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6.032 Tuberculosis Screening for C.E.S. Students

6.032 Tuberculosis Screening for C.E.S. Students

It is the intent of Cooperative Educational Services to maintain a healthy school environment for its students. All students who are entering school at C.E.S. for the first time and have not been just previously enrolled in a public school in Connecticut will be screened for risk factors for tuberculosis prior to enrollment. Any student found to meet the criteria for being at risk for tuberculosis as identified by the May 2005 Department of Public Health Guidelines for Tuberculosis Control Screening will be required to be tested for tuberculosis by their licensed health provider and submit documentation of the results of the test.

If a record of a health assessment (HAR-3) for any student submitted in accordance with Connecticut General Statutes Sections 10-206 (b) and (c), in the 6th or 7th grade and the 10th or 11th grade identifies the student as being at high risk for tuberculosis that student shall be required to be tested for tuberculosis. Testing shall be provided by the student’s licensed health provider and documentation of the results of the test shall be submitted.

Reference(s): Connecticut General Statutes Sections 10-206 (b) and (c) May 2005 Department of Public Health Guidelines for
Tuberculosis Control Screening

ADOPTED: September 7, 2006

Procedures

Due to the current low rates of transmission of tuberculosis in all parts of Connecticut, routine screening for tuberculosis for all students at school entry or for any of the required examinations is not required. It is required that at the time of original entry to school and at each mandated examination, an assessment be made of the risk of exposure to tuberculosis. Prior to initial entry to school, parents will be informed of the risk factors for tuberculosis and instructed to get a tuberculin test for their child if any of the factors exist. At the time of each mandated health assessment, the student’s licensed health care provider shall assess the risk and provide a test for any student known to have any of the risk factors in accordance with the procedures identified below. Any student found to be positive must have an appropriate management plan developed, including determination of school attendance while receiving treatment. Students are considered to be at risk for tuberculosis infection if they have any of the following risk factors:

 were born in a high risk country of the world (all countries in Africa, Asia (including former Soviet Union), Eastern Europe, Central and South
America, Dominican Republic and Haiti) and do not have a record of a tuberculin skin test performed in the U.S.;
 have traveled to a high risk country, stayed for at least a week with substantial contact with indigenous population since the previously
required examination;
 have had extensive contact with persons who have recently come to the U.S. since the previously required examination;
 had contact with person(s) suspected to have tuberculosis; or
 had contact with anyone who has been in a homeless shelter, jail or prison, uses illegal drugs or has HIV infection.
A history of BCG vaccination is not a contraindication to testing nor should it be considered in interpretation of the skin test result.

Type of Test and Recording Results

The intradermal injection test (Mantoux test) is to be used.

Negative Test Results
In general, an induration of 0-9 mm obtained by screening by the Mantoux test should be considered negative. If testing is being done as part of a contact investigation following discovery of a potentially infectious case, induration of 0-4 mm should be considered negative. No further evaluation is indicated unless the student has a chronic unexplained cough or is a result of contact to a known infectious case of tuberculosis. In such instances, the student will be referred further medical evaluation.

Positive Test Results
In general, induration of greater than or equal to 10 mm by the Mantoux should be considered positive. If testing is conducted as part of a contact investigation, induration greater than or equal to 5 mm should be considered positive. These criteria apply to all students, including those who have received BCG vaccination in the past. Students with positive test results will be referred for further medical assessment and treatment. A symptom screen and chest x-ray should be performed to rule out active TB disease on all students with a positive skin test. Treatment for students with positive test results will be determined by the treating physician. Students with positive test results will be allowed to attend school based upon the recommendation of the treating physician.

Any child with a positive test will be reported to the local health department and the Connecticut Department of Public Health Tuberculosis Control Program.

Student Name:

Tuberculosis Risk Assessment Questionnaire

(to be given to each student prior to enrolling if enrolling in a Connecticut school

for the first time)

1. Was your child born in Africa, Asia (including the former Soviet Union), Latin America, Haiti, Dominican Republic or Eastern Europe_____________
2. Has your child traveled to any of the continents or countries listed above?_________
If yes, did your child stay for more than a week and interact with local people including friends and family?____________
3. Has your child had contact with any person either known or suspected of having TB disease?_________
4. Does your child have close contact with someone with a positive tuberculin skin test?_______
5. Does your child spend time with anyone who has been in jail (or prison) or a shelter?______
6. Does your child spend time with anyone who injects illegal drugs or has HIV?______
7. Has your child drunk raw milk or eaten unpasteurized cheese since the last tuberculin skin test?_______
8. Does your child have a household member who was born in any of the countries or continents listed in question #1?_________
9. Does your child have a household member who has traveled to any of the countries or continents listed in question 1?

If the answer is yes to any of these questions, student must have a tuberculosis test prior to enrolling in school.

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