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Sep
16

Reporting requirements for King County health care providers

Healthcare providers are required to report suspected cases of active TB disease to Public Health – Seattle & King County TB Control Program within 24 hours.

To request a consultation, call our intake line: 206-744-4579, option 2, OR complete our HIPAA compliant online form.

1. When am I required to report a suspected case of active TB disease to PHSKC TB Control Program? Is extrapulmonary TB disease also a reportable condition?

Healthcare providers are required to report suspected cases of active pulmonary TB disease and extrapulmonary TB disease to us within 24 hours. We request that healthcare providers contact us when empiric treatment for active TB is considered. If you start someone on TB medication for suspected active TB disease, you must report the case to us. PHSKC TB Control Program manages all cases of active pulmonary TB disease in King County. If the patient lives outside of King County, please report the case of TB to the appropriate county per the patient’s address.

2. Is culture confirmation required before reporting a suspected case of active TB disease? What if I start patients on treatment for suspected TB disease?

No, culture confirmation is not required before reporting the case.

3. How do I report a case of active TB disease to PHSKC TB Control Program?

Call our intake line at 206-744-4579, option 2. Please provide as much detail as possible using the table below as a guide. This is a secure line and it is ok to leave PHI in a voicemail.
Please ensure the following:

  1. Verify the person lives in King County. If not, please report to the appropriate county. See a list of county contact info.
  2. Inform us if the person is living unhoused or has a high-risk work/living situation
  3. Provide your direct line, cell or pager number. Do not provider a general clinic number or nurse line number.
Reporting elements to PHSKC TB Control Program
Primary Health Care
Provider Information		 Person Providing
Report Information		 Patient Demographic Information
  • Provider Name
  • Provider Address
  • Provider Direct Telephone #
  • Person's Name
  • Person's Address (if different from Provider)
  • Person's Direct Telephone # (if different from Provider)
  • Diagnosis or suspected diagnosis of disease or condition
  • Pertinent Lab Data
  • Pertinent Radiologic Data
  • Name
  • Alias
  • Address
  • Telephone #
  • Date of Birth: Gender
  • Ethnicity
  • Primary Language

4. What happens after I report a case to the intake line?

Based on the information you provide, our team begins gathering information from relevant medical facilities, including pushing chest images for our review, gathering medical records, and registering the patient in our system. Once this process is complete, we will contact you for next steps.

5. How do I request a consultation with a provider at the TB Control Program or ask a question about a patient or situation?

You may call us at 206-744-4579, option 2, OR fill out our HIPAA compliant online form.

To receive a call back, you MUST provide a direct phone number for the provider managing the case. We will not call nurse lines, main clinic lines, or other general phone numbers regarding case consultations.

Alternatively, you may present your case to a panel of local and statewide TB expert via TB ECHO teleconference, which take place every Monday from 12:30 pm to 1:30 pm. For more information, email WTCN@kingcounty.gov

6. How do I differentiate between active TB disease and latent TB infection?

Please see the chart below for key differences in active TB disease vs. latent TB infection. You may request a consultation with us for help with active TB rule out, or question about active TB disease vs. LTBI.

Latent TB Infection Active TB Disease
  • No symptoms or physical findings suggestive of TB disease
  • TB blood test or TST result usually positive
  • Chest radiograph is typically normal
  • If done, respiratory specimens are smear and culture negative
  • Cannot spread TB bacteria to others
  • Should consider treatment for LTBI to prevent TB disease
  • Symptoms may include one or more of the following: fever, cough, chest pain, weight loss, night sweats, hemoptysis, fatigue, and decreased appetite
  • TB blood test or TST usually positive
  • Chest radiograph is usually abnormal, buy may be normal in people with advanced immunosuppression or extrapulmonary TB disease
  • Respiratory specimens are usually smear and/or culture positive, but may be negative in people with extrapulmonary TB disease or minimal/early pulmonary TB disease
  • Can spread TB bacteria to others
  • Needs treatment for TB disease

7. Where do I find patient or provider educational resources about active TB disease or latent TB infection?

Please email us at LTBI@kingcounty.gov and we will help you find appropriate educational materials, including patient education materials in their preferred language.

8. Where can I connect with TB experts and other local providers who treat patients with TB?

Join us for weekly TB ECHO telementorship sessions for case consultations, case presentations, and didactic sessions (CME/CNE credit available). Read here (LINK) more info and to register to receive the zoom link and agenda for each session (no obligation to attend). Email WTCN@kingcounty.gov with questions about TB ECHO.

9. Updated guidelines for LTBI (latent TB infection) services

In addition to the services that we provide for patients who are highly suspected of having infectious active TB, or who are diagnosed with active TB disease, the TB Control Program provides the following LTBI (latent TB infection) services.

Tuberculin skin test (TST), or QuantiFERON (QFT) if appropriate, for:

  1. Close contacts of a recent infectious TB case ("significant TB exposure" defined by the Program)
  2. Immigrants with "Class B1" status (abnormal chest X-rays consistent with pulmonary TB, identified through immigration screening process)

CXR for:

  1. Close contacts who are:
    1. TST or QFT positive, or
    2. Children under 5 years old or severely-immunocompromised requiring window period prophylaxis after significant TB exposure (e.g., HIV infection, organ transplant, certain immunosuppressive medications.)
  2. Close contacts who have compatible symptoms of active TB.
  3. Selected cases with approval of a TB Program physician

Treatment of LTBI: individuals with latent TB infection who are also:

  1. Contacts of a recent infectious case ("significant TB exposure" occurred within the past 2 years.)
  2. Persons with Class B status who are at high risk of progression to active infectious TB.

Additional resources

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