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The Role of BCG Vaccine in the Prevention and Control of Tuberculosis in the United States A Joint Statement by the Advisory Council for the Elimination of Tuberculosis and the Advisory Committee on Immunization Practices (MMWR 45(RR-4);1-18) for information on topic Tuberculin Skin Testing and Interpretation of Results After BCG Vaccination :

The Role of BCG Vaccine in the Prevention and Control of Tuberculosis in the United States A Joint Statement by the Advisory Council for the Elimination of Tuberculosis and the Advisory Committee on Immunization Practices (MMWR 45(RR-4);1-18) for information on topic Tuberculin Skin Testing and Interpretation of Results After BCG Vaccination

Postvaccination BCG-induced tuberculin reactivity ranges from no induration to an induration of 19 mm at the skin-test site (65-74). Tuberculin reactivity caused by BCG vaccination wanes with the passage of time and is unlikely to persist >10 years after vaccination in the absence of M. tuberculosis exposure and infection. BCG-induced reactivity that has weakened might be boosted by administering a tuberculin skin test 1 week to 1 year after the initial postvaccination skin test; ongoing periodic skin testing also might prolong reactivity to tuberculin in vaccinated persons (70,72).

Screening for Tuberculosis and Tuberculosis Infection in High-Risk Populations Recommendations of the Advisory Council for the Elimination of Tuberculosis (MMWR 44(RR-11);18-34) for information concerning Summary of interpretation of tuberculin skin-test results :

Screening for Tuberculosis and Tuberculosis Infection in High-Risk Populations Recommendations of the Advisory Council for the Elimination of Tuberculosis (MMWR 44(RR-11);18-34) for information concerning Summary of interpretation of tuberculin skin-test results :

1. An induration of >=5 mm is classified as positive in the following: -

•  Persons who have had recent close contact with persons who have active TB;

•  Persons who have human immunodeficiency virus (HIV) infection or risk factors for HIV infection but unknown HIV status;

•  Persons who have fibrotic chest radiographs consistent with healed TB.

2. An induration of >=10 mm is classified as positive in all persons who do not meet any of the above criteria, but who belong to one or more of the following groups having high risk for TB:

•  Injecting-drug users known to be HIV seronegative

•  Persons who have other medical conditions that have been reported to increase the risk for progressing from latent TB infection to active TB.

•  These medical conditions include diabetes mellitus, conditions requiring prolonged high-dose corticosteroid therapy and other immunosuppressive therapy (including bone marrow and organ trans- plantation), chronic renal failure, some hematologic disorders (e.g., leukemias and lymphomas), other specific malignancies (e.g., carci- noma of the head or neck), weight loss of >= 10% below ideal body weight, silicosis, gastrectomy, jejunoileal bypass

•  Residents and employees of high-risk congregate settings: prisons and jails, nursing homes and other long-term facilities for the elderly, health-care facilities (including some residential mental health facili- ties), and homeless shelters

•  Foreign-born persons recently arrived (i.e., within the last 5 years) from countries having a high prevalence or incidence of TB

•  Some medically underserved, low-income populations, including mi- grant farm workers and homeless persons

•  High-risk racial or ethnic minority populations, as defined locally

•  Children <4 years of age or infants, children, and adolescents exposed to adults in high-risk categories.

3. An induration of >=15 mm is classified as positive in persons who do not meet any of the above criteria.

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