Health Advisory: Tuberculosis testing for people who were previously incarcerated

Dec. 8, 2023

The Washington State Department of Health (DOH), Washington State Department of Corrections (DOC), and local health jurisdictions continue to work to address a large tuberculosis (TB) outbreak within the state prison system.

Actions requested

BE AWARE that since July 2021, 28 people have been diagnosed with active TB in the state prison system; during the outbreak investigation, DOH and DOC identified over 2900 potentially exposed contacts.

  • Over 800 exposed individuals were released from prison prior to their exposure being identified or declined testing while in prison. While local health jurisdictions have worked to notify these individuals of their exposure and offer testing, many individuals have not been successfully notified or tested.

BE AWARE The United States Preventive Services Task Force (USPTF) recommends TB screening testing for individuals at increased risk, including:

  • People were who were born in, or have lived in, countries with high TB prevalence,
  • People with known TB exposures, and
  • People who live in, or have lived in, high-risk congregate settings (e.g., homeless shelters or correctional facilities).

The Centers for Disease Control and Prevention (CDC) also recommends TB screening testing for people who work in correctional facilities.

ASK patients about risk factors for TB exposure (country of birth, history of living in a country with high TB prevalence, history of living or working in a correctional facility, history of living in a homeless shelter).

OFFER TESTING via Mantoux tuberculin skin test (TST) or Interferon Gamma Release Assay (IGRA) to help ensure access to all previously incarcerated people (unless they have a known history of TB infection or disease).

EVALUATE patients who test positive. Patients should receive a chest X-ray to rule out active TB disease. If active TB disease is ruled out, initiate treatment for latent TB infection if clinically appropriate.

REPORT any suspected or confirmed cases to Kitsap Public Health District by calling 360-728-2235.

Additional resources

Contacting the health district

Call us at 360-728-2235 and you will be routed to the appropriate program. Includes reporting notifiable conditions 24 hours a day, 7 days a week.

Fax us at 360-813-1168 with the same information.

This advisory is also posted on the health advisory page of our Provider Resources website,