) program serves people infected with TB, contacts of active TB cases, public and private healthcare providers throughout New Mexico, and the general public.
Our purpose is to prevent and control the spread of Tuberculosis, by ensuring that active TB cases receive adequate care, directly observed therapy, and a contact investigation if infectious. Other important program activities are: case management of all active cases; interstate/international referrals; surveillance; training for healthcare workers and other stakeholders; and screening to identify and treat Latent TB Infection (LTBI).
What We Do
- We provide directly observed therapy to all active tuberculosis cases in New Mexico to prevent non-adherence, ensure a quick response to any adverse reactions and assure completion of an adequate treatment regimen.
- We stay in regular contact with physicians and public health nurses to monitor the status of individual TB cases, medical follow-up of patients and adherence of patients to drug regimens and documentation of clinical response to therapy.
- We make and receive referrals for TB cases and their contacts who move to or from New Mexico or the United States
Education and Training
- We consult with health care providers, including infection control practitioners, Indian Health Services, community-based organizations, correctional facilities, local health offices, and the general public.
- We offer training on TB, including case management, prevention, standard recommendations for diagnostic procedures, treatment regimens, isolation guidelines, clinical follow-up and contact investigations.
- We create standardized reports for all cases reported in New Mexico.
- We compile surveillance data and report program outcomes to the CDC.
- We identify cases through direct collaboration with the New Mexico State Laboratory, private labs, and by receiving reports from healthcare providers and infection control practitioners who report potential TB suspects to us immediately.
- We screen individuals to determine if they have a latent TB infection.
- Our local public health nurses provide preventive treatment and follow-up through consultation with our nurse consultants;
- We maintain an LTBI registry
- We assure complete and timely contact investigations
Frequently Asked Questions
What is TB?
TB is short for a disease called tuberculosis. TB is spread through the air from one person to another. The TB germs are passed through the air when someone who is sick with TB disease of the lungs or throat coughs, speaks, laughs, sings, or sneezes. The people near the sick person can breathe TB germs into their lungs. TB is not like many other airborne diseases. It is not easily spread to others and usually requires close contact over several hours or days.
Sites of TB Disease TB germs can live in your body without making you sick. This is called latent TB infection. This means you have only inactive (sleeping) TB germs in your body. The inactive germs cannot be passed on to anyone else. However, if these germs wake up or become active in your body and multiply, you will get sick with TB disease.
When TB germs are active (multiplying in your body), this is called TB disease. These germs usually attack the lungs. They can also attack other parts of the body, such as the kidneys, brain, or spine. TB disease will make you sick. People with TB disease may spread the germs to people they spend time with every day.
How was I exposed to TB?
You may have been exposed to TB if you spent time near someone with TB disease of the lungs or throat. You can only get infected by breathing in TB germs that person coughs into the air. You cannot get TB from someone’s clothes, drinking glass, eating utensils, handshake, toilet, or other surfaces where a TB patient has been.
What is latent tuberculosis infection?
Latent tuberculosis infection (LTBI) is when a person breathes in TB bacteria and becomes infected, but their body fights off the bacteria and keeps it from growing. The bacteria are not active inside the person's body. However, they do remain alive in the body and can become active later on.
People with LTBI have no symptoms, don't feel sick and can't spread TB to others. They usually, but not always, have a positive skin test or blood test reaction. They can develop active TB disease if they are not treated.
Many people with LTBI never develop active TB disease. The TB bacteria remain inactive for life without causing disease. However, in other people, especially people who have weak immune systems, the bacteria can become active and cause TB disease. It is important to get treated for LTBI so that it doesn't develop into active TB disease.
How do I know if I have TB infection?
If you have been around someone who has TB disease, you should go to your doctor or your local health department for tests.
There are three tests that can be used to help detect TB infection. Usually a skin test is done. A small needle is used to put some testing material, called tuberculin, under the skin. In 2-3 days, you return to the health care worker who will check to see if there is a reaction to the test. In some cases, a test called QuantiFERON-TB Gold (QFT-G) or another called the T-Spot. TB test may be used. They are blood tests that measure how a person’s immune system reacts to the germs that cause TB. You may also be asked to have a chest x-ray if either the skin test or blood test is positive, or if you have symptoms of TB disease.
How is latent TB infection treated?
Treatment of latent TB infection substantially reduces the risk that TB infection will progress to disease. Most people with latent TB infection are treated with a medication called Isoniazid for 9 months. Certain groups are at very high risk of developing TB disease once infected, and every effort should be made to begin appropriate treatment and to ensure that those persons complete the entire course of treatment.
What is the difference between latent TB infection and TB disease?
People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease.
People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease. These can include a cough lasting more than 2-3 weeks, blood in your phlegm, fever, fatigue, excessive sweating at night, or unintended weight loss. People with TB disease of the lungs or throat are capable of spreading germs to others. They are prescribed drugs that can treat TB disease.
How is TB disease treated?
TB disease can be treated by taking several drugs for 6 to 12 months. It is very important that people who have TB disease finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again. If they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy, and helps the patient complete treatment in the least amount of time.
Services at Local Health Offices
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. 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 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 NMDOH?
The NMDOH TB Program through local Public Health Offices across the state provides a wide range of TB-related services.
Tuberculosis services to detect active TB and LTBI include:
- TB skin testing (TST) OR blood test
- 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 NMDOH?
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 Civil Surgeons Locator).
- If the immigrant is diagnosed with active TB or LTBI, then treatment and nurse case management is provided through the NMDOH
Where can I obtain a TB test?
- Your local Public 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 NMDOH?
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 NMDOH 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 NMDOH 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 in which a health department worker observes the patient take each dose of TB medications. Directly observed therapy is the standard of care for TB treatment and the directly observed therapy requirement applies to all TB patients.
What is the role of the health department in investigating TB transmission among contacts to TB cases?
The NMDOH 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 Public 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 NMDOH 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 Public 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 NMDOH @ 505-827-2473 or 505-827-2471.
Case Rate Data Reports
- Tuberculosis Case Rates by County and Region 2013
- Tuberculosis Case Rates by County and Region 2012
- Tuberculosis Case Rates by County and Region 2011
- Tuberculosis Case Rates by County and Region 2010
- Tuberculosis Case Rates by County and Region 2009
- Tuberculosis Case Rates by County and Region 2008
- Tuberculosis Case Rates by County and Region 2007
- Tuberculosis Case Rates by County 2006
- Tuberculosis Case Rates by County 2005
- Tuberculosis Case Rates by County 2004
- Tuberculosis Case Rates by County 2003
- Tuberculosis Case Rates by County 2002
- Tuberculosis Case Rates by County 2001
- Tuberculosis Case Rates by County 2000