Preparation of updated guidelines
• Expert Committee
– Neil W. Schluger, Chair
– Representation from American Academy of Pediatrics, American Thoracic Society, ACET, Association of Public Health Laboratories, CDC, FDA, Infectious Disease Society of America, NTCA, Stop TB USA, US Army, US Air Force, and VA
• Final guidelines prepared by Gerald Mazurek, John Jereb, Andrew Vernon, Philip LoBue, Stefan Goldberg, and Ken Castro
– Development of guidelines coordinated with AAP, ATS, IDSA
– To be published in June 25, 2010 MMWR
I think that we are already familiar with the content;
• Situations in which IGRA is preferred but TST is acceptable
– An IGRA is preferred for testing persons from groups that historically have low rates of returning to have TSTs read
– An IGRA is preferred for testing persons who have received BCG (as a vaccine or for cancer therapy)
• Situations in which either IGRA or TST may be used, without preference
– An IGRA or a TST may be used without preference to test recent contacts of persons know or suspected to have active tuberculosis with special considerations for follow-up
– An IGRA or a TST may be used without preference for periodic screening of persons who might have occupational exposure to M. tuberculosis (e.g., surveillance programs for health-care workers) with special considerations regarding conversions and reversions• Situations in which a TST is preferred but IGRA is acceptable
– A TST is preferred for testing children aged <5 years. Use of an IGRA in conjunction with TST has been advocated by some experts to increase diagnostic sensitivity in this age group. Recommendations regarding use of IGRAs in children have also been published by the American Academy of Pediatrics
