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TB Information for Health Providers

General Information:

Tuberculosis Health Brief Santa Clara County, 2013



December 11, 2013: UPDATE: Deferment of Public Health Mandate for Tuberculosis Testing in Santa Clara County Schools

Santa Clara County Health Department TB Symptoms Review and Risk Factor Assessment Form

August 28, 2013: School Mandate Deferred until Further Notice

September 18, 2013: Tuberculin Shortage FAQ


Reporting TB to the Health Department:

The Santa Clara County Tuberculosis (TB) Control Program provides consultation, directly observed therapy, case management and clinical services for patients with TB infection and/or disease.  A Public Health Nurse case manager is assigned to each active TB case to investigate who has been exposed, provide testing and follow-up of contacts, assess the sites of potential transmission, promote patient adherence, and ensure patients tolerate TB treatment.  Public Health Nurse case managers oversee the care of active TB patients and their contacts until completion.
Any confirmed or suspected case of active TB disease is required by law to be reported to TB Control within one working day. DO NOT wait for laboratory results to confirm the diagnosis prior to reporting. Cases can be reported by telephone at (408) 885-4214, or fax at (408) 885-2331. Please use the form below.
GOTCH Law for All Patients in Healthcare Facilities:
All active or suspect TB patients being discharged from the hospital or transferred to another healthcare facility or congregate setting require prior approval by TB Control. A GOTCH Form must be completed and approval obtained from the TB Controller or Health Officer prior to discharge or transfer. TB Control has 24 hours to review a GOTCH form, to expedite, review and obtain approval please submit an initial GOTCH as soon as a patient is considered a TB suspect or is confirmed to have TB.  When a GOTCH is received, a Public Health Nurse Case Manager is assigned and begins the evaluation of the household to ensure a safe transition home for patients and their families.
The following documentation is routinely requested prior to GOTCH approval. Please provide as soon as possible to facilitate discharge:  Physician notes (including Infectious Disease Consult notes, if any), Medication list (including non-TB medications), TB medication dosages, Radiology (Chest X-ray reports, CT reports), diagnostic testing for TB (i.e. including acid fast bacilli smears, cultures, molecular tests if available and pathology), Laboratory tests: HIV, Hepatitis B (anti-HBc, anti-HBs), and Hepatitis C.  
Reporting: Frequently Asked Questions:
Why do you report?
Because it is the law. Reporting of all patients with confirmed or suspected Tuberculosis is mandated by the State Health and Safety Codes (HSC) Division 105, Part 5 and Administrative Codes, Title 17, Chapter 4, Section 2500 and must be done within 1 day of diagnosis.
The TB Control Program performs many vital functions to ensure public health and safety. These functions include contact investigation, home visits, patient education, patient compliance assessment and directly observed therapy (DOT).
Tuberculosis Control staff also will assist in facilitating appropriate discharge planning. Health and Safety Code section 121361 also mandates that, prior to discharge, all tuberculosis suspects and cases in hospitals and prisons have an individualized, written, discharge plan approved by the Local Health Officer (i.e. TB Controller).
Who must report?
1. All health care providers (including administrators of healthcare facilities and clinics) in attendance of a patient suspected to have, or confirmed with, active tuberculosis, must report within 1 working day from the time of identification (California Code: Title 17, Chap. 4, Sec. 2500).
2. The director of any clinical lab or designee must report laboratory evidence suggestive of tuberculosis to the Health Department on the same day that the physician who submitted the specimen is notified (California Code: Title 17, Chap. 4, Sec. 2505).
When do you report?
1. When the following conditions are present:
  • signs and symptoms of tuberculosis are present, and/or
  • the patient has an abnormal CXR consistent with tuberculosis, or
  • the patient is placed on two or more anti-TB drugs
2. When bacteriology smears or cultures are positive for acid fast bacilli (AFB)
3. When the patient has a positive culture for M. tuberculosis complex (i.e., M. tuberculosis, M. bovis, M. canettii, M. africanum, M. microti).
4. When molecular testing (i.e. polymerase chain reaction tests (PCR) or Nucleic Acid Amplification Tests (NAAT) is positive for Mycobacterium tuberculosis complex.
5. When a pathology report is consistent with tuberculosis (i.e. shows granulomas)
If a known TB patient is readmitted to the hospital, do I still need to submit a GOTCH?
YES. A GOTCH is required any time a confirmed or suspect TB case is discharged from or transferred from a health facility, this includes hospitals, nursing homes, rehabilitation facilities, and all congregate settings (including jails).
How do you report?
The Confidential Morbidity Report (CMR) should be used for patients in the outpatient setting. GOTCH form is used for hospitalized patients. 
1. BY FAX: (408) 885-2331
2. BY PHONE: (408) 885-4214: After hours, leave your name, phone or pager #, patient’s name, DOB and  medical record number on voicemail.
Clinical consultation:
During business hours, please call the main line at: (408) 885-4214, after business hours please call County Communications and ask for the Health Officer On-Call: (408)998-3438
New CDC Mobile App for Latent TB Infection
The Division of Tuberculosis Elimination’s Communications, Education, and Behavioral Studies Branch is excited to announce the release of the Latent TB Infection (LTBI): Guide for Diagnosis and Treatment mobile application for health care providers. The mobile application was designed to make it easy to view CDC’s latest LTBI recommendations on an iPad, iPhone, or iPod Touch. (An Android version will be added in a future update.) When your device is connected to wireless or cellular service, the content is updated automatically to ensure you always have the most up-to-date information.

This application serves as a ready and useful reference that highlights the main points of key guidelines for diagnosis and treatment of latent TB infection.
Check out these features:
  • CDC guidelines on latent TB infection
  • Treatment table outlining regimen options
  • TB testing and diagnosis recommendations
  • TB education and training resources
  • Sample documentation forms for TB testing
  • Personalize your experience with highlighting, annotation, and bookmark options
  • Share the content with others through social media, such as Facebook and Twitter
Download it free from the App Store: 
Tuberculosis (TB) Prevention and Control Program
Public Health Department
976 Lenzen Avenue, Suite 1700
San Jose, CA 95126
Phone: 408-885-4214
Fax: 408-885-2331

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