HONOLULU — Hawaii will begin instituting new tuberculosis screening procedures starting next week.
The change means traditional tuberculosis (TB) skin tests may no longer be necessary for many Hawaii residents seeking TB clearance for employment, school, food handling or participation in other programs.
Instead of the routine screening involving an injection and a follow-up examination to “read” the injected area within 48 to 72 hours, individuals will now take part in a TB risk assessment questionnaire that takes a few minutes and includes prompts such as whether the individual has traveled abroad for four weeks or more to locations known for their prevalence of TB.
Based on responses and other observations, a physician or advance practice nurse can issue a TB clearance letter the same day without requiring the individual to take a skin test.
The state Department of Health is instituting the new screening procedures effective Monday following the recommendations of the majority of health care organizations, including the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics. It updates the state’s procedures established 12 years ago with “better, proven procedures to more accurately determine someone’s risk of exposure to TB.”
“This allows us to make better use of health resources and reduce unnecessary X-rays for those who have no risk. It also allows us to focus on providing treatment for those who would really benefit from treatment,” said TB Control Program chief Dr. Elizabeth MacNeil.
The new rule does not apply to those working in the health care field, who are still required to obtain annual screenings and tests.
The department also announced Wednesday that a TB blood test can be substituted for a TB skin test. Those age 5 and older identified by the assessment as being at risk for TB will be required to take one of the two tests. The blood test is not currently approved for children under age 5.
Individuals with a positive TB skin test are still required to have a chest X-ray. Individuals with suspicious TB symptoms will require both a TB test as well as a chest X-ray before they receive clearance.
The state said it will continue to provide free TB skin tests at designated locations statewide. People may request the blood test for TB from their health care provider.
Info: Visit www.health.hawaii.gov/tb or call or call the TB program at 832-5731.
