California implemented a TB screening law that took effect January 1, 2025. The bill requires an adult patient receiving primary care services to be offered a TB screening test if risk factors are identified, and if the patient’s health insurance covers it, followed by provision or referral for appropriate follow-up care.
Primary care providers serve a critical role in identifying patients with risk factors for TB infection. Screening and treatment for LTBI is recommended by the California Department of Public Health (CDPH), the Centers for Disease Control and Prevention (CDC), and the U.S. Preventive Services Task Force as the best way to prevent TB disease and deaths.
What should providers do?
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Assess all patients for TB risk factors (California Adult TB Risk Assessment).
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Test all patients with TB risk factors for LTBI (using an interferon gamma release assay or IGRA)
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Treat for LTBI if IGRA positive, CXR negative and the patient is asymptomatic for active TB dx (always evaluate for active TB disease before starting LTBI treatment).
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