May 2025

🔍Did You Know (DYK)? 

NTIP Indicator of the Month – Known HIV Status

DYK the National Tuberculosis Indicators Project (NTIP) is a web-based tool that utilizes nationally set indicators to measure program progress toward achieving the National Tuberculosis (TB) Objectives. Using NTIP indicator reports, TB program officials prioritize prevention and control activities, as well as program evaluation. This month, the WA DOH TB Program is focusing on documentation of known human immunodeficiency virus (HIV) status for patients with TB disease.

For patients suspected of having or diagnosed with TB and no known history of HIV infection, counseling and testing for HIV should not be based on risk and should instead be a TB standard of care for all (regardless of age). When discussing the importance of testing for HIV either with health care providers or patients, frame HIV testing as part of the standard panel of initial tests for all persons with TB disease.

Why focus on this indicator? Diagnosed and undiagnosed Stage 3 HIV (AIDS) can present challenges for the treatment of TB. People with HIV are at increased risk of becoming sick with TB disease, TB disease may be more difficult to diagnose, and there are many additional treatment considerations including polypharmacy, potential for immune reconstitution inflammatory syndrome, paradoxical worsening, extended treatment length, and a potential for post-treatment surveillance.

Washington State has consistently been above the national average for documenting HIV test results in patients with TB disease for the past four (4) years and almost reached the 2030 target of 98% in 2024. This means a consistently high percentage of patients with TB have a documented HIV test result yet there is still room for improvement to meet or exceed targets by promoting HIV testing as a part of the standard panel of initial tests for all persons with TB disease.

Questions about NTIP? Reach out the WA DOH TB Program at tbservices@doh.wa.gov.

Information for Local Health Jurisdictions (LHJs)

📅 Health Resources & Services Administration (HRSA) 340B TB Annual Recertification

The annual HRSA TB Entity recertification period began on Monday, May 5th and will continue through Monday, June 2nd. Without recertification, the WA DOH TB Program will not be able to coordinate shipment of TB medications purchased using the 340B discount to your LHJ.

As of the publishing of this Newsletter, most of the LHJs' TB Programs are now recertified for 2025, but there are a few remaining that need to complete the process.

• For most LHJs, WA DOH TB Program may reach out for some information, but the recertification will be handled on your behalf. Please respond as soon as possible if you receive a question from us.

• For a few LHJs whose Authorizing Official is at the LHJ, the WA DOH TB Program sent an email with the information needed to complete the recertification accurately. Please reach out to tbservices@doh.wa.gov if you have any questions.

Thank you to everyone assisting to make this year's recertification smooth. 

🆕2024 Cohort Review Report

The 2024 Cohort Review Report is now available on the TB Partners Data Resources SharePoint page! This document summarizes Cohort Review sessions in 2024 and identifies key takeaways from the following discussion topics:

• TB Disease Treatment Initiation & Completion
• Turnaround Time for Culture & Nucleic Acid Amplification Test (NAAT)
• Drug Susceptibility Testing (DST) Results
• Contact Elicitation & Examination
• Class B LTBI Treatment Initiation & Completion

Moving forward, Cohort Review will occur once a year in the fall, aligning with staff bandwidth while still honoring feedback that has been received. The DOH TB Program highly encourages LHJs to utilize the NTIP snapshot report and accompanying materials to guide an internal review of practices, aiming for the best possible patient outcomes.

The WA DOH TB Program will be reaching out to participating LHJs shortly to start scheduling Cohort Reviews for this fall. If you have any questions, please reach out to tbservices@doh.wa.gov.

📢Electronic Disease Notification (EDN) Message: Limited Data Entry for Paper Documents

Important Update for EDN Users

EDN is currently facing delays of 2-3 months in processing notifications for certain visa types, due to limited capacity at the Data Entry Center. Effective May 7th, the Data Entry Center will only enter information from DS 2054 and DS 3030 forms for certain visa types. Any lengthy remarks will display a "View Scanned Docs" message, but users will still have access to all relevant scanned documents for clinical management. More information here.

🎉Changes at the King County Pharmacy Congratulations and thank you to Cheryl Cole, the Public Health-Seattle and King County pharmacy technician, who is retiring on June 4th! A new pharmacy technician will begin training with Cheryl after their onboarding on May 12th.

💊Changes to DOH TB Medication Formulary Due to the current high cost of rifabutin (Mycobutin) and the state projected budget shortfall, the WA DOH TB Program is planning to remove rifabutin from the TB medications offered without cost to LHJs.

