Elvia Ledezma, M.P.H.
Communicable Disease Program Manager
The mission of the Tuberculosis Program is to prevent the
spread of tuberculosis (TB) in Health Service Region 8 through clinical
management of persons with suspected or confirmed TB, identification, screening
and treatment of people who are contacts to cases of TB, and education about
Clinical services for
- Clinical management of patients with suspected
or confirmed TB disease.
- Identification, assessment, evaluation and, if
necessary, treatment of residents who have come in contact with patients who have
confirmed or suspected TB disease.
- Evaluation and treatment of patients who are
referred through the Electronic Disease Network.
Who can receive TB
- DSHS Region 8 provide the services listed above
to patients who live in the following counties:
Bandera, Comal, Dimmit, Edwards, Frio, Gillespie, Goliad, Gonzales, Guadalupe,
Jackson, Karnes, Kendall, Kerr, Kinney, La Salle, Lavaca, Maverick, Medina,
Real, Uvalde, Val Verde, Wilson and Zavala
- For San
Antonio and Bexar County TB care is provided by San Antonio Metropolitan
Health District (www.sanantonio.gov/health).
- For Victoria,
Calhoun and Dewitt Counties TB services are provided by Victoria
City-County Public Health Department (www.victoriacountypublichealthdepartment.org).
TB in correctional
- TB is a disease that is spread from
person-to-person through the air.
- Region 8 collects information from our local,
state, and federal correctional facilities to determine if there is any risk of
the spread of TB.
- Since many people share common air in correctional
facilities, there is a greater risk for people who are currently in jail or who
have been in jail to be exposed to TB.
- If you work at a correctional facility that has
the following criteria, you or your medical designee must report inmates who
that are needed for correctional facilities to report
- If you are unsure of what to report or if you
need to report, please call 210-949-2194
Information about TB
What is TB?
TB is a disease caused by germs that are spread from
person to person through the air. TB
usually affects the lungs, but it can also affect other parts of the body, such
as the brain, the kidneys or the spine.
A person with TB can die if they do not get treatment.
What are the
symptoms of TB?
The general symptoms of TB disease include feeling sick
or weak, weight loss, fever and night sweats.
The symptoms of TB disease of the lungs also include coughing, chest
pain, and coughing up blood. Symptoms of
TB disease in other parts of the body depend on the area affected.
How is TB spread?
TB germs are put in the air when a person with TB disease of
the lungs or throat coughs, sneezes, speak or sings. These germs can stay in the air for several
hours, depending on the environment.
People who breathe in the air containing TB germs can become infected.
What is the
difference between TB infection and TB disease?
People with TB infection (also called latent TB infection)
have TB germs in their bodies, but they are not sick because the germs are not
active. These people do not have
symptoms of TB disease and they cannot spread the disease to others. However, they may develop TB disease in the
future. They are often prescribed
medicine to prevent them from developing TB disease.
People with TB disease are sick from TB germs that are
active, meaning that they are multiplying and destroying tissue in the
body. They usually have symptoms of TB
disease. People with TB disease of the
lungs or throat are capable of spreading germs to others. They are prescribed drugs that can cure TB
What should I do if I
have spent time with someone with TB infection?
A person with TB infection (latent TB infection) cannot
spread germs to other people. You do not
need to be tested if you have spent time with someone who has TB
infection. However, if you have spent
time with someone who has TB disease or symptoms of TB, you should be tested.
What should I do if I
have been exposed to someone with TB disease?
People with TB disease are most likely to spread the germs
to people they spend time with every day, such as family members or
coworkers. If you have been around
someone who has TB disease, you should go to your doctor or your local health
department for tests.
How do I get tested
There are two tests that can be used to help detected TB
infection, a skin test or a TB blood test.
The blood test measures how the patient’s immune system reacts to the
germs that cause TB. The skin test is
performed by injecting a small amount of fluid (tuberculin) into the skin in
the lower part of the arm. A person
given a skin test must return to have it read in 48 to 72 hours to have a
trained health care professional look for a reaction.
What does a positive
test for TB infection mean?
