Hi Annebeth –
In keeping with the price of your question, I'll just give you the
brief answers to each of your specific questions, and then provide you
with sources to do your own follow up.
First understand there is a difference between having a positive TB
skin test, which means you were infected with the tuberculosis virus,
and having the disease called tuberculosis, which occurs when your
immune system can't control the infection.
For an otherwise healthy child who tests positive, the antibiotic
called isoniazid (INH) is often prescribed for six to nine months.
This may have been what you took. This decreases the risk of later
developing tuberculosis by about 75 percent.
Ok, now your answers.
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If I had a positive test at age 5 and been treated would I continue to
have positive skin tests through my life?
Not necessarily.
According the CDC False Negative tests can occur when skin testing
people who were infected with M. tuberculosis a long time ago.
In some persons who are infected with M. tuberculosis, the ability to
react to tuberculin may wane over time. When given skin test years
after infection, these persons may have a negative reaction.
-----------------------------------------------------------------------
Is there some way to know for sure if I had TB in my past?
Yes.
A physician can use what is called a TWO STEP process to determine
whether you are (or have been) truly infected.
In this process the doctor first administers a standard skin test. It
is known that the test itself may stimulate the immune system to react
later if it has been previously exposed to TB. This is called a
BOOSTED REACTION.
If the first test shows a negative reaction, the doctors will repeat
the test 3 weeks later. If the reaction to the second test is
positive, then it is probably a boosted reaction -- usually from
infection that occurred years ago.
Also the FDA recently approved a blood test called the QFT
(QuantiFERON - TB test) which may be used in conjunction with the TB
skin test to help confirm or rule out latent TB infection. That test
is not yet routinely available.
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If I had been treated for TB 38 years ago, would it keep me from going
into a health profession (for example becoming a Dr.)?
No.
Although many healthcare and childcare professions require TB
screening, a documented positive TB test in your past will not
preclude you from working in such a field.
Not as long as you show a NEGATIVE reaction now and/or a clear chest
X-ray. If these results are clean, you can get a statement from your
doctor that says you are "FREE FROM COMMUNICABLE TUBERCULOSIS" and you
would be permitted to work as a health or child care worker.
Example of TB testing rules for School Employees in LA County
----------
"If you have a documented positive skin test, you must have an initial
chest radiograph (X-ray). After that, you still need to be screened
every four years. You must present a certificate from a health
provider stating that you are free from communicable TB or have your
chest radiograph repeated."
LA PUBLIC HEALTH - School TB Skin Testing Requirements:
School Employee or School Volunteer Requirements
http://www.lapublichealth.org/tb/screen/TSTemvol.html
Example of TB testing rules for Nursing Students ------------------
1 -You must obtain a baseline PPD (TB) skin-test: intracutaneous
(MANTOUX), NOT tine.
2 - If this initial test shows a positive reading, then you must get a
chest X-Ray. If the test is negative, you do not require a chest
X-Ray, but you must repeat the PPD test each year.
3 - Your doctor must indicate on your Report of Medical History
whether or not you show any symptoms suggestive of active TB.
4 - Submit proof of the initial TB skin-test and X-Ray when you submit
your Medical History Report (before you first start your first
semester in the Nursing program).
HEALTH SCIENCES NURSING – HEALTH REQUIREMENTS
http://www.washtenaw.cc.mi.us/health/nursing4a.php
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OTHER RESOURCES
-------------------------------------
CDC - TUBERCULOSIS INFORMATION
http://www.cdc.gov/nchstp/tb/pubs/tbfactsheets/250102.pdf
CDC TUBERCULOSIS FACTS
http://www.cdc.gov/nchstp/tb/pubs/tbfactsheets/skintest_eng.htm
AMERICAN LUNG ASSOCIATION – TB SKIN TEST FACTS
http://www.lungusa.org/diseases/tbskinfac.html
LAB TESTS ONLINE - THE TB SKIN TEST
http://www.labtestsonline.org/understanding/analytes/tb_skin/glance.html
FDA – QUANTIFERON
http://www.fda.gov/cdrh/pdf/p010033.html
Thanks for your question AnneBeth. The links I've provided you should
explain everything I haven't gone over here, but if anything I've said
is confusing, or if any links don't work, let me know and I'd be happy
to clarify for you.
-K~
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