Screening Information for Medical Providers

Consider Testing:

  • Person traveling in TB endemic areas
  • Migrant workers
  • Person experiencing homelessness
  • Contact to a TB case
  • Foreign-born person from TB 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, 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)
    • Available at most laboratories

When Should Testing Be Done?

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
  • Persons who inject drugs

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

Required Documentation

Per Tacoma-Pierce County Health Department policy and the 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, 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.

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