TB Disease


TB Disease is a rapidly reportable condition in Virginia as reflected in the Virginia Reportable Disease List. Providers must report all suspected and confirmed cases of TB Disease immediately to their local health department.

View contact information for your local health department at this link.

For Local Health Districts:


There are two kinds of tests that are used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests.  A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum (if symptomatic), are needed to see whether the person has TB disease.  -CDC, 2018


When TB bacteria become active (multiplying in the body) and the immune system can’t stop the bacteria from growing, this is called TB disease. TB disease will make a person sick. People with TB disease may spread the bacteria to people with whom they spend many hours.

It is very important that people who have TB disease are treated, finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the TB bacteria that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat.

TB disease can be treated by taking several drugs for 6 to 9 months.  There are 10 drugs currently approved by the U.S. Food and Drug Administration (FDA) for treating TB. Of the approved drugs, the first-line anti-TB agents that form the core of treatment regimens are:  isoniazid (INH), rifampin (RIF), ethambutol (EMB), pyrazinamide (PZA).  -CDC, 2018

Drug Resistance

Drug-resistant tuberculosis (TB) is a deadly communicable disease that poses a serious global health threat.  It impacts not only individual patients and their families, but also imposes tremendous burdens on overextended public health systems that may lack the resources to contain it.

  • Multidrug-resistant (MDR) refers to TB caused by Mycobacterium tuberculosis that is resistant to at least isoniazid (INH) and rifampin (RIF).
  • Pre-extensively drug-resistant (Pre-XDR) refers to MDR-TB that is also resistant to either a fluoroquinolone or a second-line injectable anti-TB drug, but not both.
  • Extensively drug-resistant (XDR) refers to MDR-TB that is also resistant to both a fluoroquinolone and a second-line injectable anti-TB drug.

-Curry International Tuberculosis Center, 2016

Contact Investigation

Conducting contact investigations (CIs) is one of the highest priorities for TB programs in the United States; second in importance only to detection and treatment of TB disease.

Contact investigations are complicated undertakings that typically require hundreds of interdependent decisions, the majority of which are made on the basis of incomplete data, and dozens of time-consuming interventions.  Making successful decisions during a contact investigation requires use of a complex, multi-factor matrix rather than simple decision trees.  -CDC, 2005

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