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MDH Recommendations for Use of Tuberculin During Nationwide Shortage

The Centers for Disease Control and Prevention (CDC) is expecting a three to 10-month nationwide shortage of APLISOL®, which is one of two purified-protein derivative tuberculin antigens that are licensed for use in performing tuberculin skin tests. This shortage will impact assisted living, home care, boarding care, care centers, supervised living facilities, and supplemental nursing services. 

Read the full CDC Health Advisory. Even during this shortage, it remains important to detect and treat LTBI.

MDH Recommendations for Prioritizing Tuberculin Use

Setting

Group

Recommendations

All settings

All groups

Do NOT administer TSTs to persons with a documented previous history of positive TST, IGRA, or TB disease

Boarding Care / Nursing Homes

Residents

At time of admission: Conduct TB symptom screen. Perform TB screening test; use IGRA if available. If IGRA not available, administer one TST. If tuberculin supply is low, defer second step TST until shortage resolves. If not able to obtain any tuberculin, defer both TSTs until shortage resolves.

Health Care Settings

Employees

At time of hire: Conduct TB symptom screen and individual TB risk assessment. Perform TB screening test; use IGRA if available. If IGRA not available, administer one TST and defer second step TST until tuberculin resolves. If not able to obtain any tuberculin, defer both TSTs until shortage resolves.


Annual re-testing for employees with increased occupational risk for TB (see 2019 CDC guidance): Conduct TB symptom screen. Perform TB screening test; use IGRA if available. If IGRA not available, defer annual TST until tuberculin shortage resolves.

All Settings

Contact investigation

Conduct individual TB symptom screen. Continue to use IGRA (preferred) or TST to evaluate close contacts of persons with infectious (i.e., pulmonary or laryngeal) TB disease. Consult MDH or local health department for guidance in identifying who should be included in contact testing.

You may also review this content on the MDH website at Nationwide Shortage of Tuberculin Skin Test Antigens.

See this week’s Advantage Article MDH has updated the Regulations for TB Control in Minnesota Health Care Settings for the changes to guidance related to facility assessment and requirements for TB testing.

To receive e-mail alerts and updates related to the MDH TB Program subscribe to What’s New – MD TB Program.

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