Get Vaccinated Measles Guidance Sign up for E-news! Reproductive Health NMHealth Helpline 988: 24/7 LIfeline
NMDOH Logo
Home Divisions Public Health Infectious Disease Bureau Tuberculosis Prevention

Tuberculosis Prevention Program

The New Mexico Tuberculosis Prevention Program’s primary mission is to prevent and control the spread of Tuberculosis, by ensuring that active TB cases receive adequate care, nurse case management, directly observed therapy, and a contact investigation if infectious. The three strategies to prevent and control TB are:

  1. Decrease the incidence of TB through timely diagnosis of active TB disease, appropriate treatment and management of persons with active TB disease
  2. Prevent and reduce new transmission of active TB by prompt investigation, evaluation and treatment of close contacts of patients with contagious TB.
  3. Advance toward TB elimination through prevention of TB among the substantial population of New Mexico residents with LTBI.

Please reference our Case Rate Data Reports for Tuberculosis case rates by county and region.


Recent Activity

News Articles

Latest

Health Data

Latest

Publications

Featured

Latest

Resources

Featured

Latest

Popular

What We Do

The New Mexico TB Program prioritizes public health resources to ensure services are available to carry out these functions, by order of priority. Our efforts are heavily concentrated on the first two strategies. Services beyond that are further prioritized and based on available resources.

The following services through NM DOH TB Programs include:

  • Evaluation, diagnosis, case management and supervision of treatment provided to individuals with presumptive or confirmed active TB disease.
  • Referral services for patients moving out or into New Mexico; ensuring continuity of care
  • Contact investigation, evaluation, and treatment of contacts with exposure to confirmed active TB cases.
  • Education and training to statewide community TB stakeholders
  • Clinical guidance and expert medical consultation services.
  • TB surveillance
  • Risk Screening and testing for other targeted high-risk populations (based on available resources)
  • Treatment of latent TB infection (LTBI) in the following high-risk populations:
    • Those with known recent exposure (i.e., within the last 2 years)
    • All children and adolescent (Children under 5 are the highest priority)
    • Pregnancy
    • HIV infected with positive TB test (TST or IGRA)
    • Persons with a history of untreated or inadequately treated TB disease, including those with fibrotic changes on the chest x-ray consistent with prior TB disease
    • Potential recipients for organ transplants
    • Recent immigrants (within the last 5 years) with positive IGRA, abnormal chest x-ray, and immune-compromising medical conditions that present a higher risk for accelerated progression to TB Disease
    • Persons experiencing housing insecurity
    • LTBI cases with complex issues maybe referred for NM DOH care. TB program staff will review and determine assistance.
Latent Tuberculosis Infection. Learn more from CDC

Referrals for LTBI treatment

The New Mexico Department of Health strongly endorses screening for latent TB infection in primary care due to the individual and public health benefits associated with identification of persons infected with TB and linkage with medical evaluation and treatment services. The 2023 United States Preventative Services Task Force (USPSTF) recommends screening for LTBI In populations at increased risk. Latent Tuberculosis Infection Screening

Currently treatment by NM DOH TB Program for Latent TB Infection (LTBI) is only available for individuals with medical conditions that present a higher risk for accelerated progression to TB disease if left untreated. Those with immune-compromising medical conditions below are encouraged to seek and complete a curative course of treatment from their Primary Care Provider (PCP) or Community Health Clinic (CHC).

  • Immunosuppressed persons receiving equivalent of ≥ 15 mg prednisone/day x1 month or more OR persons on Anti TNF/biologic drugs with a positive IGRA/TST
  • Persons with silicosis, diabetes, chronic renal failure, chronic lung disease, leukemia or cancer of the head, neck or lung
  • Cigarette smokers, persons who abuse drugs and/or alcohol with a positive IGRA/TST
  • Weight below 10% of ideal body weight, history of gastrectomy, jejunoileal bypass with a positive IGRA/TST
  • Recent (within 2 years) conversion from negative IGRA to positive IGRA result
  • LTBI cases with complex issues maybe referred for NM DOH care. TB program staff will review and determine assistance.

