More info on the CDC /TB testing....

Here is what I have found on the new TB test regulations from CDC, not as bad as many of us once feared.

New Procedures for Identifying and Treating Active Tuberculosis
The Embassy would like to clarify the following points about the Center for Disease Control’s (CDC) new requirements for TB testing and treatment for IV applicants, including orphans.
• The Embassy’s panel physicians will begin implementing CDC’s new Technical Instructions on March 23, 2009.

• CDC is phasing in these new requirements worldwide in order to better identify and treat immigrant visa applicants with active TB. CDC has conducted studies in other foreign countries and discovered that the previous method of identifying active TB failed to catch a large percentage of active TB cases. As a result, immigrants with active TB entered the U.S.

• It is CDCs responsibility to protect Americans from infectious diseases. These new requirements will greatly improve the Embassy’s ability to identify visa applicants with active TB, and to ensure they receive the most effective treatment for their condition before they are granted visas.

• For children under 2 years of age: there will be no change in the testing procedure. As before, if a child shows signs of TB, the panel physician will take a sputum sample. With children this age, this often is done through a procedure called gastric aspiration, which generally requires a hospital stay of 2 to 3 nights. In Fiscal Year 2008, fewer than 5 children among the Embassy’s adoption visa cases underwent gastric aspiration. None were confirmed to have active TB.

• For children between 2-14 years of age: all children will require a Tuberculin Skin Test (TST). If the TST indicates the child has been exposed to TB, then the child will have a chest x-ray to check for abnormalities.

• The Embassy’s panel pediatricians believe that many children will show exposure for TB after the TST, but a very small number will show abnormal chest x-rays. If the child has a normal chest x-ray, no further testing is required.

• For the vast majority of children, implementation of these new requirements will cause no delay in the processing of their cases.

• For those few children who have abnormal chest x-rays, a sputum sample will be taken. CDC’s new regimen requires that the sample be cultured to check for active TB. Results of this culture take up to 8 weeks to confirm that the child does not have active TB.

• For children confirmed to NOT have active TB, their cases will be processed to completion with no further delays.

• For the very small number of children whose TB culture confirms they have active TB, the requirement is that they submit to six months of Directly Observed Therapy (DOT) at the clinic of the International Organization for Migration (IOM) in Addis Ababa. Consular staff estimates fewer than 10 orphans per year will require this treatment.

• The Consular Section encourages agencies to consult with their own pediatricians and test children whom they think might have active TB in order facilitate early treatment.

• Adoptive parents should consult with their agencies if they have concerns.

• The bottom line: for the overwhelming majority of children, these new requirements will cause no delays in the processing of their cases

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