Beginning July 1st, the WA DOH TB Program will no longer be maintaining a stock of rifabutin. The current supply on the shelf may be ordered and communication will be sent out when the stock is gone.

The WA DOH TB Program will continue to monitor rifabutin for any price reductions and the opportunity to resume offering this medication.

If in the meantime there is an emergency need, please reach out to the WA DOH TB Program via email (tbservices@doh.wa.gov) to discuss. One-off rifabutin purchases based on need may be considered.

🔄New and Updated TB Program Resources TB Partners SharePoint *New* Civil Surgeon Quick Guide (PDF) *New* Class B1 Quick Guide (PDF) TB Case Management Tracker (PDF) NTIP Guide (PDF)

DOH TB Website

• LTBI Treatment Quick Reference Sheet (PDF)
• Who May Administer, Read and Interpret a Tuberculin Skin Test (TST) in Washington State (PDF)
• Tuberculosis Cases Statewide by Year, 2020 – 2024 (PDF)

📅SAVE THE DATE: TB Virtual LHJ Workshop Series Mark your calendars!    The WA DOH TB Program is excited to announce that we will be hosting a series of virtual events this summer for LHJ TB partners, every Wednesday in the month of June (6/4/25, 6/11/25, 6/18/25, 6/25/25). Sessions will be shorter than a typical LHJ workshop (two to four hours), and will cover updates, training, and collaboration opportunities specific to tuberculosis.

A formal agenda, timeslot details, and registration information will be coming soon so you can save the date(s) for sessions that best align with your role. We will record sessions as permitted by the presenters and post the recordings on TB SharePoint should you be unable to attend a session of interest. Teams meeting information for these sessions will be sent out via GovDelivery the week of May 19th - 23rd. Please keep an eye out!

💼 Job Opportunities in Lewis County, WA

Lewis County has several openings, including Emergency Preparedness Coordinator and Epidemiologists positions.

Upcoming Events and Education Opportunities

April - August 2025 | Supporting Newcomer Health Workshop: Enhancing Your Skills with Interpreters

The Minnesota Center of Excellence in Newcomer Health, in collaboration with the University of Minnesota Department of Medicine, is inviting interested health care professionals working with newcomers in clinical settings in dentistry, medicine, nursing, public health, social work, and other professions to a two-hour online simulation-based workshop. This interactive workshop is designed to build capacity in the area of working with interpreters for interprofessional team members. More information here. 

May 12, 2025 | Palliative and End of Life Care of Immigrants and Refugees

This Minnesota Center of Excellence in Newcomer Health webinar will include demographic trends, disparities, and healthcare barriers in palliative and end-of-life care. Register here. 

Innovations in Tuberculosis (TB) Webinar Series

This Mayo Clinic Center for TB monthly webinar series offers healthcare professionals the latest insights in TB.

• May 22, 2025: Differential Diagnosis of TB and Non-TB Mycobacterial (NTM)-related Lung Infections
• June 26, 2025: Unique and Emerging Aspects of Pediatric Tuberculosis

Tuberculosis Civil Surgeon Webinar Series

This Mayo Clinic Center for TB webinar series provides civil surgeons with knowledge and skills in the management of tuberculosis screening, testing, and treatment for individuals who are seeking admission into the United States.

• May 14, 2025: Interpreting IGRA Results: Advanced Insights for Civil Surgeons
• May 22, 2025: Differential diagnosis of TB and Non-TB mycobacterial (NTM)-related Lung 

May 30, 2025 | Preventing Tuberculosis in Your Clinic Setting – A Live Webinar

This Curry International TB Center training will address how to create, assess, and improve outcomes in an LTBI cascade of care in a clinic setting. Registration will be available here.

TB Expert Network Unplugged

This is a joint project among CDC’s four TB Centers of Excellence and CDC. Zoom links will be announced later. 

• June 12, 2025 9:30 am - 11:00 am PST - Curry International TB Center (CITC)

• September 11, 2025 10:00 am - 11:30 am PST - Mayo Center for Clinical Tuberculosis (MCCT)

• October 17, 2025 9:00 am - 10:30 am PST - Global TB Institute (GTBI)

• December 11, 2025 10:0 0am - 11:30 am PST - Southeastern National TB Center (SNTC)

July 8-9, 2025 | International Workshop on Clinical Pharmacology of Tuberculosis Drugs 2025

This SNTC program consists of oral presentations that will be put in perspective, with a translation to clinical care where possible, by selected experts at the end of each workshop session. In addition there will be e-poster abstract presentations. The workshop is informal in setting and is meant to be interactive. Register here.

