Alternatives to the Standard TB Test:
by Lauren Feder, M.D.

Excerpt from The Parents' Concise Guide to Vaccinations

A reader asks: I'm concerned about getting my routine TB test for work. I am 14 weeks pregnant and don't want to pass on anything harmful to my baby. Is the TB test safe for children and pregnant women?

I would suggest you consider the new TB blood test that requires no injection. Called the QuantiFERON TB Gold test (QFT-G), it will be the new standard amongst adults. The drawback is that currently the lab requires two tubes of blood which is more difficult to get from small children due to their smaller veins.

As a substitute for the skin test, there are several alternatives to test for TB. According to recent guidelines published by the CDC, the QuantiFERON TB Gold test (QFT-G) a simple blood test, that can be performed in all cases of which the TB skin test is indicated. Although recommendations are intended for healthcare providers, evaluation of immigrants with BCG vaccination, and contact investigations, many are interested in expanding the use of this test for children as well.

According to current research the sensitivity of the test on children is still unknown. This test has the advantage of requiring only one visit to the office, instead of the traditional 2 day follow up with the skin test for a reading. The QFT-G is similar to the skin test, in that both can be used for screening but not diagnosis of severity of disease. For positive tests, further evaluations are required. I've been using this blood test extensively in the office, the lab requires 2 tubes of blood which is easier to get on older children.

In addition, there is a sputum AFB test for tuberculosis has been accepted by schools and in the workplace. The sputum test is performed by coughing up mucous from the lungs. The sample is sent the laboratory to rule out tuberculosis. The sputum test may not be entirely accurate either.