The Center for Disease Control (CDC) is currently drafting a fundamental change in the guidelines for testing health care workers for Tuberculosis (TB). The present CDC guidelines for such testing have been on the books since 1994, thus, these revisions are worth significant attention! The revision addresses the changes in epidemiology of transmission. The risk categories will be reduced from five to three. Low risk settings could eliminate annual tuberculin testing.
All hospitals would provide baseline screening of all health care workers upon hire with a two-step PPD or QuantiFERON test. In conducting risk assessment, hospitals need to recognize the fact that TB is more prevalent among foreign-born Americans, and more transmissible among people with HIV infection. The guidelines will have information about how to perform and interpret the QuantiFERON test. In December 2004, the FDA approved the new version of this test called QuantiFERON-TB GOLD.
The CDC promises to release guidelines within months (Spring/Summer 2005) on using this improved test. This test checks the blood for specific proteins of M. tuberculosis. Results are available in 24 hours. Cellestis Inc. claims that their test will have a negative response for people who have had Bacillus Calmette Guerin vaccine.