Public Health

Tuberculosis (TB) is a communicable disease caused by Mycobacterium tuberculosis, primarily affecting the lungs but capable of impacting other parts of the body. TB is transmitted through the air when a person with active TB disease of the lungs or throat coughs, sneezes, speaks, or sings—releasing infectious droplets that may be inhaled by others.

TB transmission is more likely in congregate settings or environments where individuals live in close quarters. Individuals with compromised immune systems are at significantly higher risk of infection and disease progression. Although TB is treatable with antibiotics, the emergence of drug-resistant strains presents ongoing public health challenges and underscores the importance of timely intervention and treatment adherence.

Tuberculosis may be present as either an active TB or latent TB infection (LTBI). It’s important to distinguish between active and latent tuberculosis to guide appropriate prevention and treatment strategies. Active TB occurs when the bacteria that cause TB are actively multiplying in the body, typically causing symptoms such as coughing, fever, weight loss, and night sweats. People with active TB can spread the disease to others, especially through the air when they cough or sneeze. Active TB is a Category I disease in Wisconsin, requiring prompt public health intervention to prevent spread. In contrast, latent TB means a person is infected with the TB bacteria, but the bacteria are inactive and not causing symptoms. Individuals with LTBI are not contagious. However, they are at risk of developing active TB later if their immune system becomes weakened. Identifying and treating LTBI, a Category II disease in Wisconsin, is critical to controlling TB in the community.

Timely communication between medical providers, local public health departments, and the Wisconsin Department of Health Services Tuberculosis Program is critical to the effective management and control of TB.

As required by Wisconsin state law:

• All suspected or confirmed active TB cases must be reported to local public health authorities within 24 hours of identification.
• All follow-up visits related to TB care and management must also be reported to ensure ongoing coordination and support.

This mandatory reporting enables local and state public health partners to:

• Facilitate timely case management and contact investigations
• Provide treatment support and directly observed therapy (DOT) when needed
• Monitor for drug resistance and treatment adherence
• Prevent community transmission

We appreciate your continued partnership in safeguarding the health of our community.

Clients who have insurance and minimal barriers to health care can have their latent TB infection treatment prescribed and managed by their provider. Any client who is prescribed a treatment regimen for latent TB infection and is not case managed by the Public Health Department should still have their treatment status reported to our TB program per state statute.

For uninsured patients & those with financial hardship, the Public Health Department can administer a free medication regimen from the WI TB Program if a provider assists with performing a chest X-ray and ordering an appropriate treatment regimen.

The Public Health Department may work with the WI TB Dispensary to help cover the client’s co-pay or deductible. Please include PHARMACY benefit/PRESCRIPTION insurance information and a photo of insurance card to any documents sent to the Public Health Department.

* The definition of financial hardship is achieved if the cost of medications, insurance deductible, or co-pay is high enough to be a deterrent to seeking medical care or adhering to treatment.

Clinicians and laboratories must report:

• Clinical suspicion of TB (Pulmonary or Extrapulmonary)
• A smear from any site that is positive for acid-fast bacilli (AFB)
• A nucleic acid-based assay positive for M. tuberculosis complex
• A positive culture for M. tb complex
• Biopsy, pathology, or autopsy findings consistent with active TB
• A patient being treated with anti-TB medications for suspected or confirmed TB
• Any positive screening test for TB (TB Skin test or TB Blood test/IGRA such as Quantiferon Gold, Quantiferon, and T-SPOT)
• Any patient being treated with anti-TB medications for Latent TB Infection
• Any patient who has finished treatment for Latent TB Infection

Outpatient Follow-Up

Clinicians are required to report:

• Continuation, discontinuation, completion and other outcomes of patient treatment (for Active OR Latent TB).
• Contacts of active TB cases who are receiving treatment for TB Infection.

• Patients with confirmed or suspected cases of active TB in the City of Racine must be reported to us within 24 hours of diagnosis.
• People with latent TB in the City of Racine must be reported to us within 72 hours.
• Any follow-up on people with active, suspected or latent TB must also be reported to us. This includes starting treatment AND completing treatment.