CDC Overseas and Domestic Tuberculosis Guidelines

Screening for LTBI and TB Disease During the Domestic Medical Examination for Newly-Arrived Refugees: These guidelines describe the overseas medical screening process for refugees relocating to the US, and outlines guidelines for clinicians evaluating refugees for TB during the medical examination for new arrivals.
 

TB Classification and Travel Clearance

Classification

Clinical Finding Travel Clearance
No TB Classification Applicants without current clinical findings of TB disease, without known HIV infection, and with a normal CXR (and for applicants who require it, a negative IGRA) with normal TB disease screening examinations Valid for 6 months from the time the evaluation is complete
Class A TB Disease All applicants who have TB disease, including applicants with extrapulmonary TB who have a CXR suggestive of pulmonary TB disease regardless of sputum smear and culture results Applicants are not cleared for travel until completion of treatment unless a waiver is granted
Class B0 TB, Pulmonary Applicants who were diagnosed with TB disease by the panel physician or presented to the panel physician while on TB treatment and successfully completed Division of Global Migration and Quarantine (DGMQ)-defined DOT* under the supervision of a panel physician before immigration Valid for 3 months from the date final cultures are reported as negative
Class B1 TB, Pulmonary Applicants who have signs or symptoms, physical exam, or CXR findings suggestive of TB disease, or known HIV infection, but have negative sputum smears and cultures and are not diagnosed with TB disease. This classification also includes applicants diagnosed with TB disease by the panel physician who refused DOT treatment and are returning after treatment and completion of 1-year wait. Valid for 3 months from the date final cultures are reported as negative
Class B1 TB, Extrapulmonary Applicants diagnosed with extrapulmonary TB with a normal CXR and negative sputum smears and cultures Valid for 3 months from the date final cultures are reported as negative
Class B2 TB, LTBI Applicants who have a positive IGRA or TST but otherwise have a negative evaluation for TB Valid for 6 months from the time the evaluation is complete
Class B3 TB, Contact Evaluation Applicants who are recent contacts of a known TB disease case, regardless of IGRA or TST results Valid for 6 months from the time the evaluation is complete