State Publishes Screening Guide for Universities
Colleges and universities have always had a special kind of vulnerability to TB outbreaks:
1. They tend to be highly congregate settings.
2. They serve as temporary home to thousands of foreign students, many from settings where TB is endemic; none of whom are required to undergo pre-entry medical screenings, according to the American College Health Association.
Despite these difficulties, the Connecticut Tuberculosis Elimination Committee (TEAC) argues that it makes good sense to do TB screenings in the college setting.
For one thing, college students are young, with about half under age 23, and therefore usually make good candidates for prophylactic regimens. Plus, resistance rates to isoniazid tend to be low among TB cases that have developed in college students upon arrival in the United States.
Screening students upon entry is good timing, too, since 35% of cases of TB among the foreign-born occur within the first two years of arrival in the United States. From the standpoint of logistics, most colleges already require some form of health screening, making it feasible to add TB screening to the list.
Based on that rationale, TEAC recently issued these recommendations for TB screening in the university and college setting:
4 All students in the state should have a PPD skin test upon entry, with results recorded in millimeters of induration.
4 For students who arrive without such a record, the university should offer PPD skin testing within six months of the student's arrival, with special priority accorded to international students from high-incidence areas.
4 All university employees should also get a baseline skin test. When appropriate, testing should offered to families of international students, too.
4 Students returning from living abroad in a high-incidence part of the world for three months or more should be offered a repeat skin test.
4 All those screened who test positive should be evaluated for active TB.
4 The school should aggressively encourage students with latent infection to complete a course of preventive therapy as soon as possible, including, if feasible, the use of directly observed preventive therapy.
4 A history of a BCG (bacille Calmette-Guerin vaccine) vaccination is not a contraindication to testing, nor should it be considered in the interpretation of the skin-test results.
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