Reporting Requirements for Latent Tuberculosis Infection
LTBI itself is generally not reportable to public health authorities in most jurisdictions, but active TB disease is universally reportable. However, reporting requirements vary by local and state regulations, and you must verify your specific jurisdiction's requirements.
Key Distinction: LTBI vs. Active TB Disease
- Active TB disease must be promptly reported to local public health departments in all jurisdictions, as this serves critical functions including contact investigations, monitoring treatment adherence, identifying infected contacts, and surveillance 1.
- LTBI (latent infection) is typically not reportable because it is non-communicable and poses no immediate public health transmission risk 2.
- Suspected cases of active TB should be reported even before definitive culture confirmation, based on clinical diagnosis or presence of acid-fast bacilli in specimens 1.
Why Active TB Reporting is Mandatory
The rationale for mandatory reporting of active TB disease includes 1:
- Allows public health investigators to perform contact and source case investigations to identify other untreated, infectious TB cases in the community
- Enables monitoring of treatment adherence in patients who might otherwise continue spreading TB
- Facilitates identification and treatment of infected contacts
- Permits record-keeping and surveillance to evaluate TB control program effectiveness
Clinical Implications for LTBI Management
While LTBI itself is not reportable, certain clinical scenarios require coordination with public health 3:
- When a patient is exposed to active TB (e.g., household contact), the exposure should be reported to local public health authorities immediately 3.
- Public health will conduct contact investigations and identify other potentially exposed individuals 3.
- The index case with active TB should be started on appropriate treatment as soon as possible to reduce transmission risk 3.
Common Pitfall to Avoid
Do not confuse LTBI with active TB disease when considering reporting requirements. The key distinction is:
- LTBI: Asymptomatic, non-communicable infection with positive TST or IGRA but no clinical or radiographic evidence of disease 2
- Active TB: Symptomatic disease with potential for transmission, requiring immediate reporting 1
Verification of Local Requirements
You must check your specific state and local health department regulations, as reporting requirements can vary by jurisdiction 1. Some jurisdictions may have specific reporting requirements for:
- Positive TB tests in certain high-risk populations
- LTBI in healthcare workers or other occupational settings
- Contact investigations involving LTBI
The TB control plan in your jurisdiction should define essential pathways of communication between providers, laboratories, and the public health system 1.