AGING AND DISABILITY SERVICES ADMINISTRATION
2009 BH "Dear Administrator" Letters
March 27, 2009
ADSA: BH #2009-006
Tuberculosis (TB) Testing Update
Dear Boarding Home Administrator:
Previously, Washington was below the national average in the incidence of TB. Now, according
to the Department of Health (DOH), this state is slightly above the national average in reported
cases of TB.
In June 2007, RCS informed you of a TB screening blood test, called the TB Gold Test. DOH
has clarified that the TB Gold Test is one type of an Interferon – Gamma Release Assay (or IGRA blood test). DOH has also told us that the TB testing standard has changed, but has not yet revised their TB rules. Here is the current testing standard:
- The provider may use either a Mantoux (skin test) or an IGRA (blood test) to determine if an individual is positive or not.
- A repeated skin test may be done if an individual tests positive on the initial skin test.
- If an individual states s/he had a positive reaction from a prior skin test, but has no documentation from that test, the provider should make sure that either a repeated skin test or an IGRA blood test is done.
- If the individual comes from a country where TB may be endemic, the provider should make sure that an IGRA blood test is done. (DOH has identified these areas as the Philippines, Vietnam, Mexico, Korea, China, Thailand, East India, Eastern Europe, Africa and refugee camps.)
- If either the skin or blood test results in an individual testing positive, that individual needs a chest x-ray and needs to follow the recommendations of his/her health care provider. NOTE: An IGRA blood test is not an
acceptable alternative to the chest x-ray required after a positive result from testing/screening. - If an individual is diagnosed with TB, the local health department should be notified.
We will review the Washington Administrative Code to determine if the rules need to be revised to reflect this standard. In the meantime, please use the concepts above when reviewing, revising and implementing your infection control procedures around TB testing.
Enclosed is a list of participating labs.
Sincerely,
Joyce Pashley Stockwell, Director
Residential Care Services
