Discontinuation of Targeted Testing for Tuberculosis Disease and PPD Implantation
Prior to 2002, one of the requirements for first-time school entry was for every child to be tested for the exposure to Tuberculosis disease by implantation and interpretation of either the Tine or the Mantoux test. In 1985, the Miami-Dade County Health Department (MDCHD) Special Immunization Program (SIP) began assisting the medical community by providing Tuberculosis Skin Testing (TST) to all children entering private or public school in Florida as well as daycare centers and Head Start Programs. In 2002, the Centers for Disease Control and Prevention (CDC) changed its mandate surrounding the management of Tuberculosis disease by requiring medical providers to screen rather than test all patients to rule out the possible risk for Tuberculosis disease.
In conjunction with this change, the Department of Health (DOH) and the Department of Education (DOE) revised the School Health Examination Form (DH3040) to include the risk assessment, thus requiring a medical provider's signature certifying that the child is not at risk and is therefore, healthy enough for school entry. The DOH and DOE provided an 18-month grace period, which expired in 2004, as of which all medical providers would perform screenings for risk of TB exposure to all first-time school entries with the option to test if they are going to follow up by treating the infection.
The Special Immunization Program is mandated to control and eliminate vaccine preventable diseases, of which the control of Tuberculosis disease is not recognized in the United States of America as a vaccine preventable. Therefore, as of March 1, 2007, the Special Immunization Program will no longer be providing screening or testing of children 0 months through 18 years of age for risk or infection of Tuberculosis disease. Any child requiring entry to private/public school, daycare or Head Start programs in Miami-Dade County or any other county in Florida must be screened for risk of TB exposure by the medical provider who is performing and completing the School Entry Examination Form (DH3040) or performing the physical examination. This includes implantation and interpretation of the test within 48 to 72 hours. If the test is interpreted as a positive reading, the medical provider is required to evaluate the client by doing further diagnostic evaluation for testing for disease. All communicable diseases must be reported to the Department of Health, including Tuberculosis disease.
SIP will continue to provide immunization services to children between the ages of 0 months through 18 years of age under the guidelines of the Centers for Disease Control and Prevention National Immunization Program and the Advisory Committee for Immunization Practices as well as the requirements of the Standards for Child and Adolescent Immunization Practices and the Vaccines for Children Program. If you have any questions, please contact our office at 786-845-0550 Monday through Friday, excluding holidays and weekends, between the hours of 8 am and 5 pm and we would be happy to assist you.