topic Re: HOW COMMON IS TB TESTING? in Wellness

HOW COMMON IS TB TESTING?

Tinkrbl44 — Sat, 10 Jul 2021 19:19:07 GMT

First, I'm asking this because it's Saturday morning, and I can't call my MD's office until Monday, which I plan to do.

I have a new Rheumatologist and he requested the usual blood tests for a new patient. Two of the tests are questionable (for me).

First, a thyroid test was on the list. The lab told me that while every other test would not have any co-pay, the thyroid test probably wouldn't be paid for ... and would cost me about $130. I told her to do it anyway, speed was important to me, as I'm awaiting prescriptions written based on lab results. Just do it.

So, the test results were finally processed .... and one was missing. They did everything but the TB test, and no one could tell me why.

So I was back at the lab yesterday for my appointment, and after an hour's wait was told that I would have to come back next week. The reason given was that this TB test is a "special" test requiring special handling, using a specific vial and then it must be FedExed immediately to wherever it will be processed.

Here's what I don't understand .... like most of us, I've been walking around with a mask on everywhere, keeping my distance, etc etc etc. What is the likelihood I would have caught TB ... anywhere? If I had caught TB somewhere, wouldn't I feel sick?

Is the TB test just a common, routine test these days? Maybe the MD is just being thorough, but this seems a tad excessive to me.

Can anyone here give me some feedback on this? What are your thoughts? TIA!

Re: HOW COMMON IS TB TESTING?

On It — Sat, 10 Jul 2021 19:39:09 GMT

I am not familiar with a TB test being given routinely. It does seem unusual. Could it need to be ruled out before specific treatments could be used?

Re: HOW COMMON IS TB TESTING?

KingstonsMom — Sat, 10 Jul 2021 19:42:31 GMT

@Tinkrbl44

DH has Crohn's disease and receives Remicade infusions 4 x a year and once a year he has to have a TB test before he receives the infusion.

Re: HOW COMMON IS TB TESTING?

RedTop — Sat, 10 Jul 2021 19:55:42 GMT

As a hospital employee who was not a caregiver to patients, I was tested for TB on a regular basis.

Based on what you've said, I would think having a negative TB test is more for safe documentation to whatever medication you are likely to be prescribed, NOT that you may be infected, or a carrier.

Re: HOW COMMON IS TB TESTING?

SilleeMee — Sat, 10 Jul 2021 21:23:03 GMT

Unless things have changed, TB tests are done by doing a skin test with a poke to the inner-lower-arm with a small amount of fluid (tuberculin). Then you go back 48-72 hours after to have the injection site looked at for a reaction (red spot of a certain size) to determine if you have been exposed to the tuberculosis bacteria.

TB infections have been on the rise and is more common in certain areas of the US.

ETA - The FDA approved a blood test for TB in 2001 and it is more accurate than a skin test plus you don't need to go back to have it checked like you do with a skin test.

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5202a2.htm

Re: HOW COMMON IS TB TESTING?

World Traveler — Sat, 10 Jul 2021 19:57:31 GMT

People who work in the local school district are required to have a TB test every four years. Don't know why, but they do.

Re: HOW COMMON IS TB TESTING?

On It — Sat, 10 Jul 2021 20:01:54 GMT

@World Traveler wrote:
People who work in the local school district are required to have a TB test every four years. Don't know why, but they do.

When I was in school we got a mass testing for all students, but I can't remember if it was certain grade levels or everyone. We had to wait some amount of time, and then they came back and read our arms for results.

Re: HOW COMMON IS TB TESTING?

KingstonsMom — Sat, 10 Jul 2021 20:04:52 GMT

@SilleeMee wrote:
Unless things have changed, TB tests are done by doing a skin test with a poke to the inner-lower-arm with a small amount of fluid (tuberculin). Then you go back 48-72 hours after to have the injection site looked at for a reaction (red spot of a certain size) to determine if you have been exposed to the tuberculosis bacteria.

TB infections have been on the rise and is more common in certain areas of the US.

Yes, that is the TB test that DH receives before his treatment for Crohn's disease.

Re: HOW COMMON IS TB TESTING?

SilleeMee — Sat, 10 Jul 2021 20:08:43 GMT

TB can lay dormant in your body for an undetermined amount of time during which you will have no symptoms or sickness but will test positive with a TB test. Dormant TB infection is called latent TB infection which is not infectious...you can't give it to someone else. Latent infections have the potential to become infectious when the infected person develops a weakened immune system. That can happen years after the primary infection.

Re: HOW COMMON IS TB TESTING?

Kachina624 — Sat, 10 Jul 2021 20:18:49 GMT

Its a commonly routine test in many instances. I had to have one while I was in a rehab facility after knee replacement surgery. When I worked in a public office, the employees were exposed to a client who tested positive for TB. Everyone had the option of being tested.

Re: HOW COMMON IS TB TESTING?

geezerette — Sat, 10 Jul 2021 20:19:55 GMT

@SilleeMee wrote:
TB can lay dormant in your body for an undetermined amount of time during which you will have no symptoms or sickness but will test positive with a TB test. Dormant TB infection is called latent TB infection which is not infectious...you can't give it to someone else. Latent infections have the potential to become infectious when the infected person develops a weakened immune system. That can happen years after the primary infection.

My mother always tested positive for TB, yet she never had it--meaning she never had any of the symptoms of the disease. Her father had it (he died when she was three) and she always figured she had been exposed to it from him.

