Tuberculosis Screening

Consider testing

  • Person traveling in TB endemic areas.
  • Migrant workers.
  • Person experiencing homelessness.
  • Contact to a tuberculosis case.
  • Foreign-born person from tuberculosis-endemic area.
  • Person who injects drugs.
  • Immunosupressed person (e.g., HIV positive or organ transplant).
  • Resident/employee of healthcare, correctional or long-term care facility.
  • Person with chronic medical problem (e.g., diabetes, end stage renal disease).

Tuberculosis Skin Test (TST)

  • 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).
  • Available at most laboratories.

When to test

Screening should occur when a patient fits the criteria for testing. Testing is required for:

  • Healthcare workers or healthcare students.*
  • Residents of long-term care nursing facilities.*
  • People who inject drugs.

*Two-step testing is required for healthcare workers at entry and people admitted to nursing homes.

Documentation is required

Per Centers for Disease Control and Prevention, a verbal report of a positive skin test is unacceptable. There must be written documentation.

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