Division of Public Health Services  Disease Handbook for Childcare Providers 
Bureau of Infectious Disease Control   REVISED –January 2018 
TUBERCULOSIS 
 
Tuberculosis (TB) is a disease caused by a certain 
type of bacterium. A person who is sick  with 
active tuberculosis disease may spread the germ 
when they cough or sneeze.  If others inhale the 
bacteria from the air, they may become infected .  
But not everyone who is exposed will become 
infected.  A person with Latent TB infection does 
not feel sick and cannot spread the germs to 
others. 
 
Does infection mean you will be sick? 
No.  Many people were infected with TB many 
years ago when the dise ase was very common.  
Only 5-10% of people who are infected will ever 
get the disease unless they have an impaired 
immune system. 
 
What is a TB  test? 
A skin test is a method of determining if a person 
has been infected with the TB germ.  A positive 
TB ski n test reaction, however, does NOT 
necessarily mean the person has TB disease.  
 
Like the skin test there is a blood test that can test 
for tuberculosis infection. This test is often called 
an IGRA (Interferon gamma release assay). The 
IGRA does not diagnose active TB disease.  The 
IGRA is currently not recommended for children 
under two. 
 
How is the test given? 
For the skin test--a small amount of PPD (purified 
protein derivative) is injected just under the 
surface of the skin on the fore arm.  In 48 to 72 
hours, a healthcare provider or nurse will read the 
test by inspecting the skin. 
The IGRA is a simple blood draw and there is no 
return visit for reading necessary and a doctor will 
help determine the results. 
  
 
Who should have tuberculosis test? 
Persons who have been exposed to an active case 
of TB, persons born in a foreign country (where 
TB is common), people infected with HIV 
(human immunodeficiency virus), healthcare 
workers and pre-school age childcare staff.  It is a 
law that persons with a positive IGRA be reported 
to the Bureau of Infectious Disease Control. 
Persons who have a documented positive reaction 
to a TB skin test do not need repeat skin tests.  All 
persons with a positive skin test or a positive 
IGRA should be evaluated yearly for signs of  
active disease.   
 
How can TB be prevented? 
People who have a positive reaction to a TB skin 
test or a positive IGRA can prevent disease by 
taking medications. 
 
Who should be excluded? 
A person with a positive TB skin test or positive 
IGRA should have a m edical examination and a 
chest x-ray and discuss with a healthcare provider 
about taking preventive therapy.  Persons 
diagnosed or suspected to have  active TB disease 
should be reported immediately to the Bureau of 
Infectious Disease Control and should be 
excluded from attending or working in a childcare 
center until they are determined to be non-
infectious by both a healthcare provider and the 
Bureau of Infectious Disease Control. 
 
Reportable? 
Yes.  Suspect and cases of active t uberculosis and 
persons with a positive IGRA are reportable by 
New Hampshire law to the Division of Public 
Health Services, Bureau of Infectious Disease 
Control at (603) 271-4496.