July 14 - August 1, 2025 | LTBI for Nurses

Offered by the SNTC, this 3-week course is designed for nurses new to TB and covers the foundations of LTBI: using a risk assessment tool and LTBI care cascade to assess, test, treat, and case manage LTBI to successful treatment completion. Registration will be available here.

August 25 - November 14, 2025 | TB Nurse Case Management

This SNTC 40-hour course focuses on the nurse case management process for tuberculosis. Registration will be available here.

September 1 - 26, 2025 | Fundamentals of TB Contact Investigation

This SNTC 4-week course is designed for nurses and field staff new to contact investigation and covers transmission and pathogenesis of TB, deciding when to initiate an investigation, determining the start and end of the infectious period, prioritizing contacts, communication skills, and cultural and diversity considerations. Registration will be available here.

October 6 - 24, 2025 | Foundations in TB Diagnosis and Treatment

This SNTC 3-week course was designed for healthcare providers new to TB and covers all aspects of tuberculosis diagnosis and treatment. Register here.

October 8-9, 2025 | TB Clinical Intensive 2025

This Mayo Clinic conference provides healthcare professionals with the latest insights on tuberculosis (TB), including screening, diagnosis, and treatment of active TB and latent TB infection (LTBI). Register here. 

Washington's TB Project ECHO

On Tuesdays 12:30-1:30 pm PT, join the lunch-time virtual discussion about real TB cases with your peers. This free interactive event is guided by a panel of local TB experts. Click here for more information about this local project and our partners who make this ongoing event possible.

SEATRAC Seminar Series

SEATRAC hosts and promotes seminars, one Friday session per month from 12 - 1 PM, focused on TB basic and clinical sciences by local trainees', local and visiting faculty, and special guests.

Video Recordings and Education Opportunities

Conference on Retroviruses and Opportunistic Infections (CROI)

The Abstract eBook, session recordings (webcasts), and additional materials are available here.

National Jewish Health

The 61st Annual Denver TB Course was held from April 2 - 4, 2025 and is now available in recordings. Registration fee required. 

Mayo Clinic Innovations in Tuberculosis (TB) Webinar Series

Access here.

CITC Archived Webinars
CME/CE units will not be offered for these trainings. Access here.

Rutgers TB Institute Webinar Archives
CE units are not available for these archives. Access here.

SNTC Archived Webinars
CME/CE units are not offered for these trainings. Access here.

SNTC Online Courses
CME units are offered for these trainings. Access here.

CDC

• TB 101 for Health Care Workers CE units expire on 11/6/2025. Access here.
• Efficacy and Safety of 4-Month Rifapentine-Based Tuberculosis Treatments in Persons with Diabetes CME unit expires on 2/24/2026. Access here.

The Union

• Free Online Course - Interpretation of Chest X-Rays in Children with Presumptive TB
• Online Course on Management of Child and Adolescent Tuberculosis
• The Riddle of TB Drug Resistance Recording, aired March 19, 2025

TB ECHO Recorded Archives
Missed a TB ECHO^® session? TB ECHO^® has didactic presentations available for viewing on YouTube. Handouts related to the presentation are included where appropriate. Watch recorded TB ECHO®.

Tools and Resources

Minnesota's Center of Excellence in Newcomer Health

• Access helpful tools, trainings, and updates for newcomers and refugee health here.

CDC

• CDC Learning Connection.
• CDC TRAIN is a comprehensive catalog of free public health training opportunities from the Public Health Foundation. For TB-related trainings, click here.
• FindTBResources.cdc.gov - TB educational materials for patients and providers.
• Visit Everyday Words for Public Health Communication to find plain language alternatives for public health jargon.
• TB Personal Stories patient videos to help raise awareness about TB in the US.
• we are TB offers comprehensive peer support for current TB patients and TB clinics, including weekly live support group sessions.
• Subscribe to the CDC's quarterly newsletter, TB Notes!

DOH Refugee and Immigrant Health Program

• Afghan Health Resources - Fact sheets, webinars, videos, and other health resources (scroll down for TB resources).
• Ukrainian Health Resources - Fact sheets, webinars, videos, and other health resources to support new arrivals from Ukraine (scroll down for TB resources).

Southeastern National TB Center

• Individualized Country Guides

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