Tuberculosis (TB) Information for Health Care Providers

The TB Prevention and Control Program investigates all reports of persons with confirmed or suspected TB disease in Santa Clara County. We provide individualized case management to each patient to help ensure treatment completion and to prevent TB from spreading further. We also provide consultation to medical providers and community partners. 

Tuberculosis Disease

Tuberculosis (TB) is a disease caused by a bacteria that is spread through the air from person to person. Although TB most often affects the lungs, it can affect any part of the body including lymph nodes, bones, kidneys, and the brain. TB can cause very severe illness and it can be fatal. Fortunately, TB can be prevented, treated, and cured.

Symptoms
Symptoms of TB can include fever, weight loss, night sweats, and fatigue. When TB affects the lungs, symptoms can also include a cough that lasts more than 2-3 weeks, coughing up blood, and chest pain. If you have any of these symptoms you need to see a doctor.

Populations at Risk
TB can infect anyone who lives, works, or breathes in close proximity to someone with infectious TB disease, regardless of their age, race, sex, or socioeconomic status. Over 90% of patients with TB disease in SCC were born outside of the U.S., though most have lived in the U.S. for more than 5 years. In SCC, the majority of cases occur among people born in Vietnam, the Philippines, India, and China.

Screening

US Preventive Services Task Force (USPSTF) recommends screening adults at increased risk for TB infection, including those who were born in or lived in countries with increased TB disease prevalence and persons who have lived in high-risk congregate settings (e.g. homeless shelters or correctional facilities) in the U.S.

Provider Tools

    Short-course regimens (3HP or Rifampin daily for 4 months) have similar efficacy and higher treatment completion rates as compared with 9 months of daily isoniazid and are recommended for most patients who need treatment for LTBI.​

    Treatment Regimens for LTBI

    1. 12- dose Weekly Isoniazid/Rifapentine Regimen (3HP)  (3HP CDPH Fact Sheet)​

    • Isoniazid 2-11 years old: 25 mg/kg rounded up to nearest 50 or 100 mg (max. 900 mg) ≥ 12 years old: 15 mg/kg rounded up to nearest 50 or 100 mg (max. 900 mg)
    • Rifapentine 10.0-14.0 kg: 300 mg 14.1-25.0 kg: 450 mg 25.1-32.0 kg: 600 mg 32.1-50.0 kg: 750 mg >50 kg: 900 mg
    • Vitamin B6 50 mg weekly

    This regimen is not recommended for pregnant women, children <2 years-old, HIV-positive patients on antiretroviral medications, or those exposed to a person with INH or RIF-resistant TB.​​

    2. Rifampin- Daily for 4 months.​ (Rifampin CDPH Fact Sheet​)
    Adults: 600 mg; Children: 15 - 20 mg/kg (max. 600 mg)

    3. ​Isoniazid 10 mg/kg - Daily for 9 months. (Isoniazid CDPH Fact Sheet​)
    (range, 10-15 mg/kg; max. 300 mg) Recommended pyridoxine dosage is 25 mg for school-aged children (or 1-2 mg/kg/day)

    4. Isoniazid and Rifampin - Daily for 3 months. (CDC Fact Sheet
    Children: Isoniazid 10-20 mg/kg (300 mg maximum) Rifampin 15- 20 mg/kg; (600 mg maximum)


    For patients treated with an isoniazid-containing regimen, daily vitamin B6 (pyridoxine) supplementation (e.g., 50 mg) recommended for patients with other conditions associated with neuropathy (e.g., diabetes, HIV, chronic renal failure, alcoholism) or who are pregnant or breast-feeding. For children receiving vitamin B6, the recommended dosage is 6.25 mg for infants, 12.5 mg for toddlers, and 25 mg for school-aged children (or 1-2 mg/kg/day).  

    For more information, please see the  CDPH/CTCA Latent Tuberculosis Infection Guidance for Preventing Tuberculosis in California​.

      School Mandate Information

      The Santa Clara County Public Health Department  Risk Assessment for School Entry form​  is required for school registration effective June 1, 2014, for all children enrolling in kindergarten or transferring, at any grade level, from outside of Santa Clara County. 

      For more information please see the School Mandate Packet for Health Care Providers and Schools. This replaces the need to perform TB testing in all children.

      TB Screening Requirements for Children in Child Care

      Please see Tuberculosis Screening for Children in Childcare fact sheet for more information. 

      TB Screening Requirements for Child Care/School Staff and Volunteers

      The California Department of Public Health (CDPH) Tuberculosis Risk Assessment for Child Care/School Staff and Volunteers satisfies California Education Code, Sections 49406 and 87408.6 and the California Health and Safety Code, Sections 1597.055 and 121525, 121545, and 121555. Please see Frequently Asked Questions (FAQs) for additional information.

      Other Risk Assessments

      The US Preventive Services Task Force (USPSTF) recommends screening persons at increased risk for latent TB infection (LTBI), including those who were born in or lived in countries with increased TB disease prevalence and persons who have lived in high-risk congregate settings (e.g. homeless shelters or correctional facilities) in the U.S.



      Clinical Consultation 

      During business hours, please call the TB Provider line at (408) 885-2440.

      After business hours, please call Santa Clara County Communications and ask for the Health Officer On-Call at (408) 998-3438.

      Resources

      Tuberculosis (TB) Prevention and Control Program
      Santa Clara County Public Health Department
      976 Lenzen Avenue, Suite 1700
      San Jose, CA 95126
      Phone: (408) 792-1381
      Fax: (408) 885-2331  

      ©2022 County of Santa Clara. All rights reserved.