Key recommendations for screening patients for latent TB infection include:

  1. Use a TB Risk Assessment to identify patients at increased risk for infection. Sample Risk Assessment form
  2. Choose a diagnostic test for TB infection that is appropriate for your patient.
  3. Provide patients who test positive for TB infection with medical evaluation to rule out active TB disease.
  4. Report cases of latent TB infection or suspected/confirmed active TB disease to NM DOH.
  5. Review treatment options and focus on shorter regimens.
  6. Provide education and adherence support to assist patients in completing treatment for latent TB infection.

NM DOH TB Program is available for consultation for LTBI treatment recommendations, if needed. Consultation can be requested by calling 1-833-796-8773 or emailing doh-tb-program@doh.nm.gov (request and contact information only, do not include PHI in email).

Links to LTBI resources can be found under Resources

Healthcare providers should only refer individuals with medical conditions that increase their risk for progression to active disease. Providers must include supporting documentation for the diagnosis (i.e., physical examination, testing results, radiology reports, risk assessment) with the referral. Priority will be given to individuals at highest risk for progression to disease (as listed above) with no health insurance.

  • Please complete Referral Form which is required
  • Fax referrals to the NM DOH TB Program and program staff will contact the patient to schedule an appointment or to obtain more information. Walk-ins are not accepted.
  • NM DOH TB cannot proceed with referral services until all required documentation is received

NOTE: All referred LTBI treatment services are provided contingent on available public health resources. Treatment services may be suspended at any time. Priority will be given to individuals at highest risk for progression to disease with no little or no health insurance or have low income.

TB Reporting

The following information for all reporting must be reported to NM DOH TB Program:

  • The condition being reported
  • Patient’s name, date of birth/age, gender, race/ethnicity, address, patients telephone numbers and occupation;
  • Physician or licensed healthcare professional name and telephone number;
  • And healthcare facility or laboratory name and telephone number
  • Pertinent diagnostic information including, but not limited to results of Mantoux skin and IGRA (Interferon Gamma Assay) tests, laboratory tests, radiographic examinations, and physical examinations.

Notifiable Conditions and Diseases in New Mexico

Presumptive TB or Active TB Disease:

Persons with suspected or confirmed active TB disease must be reported to the NM DOH within 24 hours by phone at 1-833-796-8773, or by fax at 505-827-0163 in accordance with 7.4.3.13 New Mexico Administrative Code.

Latent TB Infection:

Persons with Latent TB Infection, as defined below, must be reported to the NM DOH within 72 hours by phone at 1-833-796-8773, or by fax at 505-827-0163 in accordance with 7.4.3.13 New Mexico Administrative Code.

Latent TB Infection CSTE Case Definition

  1. Positive TB Skin test or a positive interferon gamma release assay (IGRA) AND
  2. No clinical evidence compatible with TB Disease including:
    1. No signs or symptoms consistent with TB Disease by provider assessment
    2. AND Chest imaging without abnormalities consistent with TB (chest radiograph or CT scan) OR Abnormal chest imaging that could be consistent with TB Disease with microbiologic testing that is negative for MTB complex
    3. AND where TB Disease has been clinically ruled out

CSTE Definition

Frequently Asked Questions

What is TB?

TB is short for a disease called tuberculosis. TB is spread through the air from one person to another. The TB germs are passed through the air when someone who is sick with TB disease of the lungs or throat coughs, speaks, laughs, sings, or sneezes. The people near the sick person can breathe TB germs into their lungs. TB is not like many other airborne diseases. It is not easily spread to others and usually requires close contact over several hours or days.

Sites of TB Disease TB germs can live in your body without making you sick. This is called latent TB infection. This means you have only inactive (sleeping) TB germs in your body. The inactive germs cannot be passed on to anyone else. However, if these germs wake up or become active in your body and multiply, you will get sick with TB disease.

When TB germs are active (multiplying in your body), this is called TB disease. These germs usually attack the lungs. They can also attack other parts of the body, such as the kidneys, brain, or spine. TB disease will make you sick. People with TB disease may spread the germs to people they spend time with every day.

How was I exposed to TB?

You may have been exposed to TB if you spent time near someone with TB disease of the lungs or throat. You can only get infected by breathing in TB germs that person coughs into the air. You cannot get TB from someone’s clothes, drinking glass, eating utensils, handshake, toilet, or other surfaces where a TB patient has been.

What is latent tuberculosis infection?

