The Revised Report of Verified Case
Posted: May 2008
What is the Report of Verified Case of Tuberculosis?
The Report of Verified Case of Tuberculosis (RVCT) is the
national TB surveillance form. Data are collected by state and
local TB programs and submitted electronically to the Centers for
Disease Control and Prevention (CDC), Division of Tuberculosis
Elimination (DTBE). These data are used to monitor national TB
trends, identify priority needs, and create the DTBE Annual
What is the significance of surveillance?
Surveillance is essential to successful TB control. It is a key
component of program evaluation and provides a measurement of
progress toward TB elimination. State and local surveillance data
are essential in providing the epidemiologic profile of TB in a
given jurisdiction, as well as on a national level. For example,
surveillance data from local and state TB control programs were used
to identify the reversal of the declining trend in TB incidence in
the United States in the mid-1980’s, the peak of resurgence in 1992,
and the subsequent steady decline to an unprecedented low number and
rate of TB cases in 2007.
Why is the RVCT changing?
To control and eventually eliminate TB, state and local TB
control programs must be able to monitor trends in TB disease in
high risk populations, as well as identify new patterns of disease
and possible outbreaks. The last major revision of the RVCT was
completed in 1993--over 15 years ago! Modification of the RVCT is
needed to accommodate the changing epidemiology of TB in terms of
risk factors, new drug treatments, enhanced laboratory capacity for
diagnostic tests, and to identify priority needs. Timely and
accurate reporting of suspected and confirmed TB cases, with
inclusion of useful case data, is necessary for public health
planning and assessment at all levels. The new data elements
included in the revised RVCT will assist in this process.
Who worked on the revision?
Beginning in 2001, a DTBE-sponsored work group
consisting of nearly 30 members from 15 TB control programs, DTBE,
and the National TB Controllers Association (NTCA) worked to draft
the revised RVCT. The work group made variable additions, deletions,
and modifications that will improve data collection, yield
meaningful and useful data, and be significant for surveillance.
What are the enhancements to the RVCT?
The revised RVCT includes risk factors such as diabetes,
end-stage renal disease, immunosuppressive therapy, and contact with
a drug-resistant case. It enables collection of data on parental
origin for pediatric TB patients, primary reason for evaluation of TB disease, whether
the patient moved, immigration status, the reason therapy was
extended, drug susceptibility testing (newer drugs for
susceptibility testing), and outcome of directly observed therapy
(DOT). Enhancements accommodate the multiple changes in technology
that have occurred in recent years, such as nucleic acid
amplification tests, interferon gamma release assays, computerized
tomography, and genotyping. The changes also capture data on TB
cases not meeting the current surveillance definition. The RVCT case
number was modified to include the year and jurisdictional code.
This allows each TB case to be allocated a unique number with a
“linking state case number” field to record source cases or prior TB
How will the changes affect TB control programs?
The revised RVCT will assist TB control programs in gathering
accurate, useful data. The additions and changes made to the
variables of the RVCT will enable programs to capture data that are
more inclusive of a variety of risk factors. These additional data
will be essential to efficient and effective TB program management.
How can health professionals learn how to accurately complete
the revised RVCT?
The Report of Verified Case of Tuberculosis (RVCT) Self-Study
Orientation Modules include instructions, examples, and exercises to
help health professionals learn how to accurately complete the RVCT.
In addition, the modules can be used in facilitator-led orientation
When will the revised RVCT be implemented?
The revised RVCT was field tested by TB program staff. After OMB
approves the revised RVCT, implementation of the new form will begin
on January 2009. The final form, instructions, and Self-Study
Modules will be available in the fall of 2008.
Note: A verified case of TB for public health surveillance
may be laboratory confirmed or, in the absence of laboratory
confirmation, meet the clinical case definition as defined in the
CDC document “Case Definitions for Infectious Conditions Under
Public Health Surveillance.” The criteria for determining a laboratory confirmed case are
- isolation of M. tuberculosis complex from a clinical
- demonstration of M. tuberculosis from a clinical specimen by
nucleic acid amplification test; or
- demonstration of acid-fast bacilli in a clinical specimen when a
culture has not been or cannot be obtained.
A clinically verified case of TB meets all of the following
- a positive tuberculin skin test;
- signs and symptoms compatible with current TB disease, such as an
abnormal, unstable (worsening or improving) chest x-ray, or clinical
evidence of current disease;
- current treatment with two or more antituberculosis medications;
- a completed diagnostic evaluation.
Last Modified: 05/28/2008
Last Reviewed: 05/18/2008
Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention