Each physician's office should develop a protocol for suspected tuberculosis.

All patients should be asked about history of tuberculosis exposure, infection, and active disease.

Patient screening forms should include symptoms and signs of active tuberculosis, and conditions that would categorize patients as high risk.

Interviews should be in the patient's primary language when possible (translator resources are available at http://www.atanet.org).

Patients suspected of having active tuberculosis should be transferred from waiting areas to separate rooms (if possible, to rooms that meet isolation requirements for airborne infection); the door should be closed as soon as possible to reduce the risk of exposure to other persons.

Patients with symptoms of active tuberculosis should be given a surgical or procedure mask and instructed on respiratory hygiene and cough etiquette.

Patients with suspected or confirmed tuberculosis should be immediately reported to the local health department so that tracking, contact investigations, and case management may be arranged.

All family members (especially children) and persons exposed to active tuberculosis (including health care workers) should immediately receive screening for symptoms and a TST, followed by another screen and TST eight to 10 weeks after exposure; treatment may be considered for high-risk patients and children in the testing interim.

A TST should be considered positive if there is any induration of 5 mm or greater in patients without prior induration, or an increase in induration of 10 mm in those with prior induration.

Patients with positive TST results should receive chest radiography (and potentially other diagnostic evaluation).

All test conversions and cases of tuberculosis among health care workers should be recorded and reported according to the Occupational Safety and Health Administration standard 29 Code of Federal Regulations.