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CDC Updates Recommendations for TB Screening, Testing, Treatment of US Healthcare Personnel

NEW YORK (360Dx) – The US Centers for Disease Control and Prevention today announced that it has updated its recommendations previously published in 2005 for tuberculosis screening, testing, and treatment of US healthcare personnel.

The CDC updated a number of recommendations in a report entitled Tuberculosis Screening, Testing, and Treatment of US Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019, which it published in its Morbidity and Mortality Weekly Report.

It said the updated recommendations include "TB screening with an individual risk assessment and symptom evaluation at baseline (preplacement); TB testing with an interferon-gamma release assay (IGRA) or a tuberculin skin test for persons without documented prior TB disease or latent TB infection (LTBI); no routine serial TB testing at any interval after baseline in the absence of a known exposure or ongoing transmission; encouragement of treatment for all healthcare personnel with untreated LTBI, unless treatment is contraindicated; annual symptom screening for healthcare personnel with untreated LTBI; and annual TB education of all healthcare personnel."

The CDC noted that the annual national TB rate in 2017 (2.8 per 100,000 population) represented a 73 percent decrease from the rate in 1991 (10.4 per 100,000) and a 42 percent decrease from the rate in 2005 (4.8 per 100,000). In addition, surveillance data collected by the CDC during 1995–2007 revealed TB incidence rates among healthcare personnel similar to those in the general population, which raised questions about the cost-effectiveness of routine serial occupational testing.

The new report increases the focus on eradicating tuberculosis disease in the US through an individual risk-based approach to screening and treatment for healthcare personnel, diagnostics firm Oxford Immunotec said today in response to the recommendations. The Oxford, UK- and Marlborough, Massachusetts-based firm markets the T-Spot.TB test, while its primary competitor, Qiagen, markets QuantiFERON-TB — both of which are interferon-gamma release assays.

Peter Wrighton-Smith, CEO of Oxford Immunotec, said in a statement that the "updated recommendations underscore the need to treat LTBI in order to eradicate active TB. We expect these guidelines to further the trend toward IGRA adoption for healthcare personnel screening due to high test accuracy and reduced number of patient visits."

The firm noted that the 2017 TB diagnostic guidelines of the American Thoracic Society, Infectious Diseases Society of America, and CDC recommended performing an IGRA instead of a tuberculin skin test for patients who are unlikely to be infected with TB, such as most healthcare personnel.