Latent tuberculosis infection (LTBI) is when a person breathes in TB bacteria and becomes infected, but their body fights off the bacteria and keeps it from growing. The bacteria are not active inside the person's body. However, they do remain alive in the body and can become active later on.

People with LTBI have no symptoms, don't feel sick and can't spread TB to others. They usually, but not always, have a positive skin test or blood test reaction. They can develop active TB disease if they are not treated.

Many people with LTBI never develop active TB disease. The TB bacteria remain inactive for life without causing disease. However, in other people, especially people who have weak immune systems, the bacteria can become active and cause TB disease. It is important to get treated for LTBI so that it doesn't develop into active TB disease.

How do I know if I have TB infection?

If you have been around someone who has TB disease, you should go to your doctor or your local health department for tests.

There are three tests that can be used to help detect TB infection. Usually a skin test is done. A small needle is used to put some testing material, called tuberculin, under the skin. In 2-3 days, you return to the health care worker who will check to see if there is a reaction to the test. In some cases, a test called QuantiFERON-TB Gold (QFT-G) or another called the T-Spot. TB test may be used. They are blood tests that measure how a person’s immune system reacts to the germs that cause TB. You may also be asked to have a chest x-ray if either the skin test or blood test is positive, or if you have symptoms of TB disease.

How is latent TB infection treated?

Treatment of latent TB infection substantially reduces the risk that TB infection will progress to disease. Most people with latent TB infection are treated with a medication called Isoniazid for 9 months. Certain groups are at very high risk of developing TB disease once infected, and every effort should be made to begin appropriate treatment and to ensure that those persons complete the entire course of treatment.

What is the difference between latent TB infection and TB disease?

People with latent TB infection have TB germs in their bodies, but they are not sick because the germs are not active. These people do not have symptoms of TB disease, and they cannot spread the germs to others. However, they may develop TB disease in the future. They are often prescribed treatment to prevent them from developing TB disease.

People with TB disease are sick from TB germs that are active, meaning that they are multiplying and destroying tissue in their body. They usually have symptoms of TB disease. These can include a cough lasting more than 2-3 weeks, blood in your phlegm, fever, fatigue, excessive sweating at night, or unintended weight loss. People with TB disease of the lungs or throat are capable of spreading germs to others. They are prescribed drugs that can treat TB disease.

How is TB disease treated?

TB disease can be treated by taking several drugs for 6 to 12 months. It is very important that people who have TB disease 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 germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy, and helps the patient complete treatment in the least amount of time.

Why would someone need to be tested for tuberculosis?

Testing by a skin or blood test is used to see if a person has been infected with Mycobacterium tuberculosis, this bacteria causes tuberculosis. It may be required for school, work, change in immigration, to volunteer in certain facilities, or as part of a medical evaluation.

NOTE: A history of BCG vaccination does not exempt students or employees from the skin test.

What does a positive TB test result mean?

A positive skin or blood test means that a person may have been infected with TB bacteria sometime during their life. It does not indicate that a person has TB disease or is contagious.

What should a person do if they have positive TB test?

A person with a positive TB test needs a chest x-ray and/or other clinical exams to determine if the infection is active or in the sleeping phase (latent TB infection).

A person with a positive skin test and no symptoms and a normal chest X-ray has LTBI. This is NOT contagious.

A person with a positive TB test who has symptoms of TB (such as a cough greater than 3 weeks, fever, fatigue, weight loss, night sweats) is potentially contagious. This person needs further evaluation by the New Mexico Department of Health (NMDOH) and a medical provider.

The NMDOH TB Program CANNOT provide:

  • Routine TB skin testing for work or school requirements
  • TB testing or chest X-rays for immigrants changing their status
    • This is an elective activity and the services are provided through the civil surgeon (see the USCIS Civil Surgeons Locator).

Where can I obtain a TB test for work or school?

The NMDOH TB Program CANNOT provide:

  • Routine TB skin testing for work or school requirements
  • TB testing or chest X-rays for immigrants changing their status
    • This is an elective activity and the services are provided through the civil surgeon (see the USCIS Civil Surgeons Locator).
  • Your health care provider can offer testing for people that need a TST for school or work requirement.
  • Some pharmacists have the ability to place and read TB skin tests. Contact your local pharmacy for more information, including availability and cost.

What is the cost for TB services provided through the NMDOH?

