Tuberculosis Control
The Tuberculosis (TB) Control Program at the Sonoma County Department of Health Services detects, controls and prevents the spread of TB in our community through treatment, case management, contact investigation and education.
Active/Suspected TB
In accordance with California Regulations and California Health and Safety Code 121365, all patients with suspected or confirmed active TB disease must be reported to Sonoma County TB Control Program within 24 hours of initial suspicion. Latent TB infection is only reportable for persons with TST/IGRA conversion who live or work in a healthcare setting, or, children less than two years old.
Fax (707-565-4565) or securely email (phnurse@sonoma-county.org) the completed Sonoma County Tuberculosis Reporting Form and all relevant documents (radiology, labs, and relevant provider notes) to the TB Control Program .
Discharge/Transfer Approval (GOTCH)
Prior to the discharge or transfer of patients with confirmed or suspected TB, California Health and Safety Code Section 121361 requires all health care facilities (e.g., hospitals, skilled nursing facilities, and nursing homes) and correctional facilities to obtain written approval of the treatment plan by the Health Officer (i.e., Tuberculosis Controller) of the county in which the facility is located.
The GOTCH form should be faxed to the TB Prevention & Control Program at (707) 565-4565. Please call (707) 565-4568 to verify receipt. The TB Program has 24 hours to review the GOTCH form.
The following documentation is routinely requested prior to GOTCH approval. Please provide as soon as possible to facilitate discharge:
- Physician notes (including any Infectious Diseases or Pulmonary consultation)
- Medication list, including TB medication dosages and non-TB medications
- Documented current weight
- Radiology reports
- Diagnostic testing for TB [e.g. AFB smears/cultures, molecular diagnostic tests, pathology and cytology reports, body fluid (pleural/ peritoneal/ pericardial/CSF) chemistries and cell counts]
- TST/IGRA results
- HIV test results (testing recommended for all patients with suspected TB before treatment initiation);
- Chronic Hepatitis B/C screening for patients with risk factors
- Baseline laboratory tests: CBC, Chem 7, LFTs
Latent Tuberculosis Infection (LTBI)
LTBI is only reportable for persons with TST/IGRA conversion who live or work in a healthcare setting, or children less than two years old. Sonoma County TB Control Program does not provide LTBI treatment. Please refer to the following guidance:
- USPSTF Updated Latent TB Infection Screening Guidance 2023
- Dear Colleague Letter - An overview of updated LTBI guidance
- Prevent Tuberculosis (TB) in 4 Steps: A Guide for Medical Providers - A clinical algorithm for medical providers on how to test and treat patients for LTBI, produced by the California Department of Public Health.
- CDC LTBI Treatment Guidance
- How to Talk to Patients about LTBI – Adult and Pediatric : A clinical tool on how to counsel patients about LTBI testing and treatment, by the California Department of Public Health.
- CTCA Provider Guidelines for LTBI
Civil Surgeons
Civil surgeons are also required to refer to the local health department all applicants with CXR findings suggestive of TB disease, all applicants with symptoms or signs of TB disease, all applicants with known HIV infection, and all applicants with extrapulmonary TB for further evaluation and management.
LTBI is only reportable for persons with TST/IGRA conversion who live or work in a healthcare setting, or children less than two years old. Sonoma County TB Control Program does not provide LTBI treatment.
- To refer a patient with suspected or confirmed TB disease:
- Fax (707-565-4565) or securely email (phnurse@sonoma-county.org) the completed Sonoma County Tuberculosis Reporting Form to the TB Control Program
Skin Tests for Work Clearance
The TB Control Program does not provide TB skin tests for work clearance. You may obtain a skin test through your primary care provider. If you do not have a provider or insurance, please visit a local community clinic.
Please click here for CalOSHA guidance on requirements for annual TB testing in healthcare facilities.
Additional Resources
- Sonoma County Public Health World TB Day 2023 Presentation
- California Department of Public Health (CDPH) maintains a clinical consultation service to discuss the management of challenging TB and LTBI cases.