Do We Still Need Annual TB Skin Testing?

Written by Thomas Davis

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The CDC no longer recommends* annual TB screening of health care providers in the absence of a known exposure or ongoing transmission.

Why does this matter?
There are already enough hoops to jump through just so you can keep practicing medicine: medical license renewal, ACLS renewal, study for ABEM ConCert exam, HIPAA compliance training, and $731 for a DEA license for each state you work in (despite it being a federal license).  Wouldn’t it be nice to take one thing off the to-do list?

Is it too good TB true?
TB rates in the United States have plummeted—down 73% since 1991 and 42% since 2005.  Surveillance data show that TB incidence among health care personnel were similar to those in the general population.  Therefore, a National Tuberculosis Controllers Association (NTCA)-CDC work group performed a systematic review, analyzing the data from 36 studies.  Its big conclusion is the removal of a recommendation for routine annual TB testing.

From cited article

From cited article

*However, hospitals should still consider individualizing its policies for regular screening among high-risk groups (e.g. pulmonologists and respiratory therapists) or in certain settings if transmission has occurred in the past (e.g. emergency departments).

Source
Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel: Recommendations from the National Tuberculosis Controllers Association and CDC, 2019. MMWR Morb Mortal Wkly Rep. 2019 May 17;68(19):439-443. doi: 10.15585/mmwr.mm6819a3.

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