There is no charge for any TB services for TB cases, their contacts, and persons with latent TB infection.

Do students in New Mexico schools need a tuberculin skin test?

No. The American Academy of Pediatrics (AAP) recommends that physicians routinely assess a child's risk of TB exposure with a questionnaire and offer TB testing only to at-risk children. The AAP does not recommend routine testing of children with no TB risk factors for school entry, day care attendance, WIC eligibility, or camp attendance.

Children who have a positive TB test but no symptoms of TB disease should not be kept out of school while they are being evaluated for treatment of latent TB infection.

Do all employees in New Mexico schools need a tuberculin skin test?

No. There is no statewide requirement for teachers or other school employees to have a TB screening test. The Centers for Disease Control (CDC) discourages the use of TB testing for persons who have no risk factors for TB exposure.

How often do health care workers need a tuberculin skin test?

The New Mexico Department of Health (NMDOH), in partnership with the National Tuberculosis Controllers Association (NTCA) and Centers for Disease Control and Prevention (CDC), recommend that both paid and unpaid health care workers should receive a two-step tuberculin skin test when they start work in a health care setting unless they have documentation of a negative tuberculin skin test result within the last twelve months or documentation of a positive tuberculin skin test result at any time in the past. The frequency with which they receive additional tuberculin skin tests should be determined by the risk of exposure to persons with active TB disease in their work setting.

New Guidelines for testing Healthcare workers can be found here.

Are routine chest x-rays recommended for health care workers, patients, or institutional residents with a history of a positive tuberculin skin test result?

No. People who have a positive tuberculin skin test result should not have repeat chest radiographs performed routinely. Health care workers, patients, or institutional residents with a baseline positive or newly positive tuberculin skin test result should receive one chest radiograph to exclude a diagnosis of TB disease. Repeat radiographs are not needed unless signs or symptoms of TB develop, or a clinician recommends a repeat chest radiograph, or after a new exposure to M. tuberculosis. On a regular basis, the person in charge of infection control for their work area or facility should ask about any signs or symptoms of TB disease. The frequency of their symptom screen should be determined by the risk assessment for the facility.

Health care workers who have a previously positive TB screening test result and who change jobs should carry documentation of the results, chest radiograph, and documentation of treatment history for latent TB infection, if applicable, to their new employers.

Can I go to work with a positive TB test?

Yes, if your chest x-ray is normal and you do not have symptoms of TB.

Do I need to go through the Health Department to get TB clearance?

No, your private health care provider can give you clearance.

Do I need to get yearly chest x-rays if I have a positive TB test?

No, the CDC recommends chest x-rays only when:

  • You have your first positive TB skin test
  • You have symptoms of TB disease

What if I or one of my family members is diagnosed with TB?

Once a patient is referred to the NMDOH as a TB case or suspicious of having TB , a nurse case manager is assigned to that patient. The patient is started on TB treatment as indicated per the NMDOH TB medical consultant. TB medications and follow up are provided at no charge to the patient. The best way to reduce the burden of TB in a community is to ensure that each TB case receives a full course of treatment. The CDC recommends treatment for active TB disease be administered via directly observed therapy in which a health department worker observes the patient take each dose of TB medications. Directly observed therapy is the standard of care for TB treatment and the directly observed therapy requirement applies to all TB patients.

What is the role of the health department in investigating TB transmission among contacts to TB cases?

The NMDOH nurse case manager will work with the patient to learn the names and contact information of persons who may have been exposed (e.g., those who live or work with the patient, spend a lot of leisure time with the patient, etc.). These people are called contacts. The nurse case manager will get in touch with the contacts while maintaining patient confidentiality and make arrangements for them to be evaluated, usually with a TB test, a symptom review, and if indicated, a chest x-ray, at the health department at no charge.

What is the role of the health department in managing treatment of TB cases?

TB is a communicable disease of public health significance. Department of Health staff are active in the management of each case of TB.

I am a contact of a TB patient. What do I need to do now?

Call a local Public Health Office to ask for an appointment for an evaluation as a TB contact. If you received a letter bring it with you to the health department. The NMDOH will determine what testing is needed.

I had a positive TB test after contact to a TB patient. What do I need to do now?

Discuss the result with your healthcare provider.

Case Rate Data Reports