tb exposure outbreak at sydney school, page-9

The problem is the guidelines. A health department will tend to following guidelines, particularly where children are concerned. Thus CST need to be talking with NTAC to get better guidelines. The current ones are a joke:

• Currently TST remains the preferred method of screening for LTBI
• IGRAs may be used as a supplementary test in individualised clinical assessment for LTBI where increased specificity is valuable in reducing the confounding effect from prior BCG vaccination or prior exposure to non-tuberculous mycobacteria.


Note that all is not perfect with the CDC guidelines either:

• QuantiFERON Gold can be used in all cases where the tuberculin skin test is recommended.
• Concern has been expressed that QuantiFERON Gold is less sensitive than the skin test so a negative QuantiFERON Gold test should not be used alone to exclude LTBI in the immunosuppressed, children less than 5 years old, or patients about to undergo TNF alpha therapy.

Notice that they say QFT CAN be used not should or must be used and they say QFT is less sensitive thant the TST.

Thus no guidelines are advocating the use of QFT.

CST must get this changed if we are to see any real increase in sales.