Tuberculin Status

IMPORTANT: A TB test must be administered between May 15th – June 30th – Failure to meet this requirement of the onboarding process may jeopardize your place in the Fall nursing cohort.

TB Testing

Documentation of a two-step PPD test or a TB IGRA must be uploaded to the American Data Bank website.

Documentation requirements are listed under each option.

Incoming Juniors must have this test administered after May 15th

Instructions

Initial testing

  • Option 1 – A two step PPD. This is administered as follows:
  • NOTE: A PPD cannot be placed within 30 days of receiving an MMR or Varicella vaccine unless they are placed on the same day. If you have had a BCG vaccine you are required to use option 2, a TB IGRA. 
    • Step ONE
      • Visit 1, Day 1: PPD antigen is applied under the skin.
      • Visit 2, Day 3: PPD test is read (within 48-72 hrs of placement). If negative continue to the next step. If positive see below.
    • Step TWO
      • Visit 3, Day 7-21: a second PPD skin test is applied (for those with a negative test one result). If test is applied before 7 days or after 21 days the entire two step PPD must be repeated.
      • Visit 4, 48-72 hours after second PPD placement, the second test is read. If negative submit documentation as listed below to ADB. If positive see the “Positive Results” section of this page.  
  • Option 1 Documentation for each step you must include (1) the date the test was administered, (2) the date it was read, (3) the result, (4) the size (mm) of induration, (5) the name of the healthcare provider who placed it, and (6) the name of the healthcare provider who read it
  • Option 2 – A TB IGRA. TB IGRAs are whole-blood tests. There are two types. If you were vaccinated with a BCG vaccine the clinical consortium requires a TB IGRA and not a PPD. For more information see below. 
    •  QuantiFERON®-TB Gold In-Tube test (QFT-GIT)
    • T-SPOT® TB test (T-Spot)
  • Advantages of the TB IGRA
    • Requires a single patient visit to conduct the test.
    • Results can be available within 24 hours.
    • Prior BCG (bacille Calmette-Guérin) vaccination does not cause a false-positive IGRA test result.
  • Disadvantages  of the TB IGRA
    • Can be more expensive than a PPD.
    • Please discuss disadvantages with your healthcare provider.
  • Option 2 Documentation is a type written lab report which includes (1) the collection date, (2) the reference range, (3) the result, and (4) the name of the lab. No handwritten reports will be accepted. 

Annual testing

Annual TB testing is “Step One” (see above) and must be administered within 365 days of the first visit of the initial two step PPD or a TB IGRA. If the annual PPD test is administered on the 366th day a student must repeat the two step PPD. 

  • Option 1 – a one step PPD Skin test. (Administered within 365 days of initial TB test.)
  • NOTE: A PPD cannot be placed within 30 days of receiving an MMR or Varicella vaccine unless they are placed on the same day. 
  • Option 2 – A TB IGRA can be used as a annual TB test also. 

Positive Results 

If you know you test positive for TB OR if you are now testing positive for TB, the instructions below must be followed:

  • Make an appointment with your healthcare provider.
  • Upload a chest x-ray radiology report to American Data Bank. (No handwritten reports will be accepted.)
  • Upload a current TB Symptom Check form completed by your healthcare provider to American Data Bank.
  • If INH treatment was recommended upload document indicating completion date of to American Data Bank.

Bacillus Calmette-Guerin (BCG) Vaccine

The BCG is a vaccine for TB. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG vaccine does not always protect people from getting TB. If you were vaccinated with BCG, you may have a positive reaction to a TB skin test. This reaction may be due to the BCG vaccine itself or due to infection with the TB bacteria. Your positive reaction is more likely to mean you have been infected with TB bacteria.

If you have had a BCG vaccine the clinical consortium requires a TB IGRA and not a PPD.  If you test positive, see the section titled “Positive Results”. 

 

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