Public Health Madison & Dane County

Tuberculosis Reporting

A health care provider looking at an x-ray of lungs

Successful treatment of TB is dependent on good communication between our staff, health care providers, and the state TB program.

By law, you must notify us of anyone with suspected or confirmed TB within 24 hours of diagnosis. This includes medical providers, infection control providers, and laboratories. Routine follow up visits must also be reported.

On this page:

How We Follow Up on Referrals

We've seen a steady increase in positive TB tests being reported to us. To best utilize how we follow up on TB related referrals, our TB team will:

  • Follow up with people who have active and presumptive TB.
  • Initiate contact investigations for people with active TB.
  • Case manage people with latent TB infection who:
    • Have barriers to seeking/continuing care (language barriers, risk facts that put them at higher risk for breakdown to active disease, newly positive TB test, contacts, newly arrived in the U.S., etc).
    • Are younger than 18 years old
    • Have HIV
    • Have abnormal imaging that may require sputum collection
    • Are uninsured

Clients with insurance

Clients who have insurance and minimal barriers to health care can have their latent TB infection treatment prescribed and managed by their provider. Any client who is prescribed a treatment regimen for latent TB infection and is not followed by us should still have their treatment status reported to our TB program per state statute. 

We are available for consultation for any TB-related care! Call our TB on call nurse at 608-266-4821 anytime Monday - Friday, 7:45am - 4:30pm.

What to Report

Clinicians and laboratories must report:

  • Clinical suspicion of TB (Pulmonary or Extrapulmonary)
  • A smear from any site that is positive for acid-fast bacilli (AFB)
  • A nucleic acid-based assay positive for M. tuberculosis complex
  • A positive culture for M. tb complex
  • Biopsy, pathology, or autopsy findings consistent with active TB
  • A patient being treated with anti-TB medications for suspected or confirmed TB
  • Any positive TB test (TB Skin test or TB Blood test/IGRA)
  • Any patient being treated with anti-TB medications for Latent TB Infection
  • Any patient who has finished treatment for Latent TB Infection

Outpatient Follow-Up

Clinicians are required to report:

  • Continuation, discontinuation, completion and other outcomes of patient treatment (for Active OR Latent TB).
  • Contacts of active TB cases who are receiving treatment for TB Infection.

When to Report

  • Patients with active or suspected cases of TB in Dane County must be reported to us within 24 hours of diagnosis.
  • People with latent TB in Dane County must be reported to us within 72 hours.
  • Any follow-up on people with active, suspected or latent TB must also be reported to us. This includes starting treatment AND completing treatment. 

How to Report

People with Active/Suspected TB

  • During normal business hours (Monday - Friday, 7:45 am - 4:30 pm):
    • Call the TB on call nurse at 608-266-4821, or
    • Fax a notification to 608-266-4858. If you're faxing, please also call our TB nurse to confirm receipt of fax at the number above.
    • Through Wisconsin Electronic Disease Surveillance (WEDSS). If submitting a WEDSS web report; please also call our TB nurse to confirm receipt of web report. 

Outside of normal business hours: 

  • Call 608-267-3913.
  • If the line is busy, DO NOT leave a message. Hang up and try calling again in a few minutes. We may be working on a critical incident.

People with Latent TB

Your Next Steps After Reporting

Tell the patient how to isolate if they have symptoms

  • They must stay home until appropriate follow up is received (provider follow up, CXR, sputum collection, etc.)
  • They are not allowed to go out in public (this includes school, work, church, large gatherings, etc.)
  • They may go outside for fresh air and have their windows open
  • Make sure they have masks to wear for the ride home and to medical appointments

Complete Follow Up

  • Refer the patient to an infectious disease provider (or other provider who will manage TB care).
  • Order a chest x-ray.
  • Fax results to us at 608-266-4858
  • A public health nurse will follow up with patient on the next business day to assess the need for home sputum collection.

Resources

Frequently Asked Questions about Ordering TB Medications

How do I order TB medications?

How long does it take for the patient to receive TB medications when ordered through Public Health?

For active TB disease, the prescriptions are immediately filled through a local pharmacy and given to the patient as soon as indicated.

For latent TB infection, medications are ordered through a central pharmacy and mailed to Public Health. It can take up to 3 weeks to process the medication order and start the patient on medications. Please do not give the patient a prescription for a private fill or provide the patient with a short-term supply of medication. Treatment for latent TB infection is not urgent.

What if I want to order Vitamin B6?

Write the name and dosage requested on the "other" line of the med request form. This will either be filled by the central pharmacy or provided by Public health, depending on patient.

Do I have to go through Public Health to order LTBI treatment for my patient?

  • No, you do not. You do have to notify us when your patient starts treatment for LTBI and when they complete (or do not complete) LTBI treatment. You can do this by phone, web report via WEDSS, or completing the LTBI follow up form and faxing it to us at 608-266-4858.
  • We are available to case manage LTBI clients if your client is having difficulties accessing care, experiencing financial difficulties, or experiencing other barriers that may prevent them from completing LTBI treatment. 

What happens once Public Health gets the medication request form?

  • The medication request form is reviewed for completion.
  • If information is missing, it is returned to the health care provider for completion.
  • If meds are for active TB disease, a Public Health Nurse fills the prescription through a local pharmacy and initiates Directly Observed Therapy (DOT).
  • If meds are for LTBI, the Public Health Nurse contacts the patient to ensure their understanding and acceptance of treatment; then forwards the prescriptions to the State TB Program for fulfillment.

Does Public Health recommend any ongoing monitoring by the physician for LTBI treatment?

  • This is a medical decision.
  • If you want to do ongoing monitoring through your clinic, please indicate this on the form so the Public Health Nurse can assure the patient goes in.
  • Public Health does not draw labs for ongoing monitoring.
  • Please note the assigned Public Health Nurse will do a symptom review at each visit to monitor for any adverse reactions to the TB medications.

 

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