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Maricopa County Department of Public Health (MCDPH) has identified a cluster of genetically related infectious tuberculosis (TB) cases among Maricopa County residents experiencing homelessness. First identified in 2024, the cluster continues to expand with several new cases of genetically linked active TB. MCDPH is working to identify and notify anyone who may have been exposed to persons in this cluster. Healthcare providers should be aware of this cluster and should consider TB in the differential for clinically compatible cases, especially among individuals with unstable housing. Early recognition, prompt testing, and timely treatment of both latent TB infection and active TB disease are critical to interrupting transmission and protecting the health of our community.
It is recommended that Maricopa County providers:
- Consider tuberculosis in the differential of a clinically compatible case, especially when evaluating an individual with unstable housing and other risk factors (see below for clinical presentation and laboratory testing guidance).
- Minimize exposures of symptomatic patients to clinical staff utilizing the infection control guidance within the Infection Control at Health Care Facilities section below.
- Ensure patients under evaluation are appropriately isolated from others.
Tuberculosis Laboratory Testing:
- Initial testing includes a blood test (Interferon-Gamma Release Assay or IGRA).
- Chest x-ray and/or sputum for AFB smear and culture are recommended if a patient screens positive with the IGRA and/or present clinical tuberculosis symptoms associated with active disease.
- For suspect tuberculosis cases, call (602) 506-8282 to report and/or coordinate with MCDPH for recommendations for evaluation.
- The CDC/CSTE defines a tuberculosis suspect as any person for whom a healthcare provider suspects active tuberculosis (TB) based on symptoms (e.g., chronic cough, fever), radiographic evidence, or laboratory findings.
Immediately report suspect cases of tuberculosis to Maricopa County Department of Public Health by calling (602) 506-8282
Clinical Presentation of Tuberculosis:
Symptoms of TB depend on which part of the body is infected with the bacteria. TB bacteria typically grow in the lungs (pulmonary TB), causing the following symptoms:
- Cough lasting longer than 3 weeks
- Coughing up blood or sputum (phlegm from deep in the lungs)
Other general symptoms of TB disease include:
- Extreme tiredness or fatigue
- Fever
- Night Sweats
- Weight loss
- Decreased appetite
- Swollen lymph node/glands
Symptoms of TB disease may vary depending on parts of the body affected. Performance of AFB smears and cultures of the affected tissue/body fluid are the gold standard for TB diagnosis.
Transmission:
TB is spread by airborne transmission. Infectious droplets are generated by persons with active pulmonary TB and can be spread through coughing, talking, or singing.
Infection Control at Health Care Facilities:
Health care providers should exercise caution when evaluating persons suspected of TB disease by immediately isolating the patient in a negative pressure room away from others and should wear appropriate personal protective equipment (PPE) during patient interactions.
The following steps are recommended to prevent tuberculosis transmission in health care facilities:
- Do not allow suspect tuberculosis patients to remain in the waiting area or other common areas.
- Immediately isolate them in an airborne isolation, negative pressure room.
- For all known TB suspects, they MUST be seen in an airborne isolation negative pressure room with staff wearing a fitted N-95 or CAPR/PAPR and patient wearing a surgical mask.
Resources:
Thank you for your continued collaboration and partnership.
Maricopa County Department of Public Health
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