TB Skin Testing Requirement for Non-U.S. Residents and Students Participating in Study Abroad Programs in High Risk Areas

Carroll University is now requiring a TB skin test or Quantiferon TB blood test for non-U.S. residents and students participating in study abroad programs in high risk areas. The University established a screening requirement to prevent the spread of TB among college residents, and to avoid secondary transmission to the community.

Where can I get my TB skin test or TB blood test done?

• The Carroll University Student Health Center, located at 215 Wright Street.
• Any local clinic (Be sure to get a form with the results and the date the test was done to submit to the Student Health Center.)

When can I get my TB skin test or TB blood test done?

• For students that are non-U.S. residents, the TB skin test or TB blood test must be done after arriving in the U.S. and by or before the 25th day of classes.
• Carroll University Students that study abroad in high incidence areas listed in appendix A need to have a TB skin test or the Quantiferon TB blood test 8 to 10 weeks after returning to the U.S.
• The skin test can be done at the Carroll University Student Health Center Monday, Tuesday, Wednesday (between 9am-5pm), or Friday (between 9am-4:30pm).
• Students must return to the Health Center 48–72 hours later to have the TB skin test read by the Nurse Practitioner.
• In students that have had the BCG (TB) vaccine or a positive TB skin test in the past, the Nurse Practitioner may opt to do the TB blood test (instead of a skin test) to avoid a false positive skin test from prior BCG vaccination
• If you go to a local clinic, refer to the clinic for their policy and clinic hours; you will need to submit a copy of the results to the Carroll University Student Health Center

What is the cost of the TB skin Test or blood test?

• When done at the Carroll University Student Health Center, the cost of a TB skin test is $12, and the cost of the TB blood test is $92, billed to the student account.
• If you have the health insurance plan offered through Carroll University by WPS, both tests are covered and you will not be billed if the test is done in the Student Health Center.
• If you have a different insurance plan or use an off campus clinic, you will be billed per the clinic policy and based on your health insurance coverage.

What do I do if the TB skin test is positive?

• If the results of the TB skin test or the TB blood test are negative, no further testing is required.
• If the results of the TB skin test are positive, the individual must obtain a Quantiferon TB Gold (interferon gamma release assay) blood test and complete a TB Symptom Survey (obtained at the Carroll University Health Center).
• If the results of the TB blood test are positive, the student must obtain a chest x-ray to show the absence of active disease. The chest x-ray can be done at any U.S. clinic that has x-ray facilities. If necessary, the Carroll University Health Center staff can help students find a local clinic where a chest x-ray can be done.
• If you have the student health insurance plan offered by Carroll University through WPS, the chest X-ray is covered but there is a $100 deductible and you also will be responsible for a 20% co pay.

• A student with a prior positive TB skin test or with known TB infection or disease must report to the Carroll University Health Center for evaluation to determine if a TB blood test is needed, if a chest x-ray is needed, or if further documentation is required, and to complete a TB Symptom Survey.
• In the case of a history of positive TB skin test related to prior BCG vaccination, a Quantiferon TB Gold blood test will be performed. If the Quantiferon TB Gold blood test is positive, the protocol outlined above will be followed.
• Annual TB Symptom Surveys may be required if preventive medications were not taken as in the case of latent Tuberculosis infection or in lieu of a TB skin test in a student that needs documentation for their major (i.e. Nursing, Physical Therapy, Education, or Athletic training)

Questions?

Call or stop by and talk to the nurse practitioner in the Student Health Center 262-524-7233, located in the lower level of New Hall near the Oak Room.

APPENDIX A

High-incidence areas are defined as countries with an annual incidence of TB disease of greater than or equal to 20 cases per 100,000 population. Most countries in Africa, Asia, Central America, Eastern Europe, and South America are included in this group. See below for a current list of High and low-incidence countries, as identified by the World Health Organization (WHO) Global Health Observatory. (Source: World Health Organization Global Health Observatory, Tuberculosis Incidence 2010 and American College Health Association http://www.acha.org/Publications/docs/ACHA_Tuberculosis_Screening_Apr2012.pdf)

For future updates, refer to http://apps.who.int/ghodata

Afghanistan, Algeria, Angola, Argentina, Armenia, Azerbaijan, Bahrain, Bangladesh, Belarus, Belize, Benin, Bhutan, Bolivia (Plurinational State of), Bosnia & Herzegovina, Botswana, Brazil, Brunei Darussalam, Bulgaria, Burkina Faso, Burundi, Cambodia, Cameroon, Cape Verde, Central African Republic, Chad, China, Columbia, Comoros, Congo, Cote d’Ivoire, Croatia, Democratic People's Republic of Korea, Democratic Republic of the Congo, Djibouti, Dominican Republic, Ecuador, El Salvador, Equatorial Guinea, Eritrea, Estonia, Ethiopia, Fiji, Gabon, Gambia, Georgia, Ghana, Guam, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Honduras, India, Indonesia, Iraq, Japan, Kazakhstan, Kenya, Kiribati, Kuwait, Kyrgyzstan, Lao People's Democratic Republic, Latvia, Lesotho, Liberia, Libyan Arab Jamahiriya, Lithuania, Madagascar, Malawi, Malaysia, Maldives, Mali, Marshall Islands, Mauritania, Mauritius, Micronesia (Federated States of), Mongolia, Morocco, Mozambique, Myanmar, Namibia, Nepal, Nicaragua, Niger, Nigeria, Pakistan, Palau, Panama, Papua New Guinea, Paraguay, Peru, Philippines, Poland, Portugal, Qatar, Republic of Korea, Republic of Moldova, Romania, Russian Federation, Rwanda, St. Vincent & the Grenadines, Sao Tome & Principe, Senegal, Seychelles, Sierra Leone, Singapore, Solomon Islands, Somalia, South Africa, Sri Lanka, Sudan, Suriname, Swaziland, Syrian Arab Republic, Tajikistan, Thailand, The former Yugoslav Republic of Macedonia, Timor-Leste, Togo, Tunisia, Turkey, Turkmenistan, Tuvalu, Uganda, Ukraine, United Republic of Tanzania, Uruguay, Uzbekistan, Vanuatu, Venezuela (Bolivarian Republic of), Vietnam, Yemen, Zambia, Zimbabwe

“Low Incidence” areas are defined as areas with reported or estimated incidence of <20 cases per 100,000 population

Albania, Andorra, Antigua and Barbuda, Australia, Austria, Bahamas, Barbados, Belgium, British Virgin Islands, Canada, Chile, Cook Islands, Costa Rica, Cuba, Cyprus, Czech Republic, Denmark, Dominica, Egypt, Finland, France, French Polynesia Germany, Greece, Grenada, Hungary, Iceland, Iran (Islamic Republic of), Ireland, Israel, Italy, Jamaica, Jordan, Lebanon, Luxembourg, Malta, Mexico, Montenegro, Nauru, Netherlands, New Zealand, Norway, Oman, Puerto Rico, Saint Kitts and Nevis, St. Lucia, Samoa, Saudi Arabia, Serbia, Slovakia, Slovenia, Spain, Sweden, Switzerland, Tonga, Trinidad and Tobago, United Arab Emirates, United Kingdom, United States of America, West Bank and Gaza Strip