Re: HOW COMMON IS TB TESTING?

Tinkrbl44 — Sat, 10 Jul 2021 20:32:43 GMT

@World Traveler wrote:
People who work in the local school district are required to have a TB test every four years. Don't know why, but they do.

@World Traveler

Hmm. I wonder how often they have a positive result.

Re: HOW COMMON IS TB TESTING?

Tinkrbl44 — Sat, 10 Jul 2021 20:37:17 GMT

@SilleeMee wrote:
Unless things have changed, TB tests are done by doing a skin test with a poke to the inner-lower-arm with a small amount of fluid (tuberculin). Then you go back 48-72 hours after to have the injection site looked at for a reaction (red spot of a certain size) to determine if you have been exposed to the tuberculosis bacteria.

TB infections have been on the rise and is more common in certain areas of the US.

@SilleeMee

Well, this will be interesting. I am almost positive that they are going to draw blood. My appt is Monday at 2pm.

Re: HOW COMMON IS TB TESTING?

quilter61 — Sat, 10 Jul 2021 20:36:46 GMT

I had to have one when I started working at the school. Do you have a med express or something similar in your area. That is where I went. Had a skin ****** and when back in 72 hours to have the nurse look at my arm.

Re: HOW COMMON IS TB TESTING?

World Traveler — Sat, 10 Jul 2021 20:51:58 GMT

I do know that the school employees who are pregnant or for some other reason are not to have the test because of some underlying problems, don't have to take the test, but are required to present a letter from their doctor that states they are not perceived to have TB. They are still required to answer the school nurse's questions about any possible symptoms.

The employees are not required to pay for the testing. Since it is mandatory, the school district foots the bill.

Re: HOW COMMON IS TB TESTING?

On It — Sat, 10 Jul 2021 20:49:48 GMT

Since a rheumatologist is ordering the test, it made me recall that my mother had to stop taking her arthritis medications for a period of time before she could have surgery. I think these medications possibly lower the immune response. If someone had TB in their body, could the medications cause it to become active? Since you haven't been prescribed yet, these could be good questions to ask your new doctor.

Re: HOW COMMON IS TB TESTING?

SilleeMee — Sat, 10 Jul 2021 20:59:17 GMT

@Tinkrbl44 wrote:
@SilleeMee wrote:
Unless things have changed, TB tests are done by doing a skin test with a poke to the inner-lower-arm with a small amount of fluid (tuberculin). Then you go back 48-72 hours after to have the injection site looked at for a reaction (red spot of a certain size) to determine if you have been exposed to the tuberculosis bacteria.

TB infections have been on the rise and is more common in certain areas of the US.
@SilleeMee

Well, this will be interesting. I am almost positive that they are going to draw blood. My appt is Monday at 2pm.

@Tinkrbl44

There is a blood test for TB which has a 99% specificity as compared to 88% (on average depending on test product) specificity of a skin test. TB blood tests are not routinely done. Skin tests are the most common method of testing. Blood tests are the more accurate of the two methods of detection.

Re: HOW COMMON IS TB TESTING?

SilleeMee — Sat, 10 Jul 2021 21:13:18 GMT

The TB blood test is relatively new, FDA approved in 2001. So it's new to me as well. I've been briefly reading about it and the TB blood test may soon be the method of testing for adults b/c of the cost-effectiveness of it. The results are clear cut rather than having a red spot on your skin examined to determine a result which can be subjective at times leading to errors in reporting. Blood test results are also one and done rather than having to go back later to have a skin test 'read' which requires time and money on both sides of the fence.

Re: HOW COMMON IS TB TESTING?

Sage04 — Sat, 10 Jul 2021 21:15:04 GMT

@geezerette wrote:
@SilleeMee wrote:
TB can lay dormant in your body for an undetermined amount of time during which you will have no symptoms or sickness but will test positive with a TB test. Dormant TB infection is called latent TB infection which is not infectious...you can't give it to someone else. Latent infections have the potential to become infectious when the infected person develops a weakened immune system. That can happen years after the primary infection.
My mother always tested positive for TB, yet she never had it--meaning she never had any of the symptoms of the disease. Her father had it (he died when she was three) and she always figured she had been exposed to it from him.

@geezerette I had a Family Day Care when I lived in Florida and had to be tested for TB. I tested positive and the Dr gave me an exray and that was negative, so they told me when ever a TB test was required, I should ask for an exray instead and that´s what I always did.

Re: HOW COMMON IS TB TESTING?

Mindy D — Sun, 11 Jul 2021 20:31:01 GMT

@Tinkrbl44 @There is more than one kind of TB test. One type is called a tuberculin skin test. It's usually done as a requirement for a job. It tests for latent TB. With latent TB you do not usually feel sick. You might not even know you have TB. This test is done with a pin ******. After pricking, if positive, there's a reaction on the skin days after the test. The other type of TB involves a blood test and this tests for active TB. You might feel ill will active TB. If either type of test comes back positive, XRays will be done. It's standard practice to test for TB before starting biologic medications. It’s standard to test you for a tuberculosis infection because biologics suppress the immune system. If you’re found to be infected, your doctor will treat you for latent TB before starting the biologic drug in order to prevent a latent infection from becoming active. Treatments for rheumatoid arthritis and other autoimmune diseases often involve biologics. I don't know the purpose for your visit, but a rheumatologist might routinely rule out TB in many patients because many patients that visit a rheumatologist are treated with biologics.