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Tuberculosis Screening Added to Adult Preventive Care

September 27, 2023

The California Department of Public Health (CDPH) issued a notice that the United States Preventive Services Task Force (USPSTF) has updated guidance on screening for latent tuberculosis infection (LTBI) in adults. Tuberculosis (TB) incidence in California continues to be higher than in the rest of the country, causing pain and death even though it is preventable. Therefore, USPSTF recommends screening for LTBI in asymptomatic adults ages 18 and older to stop new cases of active TB.

Who to test for LTBI

USPSTF recommends testing for TB infection in:

  • Asymptomatic adults with risk factors. This includes births or those who live in countries with high TB rates.
  • Persons who have lived in high-risk congregate settings.
  • Close contact or immunosuppressed persons should also be tested for TB infection by public health programs or by clinical standards of care.

What tests are effective

Instead of using the TB skin test, the Centers for Disease Control and Prevention (CDC) states that the interferon release assays (IGRA) should be given to test adults. The IGRA offers increased specificity, single blood draw and requires no return visit to read the test.

LTBI treatments available

There is no effective vaccine against LTBI. The Bacille Calmette-Guerin (BCG) vaccine doesn't offer lifetime protection. The best tool to date is diagnosing and treating LTBI. The USPSTF evidence summary suggest:

  • Treating LTBI with 3-4 month rifamycin-based therapies instead of isoniazid monotherapy.
  • Isoniazid monotherapy is associated with poor completion rates and higher rates of liver damage.


Please contact CDPH TB Control Branch with any questions.

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Y0020_WCM_87476E Last Updated On: 10/1/2023