Health Service Region 8 - Tuberculosis

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Elvia Ledezma, M.P.H.
Communicable Disease Program Manager
210-949-2177  

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 TB.                                                          

Clinical services for TB

  • 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 services?

  • DSHS Region 8 provide the services listed above to patients who live in the following counties: 
    Atascosa, 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 facilities

  • 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 were evaluated:
  • Qualifications 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

General 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 disease.

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 for TB?

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 Calmette-Guérin (BCG)?

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 treated? 

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 treated?

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

Contact Information:

  • 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
TB Program
7430 Louis Pasteur Dr.
San Antonio, TX 78229

Reporting Guidelines

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.

Clinical services we provide

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 collection.   

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.  

TB treatment guidelines

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.    

Links  

TB – Centers for Disease Control and Prevention
TB – Department of State Health Services (DSHS)

 



Last updated January 4, 2017