Frequently Asked Questions


Question Answer
What do I do if I think I have Tuberculosis (TB)? Contact your doctor or your local health department and discuss your symptoms and exposure to TB. They will want to do either a skin test or blood test. Depending on the results of that test they will do a chest x-ray. They may also collect three sputum samples 8 hours apart. The results of these tests will let them know if you have TB disease or TB infection.
If you have TB Disease, you are infectious and can spread the bacteria to others. You will be treated with a four-drug regimen for at least 6 months. If you have TB Infection you are not infectious and can NOT spread the bacteria to others. Talk to your doctor or the health department about your treatment options. Treatment will take 3-9 months depending on which option you choose. Getting treatment for LTBI will keep you from developing TB disease in the future, unless exposed to TB disease again.
What is the difference between TB disease and Latent TB infection (LTBI)? Please go to the CDC website for this information.
https://www.cdc.gov/tb/topic/basics/tbinfectiondisease.htm
How did I get Tuberculosis? TB bacteria are spread through the air from one person to another. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, speaks, or sings. People nearby may breathe in these bacteria and become infected.

TB is NOT spread by
  • shaking someone’s hand
  • sharing food or drink
  • touching bed linens or toilet seats
  • sharing toothbrushes
  • kissing

When a person breathes in TB bacteria, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.

TB disease in the lungs or throat can be infectious. This means that the bacteria can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.

People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers or schoolmates.

Is there a cure for TB Disease? Yes, when caught in time, most people will be given medication for at least 6 months but will be cured of TB Disease. It is important that you keep your directly observed therapy (DOT) appointments and take all your medication, even if you feel well.
What is a TB Blood test (IGRA)? A TB blood test is a test that uses a blood sample to find out if you are infected with TB bacteria. The test measures the response to TB proteins when they are mixed with a small amount of blood. Examples of these TB blood tests include QuantiFERON®-TB Gold (QFT) and T-Spot®.TB test.  Other tests will be needed to find out if you have latent TB infection or TB disease
What is a TB Skin test? A TB skin test is used to find out if you are infected with TB bacteria. A liquid called tuberculin or PPD is injected under the skin on the lower part of your arm. If you have a positive reaction to this test, you probably have TB infection. Other tests will be needed to find out if you have latent TB infection or TB disease.
I had a positive skin test/IGRA and a negative CXR, what does that mean? Having a positive skin or blood test and a negative or normal chest x-ray means that you have Latent Tuberculosis infection (LTBI). You are not contagious but should talk to your doctor about treatment options.
Where can I find out more information on Latent Tuberculosis Infection (LTBI) and Active Tuberculosis (TB)? Visit our Resources page for a full list of TB resources in the US and globally
Can I change to a different Latent Tuberculosis Infection (LTBI) treatment regimen after I start treatment? Changing regimens during LTBI treatment can be necessary for various reasons, including medication tolerance issues (side effects, elevated liver enzymes, etc.) and barriers to adherence. There are no rules against changing LTBI treatment regimens, but the pros and cons of changing regimens should be carefully considered with a medical provider or nurse to ensure the new regimen will be effective and to decrease the risk of developing drug resistance. 
Question Answer
Is a skin test required on a new hire? What are the requirements for annual testing of employees? The answer is dependent upon whom licenses your facility.  There are no specific TB statutes in Kansas that govern TB control activities in health care facilities but there are licensing regulations that are set for specific requirements that must be in policy. You would need to talk to your licensing surveyor.
What are the Active Disease Stats for Kansas? Historic state and national rates can be found here through the CDC.  For current state and county specific data for facility risk assessments call 785-296-5589 or 785-296-0739
Question Answer
What days are Medications and PPD Shipped? Shipping days are Monday, Tuesday, and Wednesday unless disrupted by state/Federal holidays or otherwise determined by the TB Control Program.
How do I track my medication or PPD order? Please contact Maddisen Rivera, Bureau of Disease Control & Prevention Senior Administrative Assistant (Maddisen.Rivera@ks.gov or 785-296-0352) or the TB Control Program for information on tracking your shipment.
How much medication will I get per order? Unless otherwise requested/specified, typically only one bottle of each requested medication is shipped. So, if ordering Isoniazid, your facility would receive one 100 count bottle per patient listed on the medication order form. If you wanted 3 bottles at once (enough to cover a 9 month regimen) you need to specify 3 bottles on the order form. The TB Program reserves the right to limit the amount of medication provided to a facility at anytime and for any reason (e.g. medication shortages, impending medication expiration dates etc.)
Can I give the patient a whole bottle of medicine to take home? This depends on if the patient is LTBI or Active TB and which medication regimen they are taking.

