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Topic : PPD
The Role of BCG Vaccine in the Prevention and Control of Tuberculosis
in the United States A Joint Statement by the Advisory Council
for the Elimination of Tuberculosis and the Advisory Committee
on Immunization Practices (MMWR 45(RR-4);1-18) for information
on topic Tuberculin Skin Testing and Interpretation of Results
After BCG Vaccination :
The Role of BCG Vaccine in the Prevention and Control of
Tuberculosis in the United States A Joint Statement by the
Advisory Council for the Elimination of Tuberculosis and the
Advisory Committee on Immunization Practices (MMWR 45(RR-4);1-18)
for information on topic Tuberculin Skin Testing and Interpretation
of Results After BCG Vaccination
Postvaccination BCG-induced tuberculin reactivity ranges
from no induration to an induration of 19 mm at the skin-test
site (65-74). Tuberculin reactivity caused by BCG vaccination
wanes with the passage of time and is unlikely to persist
>10 years after vaccination in the absence of M. tuberculosis
exposure and infection. BCG-induced reactivity that has weakened
might be boosted by administering a tuberculin skin test 1
week to 1 year after the initial postvaccination skin test;
ongoing periodic skin testing also might prolong reactivity
to tuberculin in vaccinated persons (70,72).
Screening for Tuberculosis and Tuberculosis Infection in High-Risk
Populations Recommendations of the Advisory Council for the
Elimination of Tuberculosis (MMWR 44(RR-11);18-34) for information
concerning Summary of interpretation of tuberculin skin-test
results :
Screening for Tuberculosis and Tuberculosis Infection in
High-Risk Populations Recommendations of the Advisory Council
for the Elimination of Tuberculosis (MMWR 44(RR-11);18-34)
for information concerning Summary of interpretation of tuberculin
skin-test results :
1. An induration of >=5 mm is classified as positive
in the following: -
- Persons who have had recent close contact with persons
who have active TB;
- Persons who have human immunodeficiency virus (HIV)
infection or risk factors for HIV infection but unknown
HIV status;
- Persons who have fibrotic chest radiographs consistent
with healed TB.
2. An induration of >=10 mm is classified as positive
in all persons who do not meet any of the above criteria,
but who belong to one or more of the following groups having
high risk for TB:
- Injecting-drug users known to be HIV seronegative
- Persons who have other medical conditions that have
been reported to increase the risk for progressing from
latent TB infection to active TB.
- These medical conditions include diabetes mellitus,
conditions requiring prolonged high-dose corticosteroid
therapy and other immunosuppressive therapy (including
bone marrow and organ trans- plantation), chronic renal
failure, some hematologic disorders (e.g., leukemias and
lymphomas), other specific malignancies (e.g., carci-
noma of the head or neck), weight loss of >= 10% below
ideal body weight, silicosis, gastrectomy, jejunoileal
bypass
- Residents and employees of high-risk congregate settings:
prisons and jails, nursing homes and other long-term facilities
for the elderly, health-care facilities (including some
residential mental health facili- ties), and homeless
shelters
- Foreign-born persons recently arrived (i.e., within
the last 5 years) from countries having a high prevalence
or incidence of TB
- Some medically underserved, low-income populations,
including mi- grant farm workers and homeless persons
- High-risk racial or ethnic minority populations, as
defined locally
- Children <4 years of age or infants, children, and
adolescents exposed to adults in high-risk categories.
3. An induration of >=15 mm is classified as positive
in persons who do not meet any of the above criteria.
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