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Information for TB Class B arrivals

Information for TB Class B arrivals

What to bring to your appointment:

  • Valid photo ID (Passport, License, State ID etc.)
  • Chest X-Ray film or disc from overseas
  • Any medical records from country of origin
  • Medical insurance (This is NOT a requirement to be seen)

  • Download directions to get to the TB Clinic (PDF)

When you come to the U.S as an immigrant or refugee, you have a pre-immigration exam to check for certain diseases, one is TB. All people aged 15 years and older have chest x-ray for active TB disease overseas and children ages 2-14 have tests for TB-infection (TB blood or skin test).

If you are diagnosed with active TB disease during your pre-immigration exam, you must take medicine for active TB disease before you can travel to the U.S.

Class B Type What Your Class B Type Means How We Help
Class B1

Chest x-ray overseas suggested active TB disease, but no TB if found on follow-up or you took medicine for active TB disease in the past, or you are positive for HIV

You will have a TB evaluation which may include a test for latent TB infection
Class B2 Blood test or skin test and x-ray shows latent TB infection You will have an evaluation to potentially start latent TB infection treatment
Class B3 You are or were in close contact with someone who has active TB disease

You will have a TB contact evaluation and blood or skin test

Our role is to help you see a doctor for TB follow-up and evaluate and treat if needed.

The Centers for Disease Control and Prevention (CDC) recommends all immigrants and refugees with Class B status be seen by your local public health department to rule out active TB disease, latent TB infection, and start medicine if your doctor thinks you need it.

No, we will cover all costs associated with your TB evaluation if you are seen at our clinic.

A positive result on a blood test (called IGRA, QFT, or TSPOT) and normal chest x-ray means that you have a latent TB infection. You can have latent TB infection if you don’t have symptoms and aren’t sick. Latent TB infection means you have “sleeping” TB germs in your body that could “wake up” and become TB disease, making you sick. Once you have TB disease, you will have symptoms and can spread the infection to other people, like family and friends. Lots of people have latent TB infection. Some doctors may not want you to take medicine for latent TB infection unless you have certain health conditions that suppress your immune system. Even if you are healthy, latent TB infection can turn into TB disease.

Getting the TB vaccine (BCG) as a child does not change the results of a blood test but may change the results of a skin test. Many people born outside of the US may have received the BCG vaccine in their country of origin. The TB vaccine can protect against the worst types of childhood TB, but you can still get TB infection and disease.

If latent TB infection becomes TB disease it can cause a lot of problems. You will have to isolate from family and friends, stay home from work, and take medicine for a long time. Taking medicine for latent TB infection decreases your change of getting TB disease in the future. This protects you and also your family and friends.

The price of latent TB infection medicine will depend on if you have insurance and what medicine you will be taking. Community health centers give medicine on a sliding scale, which means they will work with you to give you medicine at a price you can afford. Call us if you need help finding a community health clinic for medication.

If you have already taken medicine for latent TB infection or TB disease, you usually don't have to take treatment again. Call your doctor if you have questions.

If you take medicine for latent TB infection, ask your doctor for a letter that says you have finished your medicine. If someone asks you to take a TB test, show them the letter from your doctor and ask for a “symptom screen” instead. You will likely test positive on any future TB tests as your immune system still recognizes TB.

We’re happy to help, email us at or call us at 206-744-4579, option 1