World TB Day 2021March 24 is World TB Day, an annual event that commemorates the announcement in 1882 of Dr. Robert Koch’s identification of M. tuberculosis as the causative agent of TB. In our current moment, as we collectively confront the challenges of the COVID-19 pandemic, it is worth remembering the context in which Koch made his profound discovery. In the 1880s, average life expectancy in the U.S. was 39 years. In 1900, an estimated 450 Americans, most aged 15-44, died of tuberculosis each day. Although the impact of Koch’s work in bacteriology was seismic, the first antibiotic treatments for TB were still more than 50 years away.
The global response to the latest emerging infectious disease, COVID-19, highlights a universal truth – public health interventions and comprehensive safety nets are essential to community health. TB and COVID-19 are both caused by respiratory pathogens; controlling them will demand the same commitment to support new interventions, accessible diagnostics, preventive vaccines, treatment innovations, and the public health infrastructure needed to investigate, respond to, and contain outbreaks.
On World TB Day 2021, we take a moment in the current storm to recognize our health care colleagues – past, present, and future – who play a central role in protecting our health and safety. If you are a TB physician, nurse, outreach worker, researcher, epidemiologist, or administrator, you follow in the legacy of Robert Koch. Whether your “frontline” is currently a TB clinic, a primary care office, an ER, or an ICU, you are a champion – when the world is paying attention, and when it is not.
On March 24, and every day, you humble and inspire us. We thank you, one and all.
Contra Costa County Public Health TB Control is pleased to share with you important information about how we, along with the help of our community partners, healthcare providers and client families, control and strive to eliminate TB in our county. Attached is our 2021 report on Tuberculosis in Contra Costa County. Additional information may also be found at cchealth.org/TB or you may call the TB Control program directly at 925-313-6740 with questions.
- Tuberculosis in Contra Costa 2020
- TB in California: 2020 Snapshot
- COVID19 Vaccine and TB Testing CDC Guidance
- TB and COVID-19
TB and COVID-19
Tuberculosis (TB) disease is endemic in Contra Costa County, and delays in TB diagnosis have been seen in patients with suspected, confirmed, or resolved COVID-19. TB disease should be considered in patients with compatible clinical and radiological features, even if they also have suspected or confirmed COVID-19. It is essential that TB clinical care and control are continued during the COVID-19 pandemic, including: evaluation and treatment of suspected or confirmed active TB disease; evaluation after significant exposure to infectious TB disease; and treatment of latent TB infection (LTBI) for high risk individuals.
The TB Control Program receives reports on all cases of TB. Physicians, clinical lab directors, and other providers are required by law to report confirmed and suspected cases of TB to Public Health within one working day of the diagnosis of TB or suspected TB. Reports must include the following information (if known): patient demographics, the date of onset, the date of diagnosis, date of death (if applicable), diagnostic status, bacteriologic, radiologic and tuberculin skin test findings, information regarding the risk of transmission of the disease to other persons, a list of anti-TB medications prescribed and the name, address and phone number of the medical provider. Initial reports may be made by phone 925-313-6740 or fax 925-313-6465. Providers are also required to make follow-up reports to Public Health upon request, and whenever a patient ceases treatment for TB disease (H&S 121362).
To report a case or suspected case of TB in an outpatient, providers should complete a Confidential Morbidity Report (CMR), and FAX to CCPH at 925-313-6465. For questions about TB reporting, providers should call us at 925-313-6740.
Inpatients and Hospital Discharges
California law requires that patients with suspected or confirmed active TB may be discharged or transferred from a health facility only after a written discharge plan has been received and approved by Public Health, unless the transfer is due to an immediate need for a higher level of care or is to a correctional institution. Please see below for instructions on requesting a discharge, and the TB Case Report: Request for Discharge Form which should be faxed to Contra Costa Public Health at 925-313-6465. For questions about hospital discharges, please call us at 925-313-6740.
- Discharge of a Suspected or Confirmed Case of TB
- TB Case Report: Request for Discharge Form (fillable form)
- Home Isolation Rules | Spanish
CCPH provides medical consultation to providers regarding the diagnosis and management of patients with LTBI and confirmed or suspected TB disease. For medical consultation, providers may call us at 925-313-6740.
Medical consultation is also provided by the Curry International TB Center Warmline Consultation Service (response within 24 hours). Call 877-390-6682 or 415-502-4700.
Links to Guidelines & Resources
Here are a number of State and Federal websites that provide additional guidance and information to assist in the management of your TB patients.
- TB Control Branch, California Department of Public Health
- California TB Controllers Association
- Curry International TB Center
- Centers for Disease Control and Prevention, Division of TB Elimination
- California Risk Assessment Tools & Guidelines