MDH Recommendations for Use of Tuberculin During Nationwide Shortage
On June 18, 2019 by Sue Boyd
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.
|
|
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.
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