Culture-Based TB Screening for U.S.-Bound Immigrants and Refugees

Most new tuberculosis (TB) cases in the U.S. involve people born elsewhere. Consequently, U.S.-bound immigrants and refugees are required to undergo predeparture screening and, if found to have active TB, to receive treatment overseas.

Before 2007, screening was limited to chest x-ray of individuals aged ≥15 years and — if results were suggestive of active TB or the person had symptoms of the disease — examination of three consecutive sputum samples. In 2007, the CDC introduced a culture-based screening algorithm that added mycobacterial culture for individuals with suspected TB, plus latent TB infection screening for children aged 2 to 14 years. This policy, first implemented in countries with high TB prevalence, had been implemented in 81 …