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  • Tuberculosis Screening

    TB screening information for medical providers

    Consider testing:

    • People who travel in TB endemic areas.
    • Migrant workers.
    • People who experience homelessness.
    • Contacts to a TB case.
    • Foreign-born people from TB endemic areas.
    • People who inject drugs.
    • Immunosuppressed people (e.g., HIV positive or organ transplant).
    • Residents or employees of healthcare, correctional, or long-term care facility.
    • People with chronic medical problem (e.g., diabetes, ESRD, etc.).

    Types of tests

    • TB Skin Test (TST).
      • A Mantoux test with Tubersol or Aplisol PPD material.
      • Remember to date the vial and discard 30 days after opening.
      • Tine tests are no longer recommended.
    • Interferon Gamma Release Assay.
      • Blood testing for TB infection with a QuantiFERON-TB Gold In-tube® (QFT)or T-SPOT.TB test.
      • Available at most laboratories.

    Who should I test?

    You must screen patients who fit the criteria for testing:

    • People have close contact to a person with active pulmonary TB.
    • People with symptoms of active TB disease—cough for more than three weeks, weight loss, fatigue, night sweats, fever.
    • Healthcare workers or healthcare students.*
    • Residents of long-term care nursing facilities.

    *Healthcare workers at entry and people admitted to nursing homes need two-step testing.

    Testing documentation for work or school

    Per Tacoma-Pierce County Health Department policy and Centers for Disease Control and Prevention (CDC), a verbal report of a positive skin test is unacceptable. There must be written documentation.

    • If no documentation is available, apply and read a skin test. If it is positive, order a chest x-ray.
    • A TST “converter” is a person who has an increase in reaction size of ≥10 mm within a period of two years.