TB Manual

When notification of a new TB diagnosis is received, the public health authority should ensure that all medical investigations to confirm the diagnosis and determine the degree of infectiousness are under way, and the patient is in home isolation or hospital airborne isolation. Once pulmonary/laryngeal TB is confirmed (by GeneXpert or other nucleic acid amplification test, by positive smear in regions with little non-tuberculosis mycobacterium infection or by positive culture), or if the clinical suspicion is sufficiently strong to begin TB treatment pending laboratory confirmation, then investigation of household and other high-priority contacts should begin promptly, especially for any children less than 5 years old and immunocompromised individuals (see Chapter 2: Transmission and Pathogenesis of Tuberculosis and Chapter 3: Diagnosis of Tuberculosis Disease and Drug-resistant Tuberculosis). Investigation of contacts beyond the high-priority group (see below) should always await laboratory confirmation of the diagnosis.

Good practice statement

• The initial contact tracing interview should be done within three days of the TB patient being notified to the public health TB team. Screening of high-priority contacts should begin within the next 7 days.