Which TB exposure risk management step is recommended in military or expeditionary settings?

• A. Chest X-ray only
• B. Latent TB infection screening with PPD/IGRA
• C. No screening
• D. Annual blood typing

Answer: (B)

Screening for latent TB infection with PPD or IGRA is the key step in these settings because it identifies people who carry TB bacteria without symptoms and who could later develop active TB. In military and expeditionary environments, where close living quarters and rapid movement increase transmission risk, detecting latent infection allows for preventive treatment and reduces the chance of an outbreak.

Chest X-ray alone only detects active disease, not latent infection, so it would miss many who are infected but not yet sick. No screening, on the other hand, leaves latent infections undiscovered and untreated. Annual blood typing has no relevance to TB risk or prevention.

Using PPD or IGRA for latent TB screening provides a practical way to manage risk and protect both individual service members and the unit as a whole.