For LTBI:
The following medications can be dispensed as a 30 day supply:
  • Rifampin
  • Isoniazid
  • Vitamin B6
For LTBI OR Active TB:
The following medications should be dispensed one dose at a time at the patient’s DOT appointment:
  • 3HP (Isoniazid & Rifapentine)
  • RIPE Therapy for Active TB
    • Rifampin
    • Isoniazid
    • Pyrazinamide
    • Ethambutol
  • Any other medication for Active TB Treatment
What are the approved treatments for Latent Tuberculosis Infection (LTBI)? The Center for Disease Control and Prevention (CDC) have approved four treatment regimens for LTBI:
  • Rifampin daily for 4 months (4R)
  • Isoniazid & Rifapentine once weekly for 12 weeks/3 months (3HP)
  • Isoniazid & Rifampin daily for 3 months (3HR)
  • Isoniazid daily for 9 months (9H)
Of these four regimens, the State of Kansas will provide the following three regimens free of charge to the patient:
  • Rifampin daily for 4 months (4R)
  • Isoniazid & Rifapentine once weekly for 12 weeks/3 months (3HP)
  • Isoniazid Daily for 9 months (9H)

Isoniazid & Rifampin daily for 3 months is still considered an appropriate treatment and may be utilized by providers, but due to the risk of developing drug resistance if taken inappropriately, the State of Kansas has chosen not to offer this treatment through the TB Control Program at this time. Any patient wishing to utilize this treatment will have to obtain the medication from their local pharmacy. 

What dose of medication should my patient receive? Medication dosing as recommended by the Center for Disease Control (CDC) is based on weight in kilograms (kg) and patient age. Dosing information can be found through the following website links:

LTBI: https://www.cdc.gov/tb/topic/treatment/ltbi.htm
Active TB: (Dosing guidance is listed in table 3 of the MMWR) https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5211a1.htm#tab1
When is Directly Observed Therapy (DOT) required? Any patient on treatment for active TB disease or 3HP (Isoniazid & Rifapentine) is expected to receive DOT for the duration of treatment. DOT ensures compliance, monitoring for adverse events, and encourages treatment completion.
Can I or my facility do Video Directly Observed Therapy or Electronic Directly Observed Therapy? Yes, VDOT/EDOT is an approved method for DOT in Kansas, however, VDOT/EDOT must be performed in a HIPAA compliant platform AFTER a patient has demonstrated willingness to adhere to the medication regimen.  For active TB disease patients, VDOT/EDOT cannot begin until the patient has completed the initiation/intensive phase of treatment (i.e. after 40 DOT doses).
Why do IGRA indeterminant results occur? Indeterminate results may occur due to:
  • Deviations from the procedure described in the package insert
  • Incorrect transport/handling of blood specimen
  • Elevated levels of circulating IFN-γ or presence of heterophile antibodies
  • Exceeding validated blood times from blood specimen draw to incubation:
    • Blood samples collected directly into QFT-Plus Blood Collection Tubes stored longer than 16 hours at room temperature (17–25°C).
    • Blood samples collected in lithium-heparin tube stored longer than 12 hours at room temperature (17–25°C) prior to transfer to QFT-Plus Blood Collection Tubes.
Blood samples collected in lithium-heparin tube for refrigeration stored outside temperature and time ranges included in “Lithium-Heparin Tube Refrigerated Storage and Handling” procedure
If a person has a positive skin test or positive blood test and a negative chest x-ray, do they need to be reported to the state? Yes. A positive TST or IGRA and a negative Chest x-ray means that the person has Latent TB Infection and should be reported to the state and the local county health department. It is highly recommended that the person receive treatment to insure they don’t breakdown to disease later.
What if a person has been vaccinated with BCG? BCG is a vaccine for TB. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG vaccine does not always protect people from TB.
Persons who were vaccinated with BCG, may have a positive reaction to a TB skin test. This reaction may be due the BCG vaccine itself or to a real TB reaction. But one’s positive reaction probably means that they have TB infection if:
  • The skin test reaction is large
  • The BCG vaccine was administered many years ago
  • The person has ever spent time with a person with infectious TB
  • Someone in the person’s family has had TB
  • The person is from a country where TB disease is very common (most countries in Latin America, the Caribbean, Africa, and Asia except for Japan)
It is recommended that a person with a BCG vaccine, take an IGRA (QFT or T-Spot) to avoid a false positive skin test.
Who can enroll in TB Care (TB Medicaid)? Anyone that has been diagnosed with TB Disease or is being ruled out as having TB Disease and does not already have insurance or Medicare/Medicaid coverage.
How do I get an old case opened in Epitrax? Contact the TB Control Program via phone at 785-296-5589 or 785-296-0739 or via HIPAA compliant email to have previously closed cases reopened or to obtain legacy case records.
What is a “Legacy Case” and how do I access the case information? “Legacy Cases” are TB or LTBI cases from our previous state tracking systems (HAWK or EDSS).  When the State of Kansas moved to Epitrax as our disease reporting system, the case numbers from the old systems were moved, but not the case information.

To obtain copies of these legacy records, contact the TB Control Program via phone at 785-296-5589 or 785-296-0739 or via HIPAA compliant email.

Where do I find the Disease Investigation Guidelines (DIG)? The DIG can be found at https://www.kdheks.gov/epi/disease_investigation_guidelines.htm
Under Tuberculosis.