Tuberculosis
Screening Test
The State of Hawaii requires tuberculosis screening tests for all persons living or working in the residential care setting. We are here to help. We offer on-location new admission and annual TB screening tests for all residents and staff. This page outlines some useful information regarding TB clearance regulations and some of the tests we offer at health2me.
If you have any questions we are here to help. Give us a call today to schedule an appointment.
Do I need a PPD or a IGRA?
Health2me offers the IGRA screening test for TB. Both PPD and IGRA tests are accepted by the State of Hawaii. The IGRA can be used instead of two step and single step PPD screenings. As a result, IGRAs are ideal for new patients who require two step PPDs before admission to a care facility. Two step PPDs require a total of four visits, while an IGRA can be completed in a single visit.
Tuberculin Skin Test (PPD)
The Tuberculin Skin Test, more commonly known as a PPD, is the traditional screening method for Tuberculosis (TB) infections. It involves injecting a small amount of a purified protein derivative into the skin. If an individual is infected, a reaction will occur, resulting in reddening and elevation of the skin (induration). A licensed healthcare professional must read the test between 48 and 72 hours after administration.
​
Two-Step PPD
Two-step PPD tests are required for all new admissions. The first PPD is administered on day one and must be read within 48 to 72 hours. The second PPD is administered 7 to 21 days after the first PPD and is read on the fourth visit 48 to 72 hours later.
Interferon-Gamma Release Assays (IGRAs)
An alternative to the PPD test is an Interferon-Gamma Release Assay (IGRA). IGRAs are blood tests that measure the immune response to TB proteins in whole blood. There are currently two IRGAs that are approved by the U.S. Food and Drug Administration (FDA) and the Hawaii Department of Health, QuantiFERON and T-SPOT. Since IGRAs are blood tests, they can be completed in a single visit.
New Admission Tuberculosis Screening Test
Hawaii state law requires that all new residential care home residents obtain TB clearance within two weeks of admission. PPDs and IGRAs are both accepted by the State of Hawaii.​
​
No Documented Previous Positive Test for TB
Individuals without a previous positive test for TB may receive TB clearance after receiving a two-step PPD or a single IGRA blood test. At Kuru Health we offer IGRAs. Not only are IGRAs more accurate, but they also reduce the number of visits from four to one.
​
Documented Previous Positive Test for TB
In the case of a patient with a previous positive TB test, the process is slightly different. In most cases, the patient will require a Chest X-ray (CXR) to evaluate for TB disease. If the CXR is negative, the patient will receive TB clearance. If a patient had a CXR that excluded TB disease within the past twelve months, they may be exempt from having a repeat CXR after screening by a provider.
Annual Tuberculosis Screening Test
Hawaii state law requires all residential care home residents to obtain an annual TB clearance. Annually refers to a period of 335 to 395 days.
​
No Documented Previous Positive Test for TB
Individuals without a previous positive test for TB may receive annual TB clearance after receiving a single step PPD or a single IGRA blood test. Kuru Health offers both options for our patients. Depending on your insurance and timeline, one test might be better than the other for your given situation. Give us a call and we can help determine which test is best for your patient.
​
Documented Previous Positive Test for TB
In the case of a patient with a previous positive TB test, the process is slightly different. First, the patient will undergo a symptom screening with one of our providers. If the provider determines that the patient does not exhibit symptoms consistent with TB, the patient may receive TB clearance. In some cases, TB clearance may require another Chest X-ray.