A positive test for TB infection only tells that a person
has been infected with TB germs. It does
not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a
sample of sputum are needed to see whether the person has TB disease.
What is Bacille
BCG is a vaccine for TB disease used in many countries, but
not in the United States. BCG
vaccination does not completely prevent people from getting TB. It may also cause a false positive tuberculin
skin test. People who have had BCG
vaccine can be given a skin test or the TB blood test.
Why is TB infection
If you have (latent) TB infection but not TB disease, your
doctor may want you to take medicine to kill the TB germs in your body. This will prevent you from developing TB
disease. Treatment for TB infection is
especially important for people with HIV infection, people who were recently
exposed to someone with TB disease, and people with certain medical conditions.
How is TB disease
TB disease is treated by taking several drugs for 6 to 12
months. It is very important that people
who have TB disease finish taking the medicine and take the drugs exactly as
prescribed. This is why taking the
medicine is always observed by a trained health care provider. This keeps the patient from developing drug
resistant TB and from getting sick again.
TB Information for Medical Providers
- Cases of TB or suspected TB, please call 210-949-2166
- Contacts to cases or suspected cases of TB, call 210-949-2195
- Correctional Facilities, call 210-949-2194
- General questions, please call 210-949-2000 (ask for TB program)
Please address any mailed documents to:
Texas Department of State Health Services, Region 8
7430 Louis Pasteur Dr.
San Antonio, TX 78229
Texas law requires that certain communicable diseases, including TB, be reported to the local health department.
What to report
Please report the following items on all patients who are suspected to have TB disease or who have TB disease (if available):
- Patient's name, Date of birth, address and phone number
- Most recent history and physical
- Copy of TB skin test result of IGRA result
- Copy CXR report
- Copy of sputum results - both AFB smear and culture results
- Most recent CBC and liver function tests
- HIV test results (if done)
- Documentation of signs and symptoms of TB
Please report the following items on all patients who have been diagnosed with latent TB or TB infection:
- Patient's name, DOB, address and phone number
- Copy of TB skin test results or IGRA results
- Copy of CXR report that shows no evidence of active TB disease
- Documentation that patient has no signs of symptoms of active TB disease
Where to report
- All reports are to be faxed to the TB program at 210-692-1477.
- If you have trouble faxing the records, please call 210-949-2166 or 210-949-2195.
Region 8 provides clinical services to patients with
suspected or confirmed TB disease.
These include medication, directly observed therapy, case management,
laboratory testing during treatment, chest X-ray follow-ups and sputum
Region 8 provides clinical services to patients who are contacts to cases of active disease. These include identification
and testing of patients with a TB skin test or IGRA test, directly observed
preventive treatment for contacts who are at high risk for progression to
active TB disease, CXR referrals, and medication for those patients who are
diagnosed with latent TB or TB infection.
Region 8 provides clinical services to patients who are referred through the Electronic Disease
Network that include nursing assessments, TB skin tests or IGRA tests,
sputum collection, CXR referrals, medication administration.
Active TB disease is treated with many medications over
the course of many months. It is important to ensure the patient is responding
to treatment clinically, radiographically, and bacteriologically. Additionally,
close monitoring of liver functions and complete blood counts are required due
to the side effects and hepatotoxic nature of the medications.
DSHS staff provide medications to patients with active or
suspected TB disease via directly observed therapy to ensure compliance and to
quickly identify any problems in treatment. DSHS staff also coordinate with
medical providers in the community to share treatment updates and refer
patients for services.
LTBI or TB
infection treatment guidelines
Many medical providers provide TB skin testing or IGRA
testing for their patients. When a patient has a positive test, screening for
signs and symptoms of TB and a CXR are required to determine if the patient has
active TB disease.
If a patient has no evidence of active TB on his or her
CXR, has no signs or symptoms of active TB disease and has a positive TB skin
test or IGRA test, he or she may be diagnosed with latent TB or TB infection.
Treatment for latent TB or TB infection requires fewer medications and can be
prescribed by providers in the community.
TB – Centers for Disease Control and Prevention
TB – Department of State Health Services (DSHS)