FAQs on Tuberculosis Risk Assessment and Management

ACHA recommends screening and targeted testing for TB as a key strategy for controlling and preventing infection on campuses and in surrounding communities and provides detailed Tuberculosis (TB) Risk Assessment and Management Guidelines on the topic. Developed by the ACHA TB Workgroup, these FAQs are a companion to the ACHA TB guidelines and provide additional details for many key areas related to TB risk assessment and management on campus.

Summary of Changes for 2026

The Tuberculosis (TB) Workgroup made a limited number of updates to the Tuberculosis Guidelines and associated Frequently Asked Questions (FAQ) in In 2026, following the major revision completed in 2025. A total of 41 comments were received from 12 ACHA members, including 29 comments from a major urban public health department, 10 comments from a range of institutions, and two comments submitted via ACHA Connect. Many of these comments were incorporated into the current revision, while several others have been flagged for consideration in the 2027 update of the TB Guidelines.

The 2026 updates include:

• Updated the Introduction to align with and reference the Immunization Guidelines, reinforcing our shared goal of protecting the nation’s 19 million college students and the communities in which they live and learn.

• Updated Appendix A—(Tuberculosis Screening Tool), Question 3:  “Have you resided in or traveled to one or more of the countries or territories listed above for a cumulative period of at least one month …” (previously “one to three months or more”). Note: Institutions may need to update this question in their electronic health record templates.

• Updated Appendix B—High‑Incidence Country List, with the following changes:
  • Added: French Polynesia, Latvia, Syrian Arab Republic, and Trinidad and Tobago (incidence rose above the threshold).
  • Removed: Anguilla and Belarus (incidence fell below the threshold).

Note: Institutions may need to update this question in their electronic health record templates.

• Added Appendix D—Inactive TB Infection (LTBI) Risk Assessment Matrix, customized for college student populations.

• Made minor editorial updates, including verification and adjustment of references throughout the TB Guidelines and the FAQ.