Tuberculosis

We:

• Investigate all reports of active or suspected cases of Tuberculosis
• Ensure required follow-up has been done on all reported positive TB skin tests
• Provide TB skin testing at our clinics
• Provide free TB medication for prophylaxis and treatment
• Provide information, advice on the management of LTBI and Active TB cases to healthcare providers
• Provide multilingual resources on TB
• Follow-up of persons under medical surveillance for Tuberculosis

Public Health TB clinics

• Offered one Monday per month at our Guelph – 20 Shelldale Crescent location
• Staffed by a Respirologist and public health nurses
• We welcome written referrals from physicians and nurse practitioners. Please fax referrals to the Reportable Disease Secure Fax at 519-846-3307. 

Reporting Requirements

Tuberculosis is a reportable disease under the Health Protection and Promotion Act - R.S.O. 1990, Chapter H.7.

All physicians, laboratories, institutions, hospital administrators, and schools must report all persons with any of the following to Public Health:

• Latent TB infection
• Suspected active TB
• Confirmed active TB

To report a positive Mantoux TB skin test result, use this form: Reporting Mantoux TB Skin Test (PDF).

Practice Guidelines and Resources

• Canadian Tuberculosis Standards 6^th Edition, 2007
• Tuberculosis Information for Health Care Providers 4^th Edition, 2009 (PDF, 32 pages)
• TB Surveillance Protocol for Ontario Hospitals (Ontario Hospital Association, PDF, 14 pages)
• World Atlas of BCG Policies and Practices

For detailed information on current and past BCG policies and practices for over 180 countries.

• Online TST/QFT Interpreter
  A useful tool to estimate the risk of active tuberculosis for person with TB skin tests of 5mm+.

Forms and fact sheets

• Reporting Mantoux TB Skin Test Form
• Tuberculosis: How to Assess New Residents, Employees, and Volunteers
• The 4 R’s of the Tuberculin Skin Test
• TB Skin Test fact sheet
• Two-Step TB Skin Test fact sheet
• BCG Information for Healthcare Professionals
• Ethambutol fact sheet
• Isoniazid fact sheet
• Pyrazinamide fact sheet
• Rifampin fact sheet
• Collection of Sputum Samples
• TB Information for Workplaces
• TB fact sheet

Interferon Gamma Release Assays (IGRA Testing)

Two Interferon Gamma Release Assays (IGRAs) are licensed for use in Canada:

• Quantiferon TB Gold (available through Gamma-Dynacare commercial laboratories)
•  T-SPOT TB

These tests are not covered under the Ontario Health Insurance Plan (OHIP) and cost approximately $90 each.

For more information see the Canada Communicable Disease Report Volume 34, ACS-6, October 2008:  Updated Recommendations on Interferon Gamma Release Assays for Latent Tuberculosis Infection.