In 2014, tuberculosis overtook HIV as the number one infectious disease killer in the world and continues to remain at the top. In the United States, there were 9,287 persons diagnosed with active TB in 2016. The CDC estimates that of the cases with genotype data, only 14% are attributable to recent transmission. That means majority are reactivation from latent infection. Prompt identification and treatment of active TB is necessary but insufficient by epidemiologic modeling to achieve the goal of TB elimination. Identifying and treating persons with latent TB is needed. Thus, the United States Preventive Services Task Force issued recommendation to screen patients with risk factors (such as in general being foreign-born) in September 2016.