TB Screening for Healthcare Workers:
Reversions and Conversions, and Contacts – Oh my!

This activity offers CE credit for:
1. Physicians (CME)
2. Nurses (CNE)

Credit Expiration Date: April 21, 2018


Lisa V. Adams, MD
Associate Professor of Medicine
Section of Infectious Disease & International Health
Associate Dean for Global Health
Director, Center for Health Equity
Geisel School of Medicine
Dartmouth College
Hanover, New Hampshire USA

Elizabeth A. Talbot, MD
Associate Professor of Medicine
Section of Infectious Disease & International Health
Geisel School of Medicine
Dartmouth College
Hanover, New Hampshire USA

Milo Richard , MD
National TB Program, Haiti

Randall E. Reves, MD
Denver Health Medical Center
University of Colorado Denver,
Colorado USA

Charles Robert Horsburgh, MD
Professor of Epidemiology and Infectious Diseases,
Boston University SOM
Professor of Biostatistics and Global Health,
Boston University School of Public Health
Boston, MA USA

Statement of Need

The CDC’s Division of Tuberculosis Elimination has developed a strategic plan for 2016-2020, with an ultimate goal of elimination of tuberculosis in the United States (defined as < 1 case/million annually).1 Progress toward eradicating TB incidence in the US will require more comprehensive public health approaches, both globally and domestically. These include increasing case detection and cure rates globally, reducing TB transmission in institutional settings such as health care facilities, and increasing detection and treatment of preexisting latent TB infection.2 Serial screening of healthcare workers (HCWs) for LTBI is important at healthcare institutions that are at greater than medium risk for transmission of tuberculosis because of their patient populations, inadequate controls, and/or the risk factors of their HCWs. Public Health and Infectious Disease specialists need information to determine the best test for their HCW population, how to manage conversions and reversions, and how to avoid false positive results that may lead to unnecessary INH therapy.

  1. CDC Division of Tuberculosis Elimination Strategic Plan: https://www.cdc.gov/tb/about/strategicplan.htm. Accessed 1/3/2017
  2. Salinas JL, Mindra G, Haddad MB, Pratt R, Price SF, Langer AJ. Leveling of Tuberculosis Incidence — United States, 2013–2015.
    MMWR Morb Mortal Wkly Rep 2016;65:273–278. DOI: http://dx.doi.org/10.15585/mmwr.mm6511a2

Activity Goal

This program will inform health care providers about the use of IGRAs among healthcare workers in high and low TB burden settings. It will evaluate examples of programmatic use of IGRAs among healthcare workers in high TB burden settings. 

Learning Objectives

At the end of this CME activity, participants should be able to:


  1. Discuss the current literature regarding the use of IGRAs among healthcare workers in high and low TB burden settings.
  2. Evaluate examples of programmatic use of IGRAs among healthcare workers in high TB burden settings.
  3. Describe the steps for programmatic implementation of healthcare worker screening in high TB burden settings.

Target Audience

The target audiences for this activity are physicians, nurses and other health care professionals who specialize in public health, infectious diseases, infection control, respirology, laboratory medicine, and other associated fields..

Financial Support

This program is supported by an educational grant from Oxford Immunotec, Inc.

Credit Information

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of CME Outfitters, LLC and Jespersen & Associates, LLC. CME Outfitters, LLC is accredited by the ACCME to provide continuing medical education for physicians.

CME Outfitters, LLC designates this enduring material for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CNE Credit (Nurses): Provider approved by the California Board of Registered Nursing, Provider Number CEP 15510, for 1.5 contact hours.

Post-tests, credit request forms, and activity evaluations must be completed online at www.cmeoutfitters.com/JA046 (requires free account activation), and participants can print their certificate or statement of credit immediately (80% pass rate required). This website supports all browsers except Internet Explorer for Mac. For complete technical requirements and privacy policy, visit www.neurosciencecme.com/technical.asp.

Disclosure Declaration

It is the policy of CME Outfitters, LLC, to ensure independence, balance, objectivity, and scientific rigor and integrity in all of its CME/CE activities. Faculty must disclose to the participants any relationships with the commercial companies whose products or devices may be mentioned in faculty presentations, or with the commercial supporter of this CME/CE activity. CME Outfitters, LLC, has evaluated, identified, and attempted to resolve any potential conflicts of interest through a rigorous content validation procedure, use of evidence-based data/research, and a multidisciplinary peer review process. The following information is for participant information only. It is not assumed that these relationships will have a negative impact on the presentations.

Lisa V. Adams, MD : no relationship to disclose

Elizabeth A. Talbot, MD: no relationship to disclose

Randall E. Reves, MD: no relationship to disclose

Milo Richards, MD: no relationship to disclose

Robert Horsburgh, MD: no relationship to disclose

Jeffrey Helfand, DO (peer reviewer): no relationships to disclose

Caitlin Harrington (planning committee): no relationships to disclose

Unlabeled Use Disclosure

Faculty of this CME/CE activity may include discussions of products or devices that are not currently labeled for use by the FDA. Faculty members have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses (any uses not approved by the FDA) of products or devices. 

Questions about this activity? Call us at 877.CME.PROS (877.263.7767).