Los Angeles County
Department of Public Health Tuberculosis Control Program
2615 S. Grand Avenue, Room 507
Los Angeles, CA 90007
Phone: (213) 745-0800
*The phones may not be working properly, if are experiencing difficulties, call (213) 745-0811*
Fax: (213) 749-0926
Email: tbc@ph.lacounty.gov
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Instructions for Civil Surgeons
New requirements of the Centers for Disease Control and Prevention (CDC) Division of Global Migration and Quarantine Tuberculosis
(TB) Technical
Instructions which went into effect October 1, 2018.
New technical instructions require the use of Interferon
Gamma Release Assay (IGRA) blood tests (either QuantiFERON or T-SPOT.TB Test),
instead of the TB Skin Test, for all applicants 2
years and older. During the status adjustment medical evaluation, an indeterminate test does not
need to be repeated and a chest x-ray does not need to be performed in order to
complete the I-693 form. A chest x-ray is needed for all applicants with a positive IGRA result.
Reporting to the local health department for TB
infection is now required once TB disease has been ruled
out.
For applicants who are diagnosed with LTBI, civil surgeons must:
Inform such applicants that their LTBI diagnosis has been reported to the local health department.
Advise the applicant that follow-up treatment is important to prevent TB disease.
Complete and give the I-693 to the applicant - treatment is not required in order to continue the status
adjustment process. For TB disease, applicants are given a designation on their I-693, however, the status adjustment process is
stalled until treatment has been completed.
Required Civil Surgeon Reporting to local health
department:
Category
Definition
Reporting Requirements
Latent TB Infection
(LTBI)
Positive IGRA
Normal Chest X-ray
No known HIV
No signs / symptoms of active TB disease
The applicant's
name, contact
information, IGRA and
chest x-ray results must
be reported to the local
health department
electronically through the California
Reportable Disease
Information Exchange (CalREDIE)
Provider Portal. To sign
up for the Provider
Portal, submit a
CalREDIE provider portal
authorization form
to
tbc@ph.lacounty.gov.
All HIV-infected
applicants
History of HIV
infection
If the applicant has
known HIV infection, an
IGRA and a chest x-ray
must be performed. HIV
infected applicants must
be referred to the
health department for
sputum testing.
Active TB disease
(suspected or confirmed)
Positive IGRA
Abnormal chest x-ray
Extrapulmonary disease regardless of
chest x-ray results
May or may not have signs / symptoms of active
TB disease
Any confirmed or
suspected case of active
TB disease is required
by law to be reported
within one business day.
To report, complete the
Confidential Morbidity
Report (CMR) and submit
to the TB Control
Program by fax at (213)
749-0926, or by phone at
(213) 745-0800.
Upcoming Events
First Friday CME Conference - TB Meningitis/CNS-TB - Implementing a Local Standardized Checklist for Clinical Management (No CME Offered)
Friday, February 3rd, 2023
MS Teams
Coalition to End TB in Los Angeles County Wednesday,
Jan 18th, 2023
MS Teams