Jordan Ellis
Tuberculosis (TB) is an infectious disease that primarily affects the lungs. It is caused by bacteria that are spread through the air from person to person. While the number of infections in the U.S. has declined since 1993, it remains a concern as many strains of TB are resistant to drugs. A TB skin test can tell if you have TB germs in your body. The test requires two visits with a healthcare provider. During the first visit, the provider uses a small needle to inject some testing material under the skin on the lower part of your inner arm. After two or three days, you must return to the clinic to have the skin test read. While some hospitals offer TB skin tests for a fee, it is free if you have been exposed to an active case, are considered high-risk, or have symptoms.
| Characteristics | Values |
|---|---|
| Test Availability | TB skin tests are widely available at hospitals, clinics, and health departments. |
| Cost | The cost of TB skin tests varies. Some locations offer free testing for certain individuals, while others charge a fee (ranging from $20 to $25). Insurance coverage may apply. |
| Eligibility | Anyone can get a TB skin test, especially those with symptoms, exposure to TB, or belonging to high-risk groups. |
| Procedure | The test involves two visits. The first is for the injection of tuberculin under the skin, and the second, after 48-72 hours, is to assess the skin reaction. |
| Results | A positive result indicates the presence of TB germs but does not confirm an active infection. Further tests are needed for diagnosis. |
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What You'll Learn
TB skin tests are free for those exposed, at-risk, or symptomatic
Tuberculosis (TB) is an infectious disease that primarily affects the lungs. It is caused by bacteria that spread through the air from person to person. While the number of infections in the U.S. has declined since 1993, it remains a concern, especially as many strains of TB are resistant to the drugs used to treat it.
People with latent TB do not exhibit symptoms and are not contagious, but if untreated, it can develop into active TB. Those with active TB experience symptoms such as feelings of sickness or weakness, weight loss, fever, night sweats, coughing, chest pain, and coughing up blood. Due to the contagious nature of active TB, it is important to get tested if you are experiencing any of these symptoms or have been exposed to someone with TB.
TB skin tests are often recommended for those who have been exposed to TB, are at high risk, or are exhibiting symptoms. The tuberculin skin test (TST) is a screening test for TB that involves placing testing material under the skin and observing any reactions. This test is typically free of charge for those who meet the criteria of exposure, risk, or symptomatics.
Some clinics offer TB skin tests for a fee to those who require testing for work, travel, or other reasons. It is important to contact your healthcare provider or local TB program to determine your eligibility for free testing and the specific procedures involved.
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The two-step skin test
The two-step tuberculin skin test (TST) is a screening test for TB that is administered in two parts: placement and reading. During the first visit, a healthcare provider injects a small amount of testing fluid called tuberculin under the skin on the lower part of the inner arm using a small needle. After two to three days, the patient must return to the clinic to have the skin test read. A trained healthcare provider will measure the size of the bump or reaction. A positive or negative test result depends on the size of the bump or reaction.
The two-step TB skin test is recommended for individuals who will be screened for TB periodically, such as healthcare workers. The first TB skin test can "trigger the memory" of the immune system, boosting its ability to react to the second TB skin test. This means that some people with latent TB who initially test negative may exhibit a positive reaction when tested again within a year of the first test. The two-step TB skin test can lower the chance that this boosted reaction from an old TB infection will be misinterpreted as a recent infection.
A positive TB skin test result indicates the presence of TB germs in the body, but it does not mean that the individual has an active TB infection. Individuals with a positive TB skin test will require further tests, such as a chest X-ray or a test of the sputum (phlegm), to determine whether the TB infection is active or inactive. A negative skin test result, on the other hand, suggests that it is unlikely for the individual to have inactive or active TB disease. However, healthcare providers may perform additional tests, especially if the individual exhibits symptoms such as weight loss or tiredness, has HIV, or was recently exposed to TB germs.
It is important to note that the TB vaccine may cause a false-positive TB skin test reaction. Therefore, individuals who have received the TB vaccine should opt for the TB blood test, which is not affected by the vaccine. The TB skin test is generally safe, but individuals who have had a severe reaction, such as a severe allergic reaction, in the past should avoid it.
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TB blood tests are $48
While I cannot find explicit information on whether hospitals offer free TB skin tests, I have found some information on the cost of TB blood tests.
The TB skin test is also known as the tuberculin skin test (TST). It is a screening test for TB and can tell if someone has TB germs in their body. However, the TB vaccine may cause a false positive. Unlike the TB skin test, the TB blood test is not affected by the TB vaccine. This makes it a more suitable option for those who have received the TB vaccine.
The TB blood test is a good alternative for those who cannot return to the clinic after two to three days to have the skin test read. It is also recommended for those who have received the TB vaccine. The cost of the TB blood test is $48, which may be covered by insurance. For those who are uninsured or prefer to pay out-of-pocket, it is important to check the cost beforehand.
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TB skin tests are not always accurate
A positive result indicates that you have TB germs in your body, but it could be a latent infection that is not contagious and does not cause symptoms. To determine whether the infection is active or latent, further tests, such as a chest X-ray or sputum test, are required.
Additionally, certain factors can affect the accuracy of TB skin tests. For example, if you have received the TB vaccine (Bacille Calmette-Guérin or BCG), you may experience a false positive reaction to the skin test. The TB vaccine is not commonly used in the United States, but it is administered to infants and young children in countries where TB is prevalent.
People with weak immune systems or frail skin conditions may also have unreliable skin test results. Furthermore, the size of the bump or reaction at the injection site can vary depending on individual risk factors, such as recent immigration from a country with a high TB prevalence or residence in a high-risk setting.
To summarize, while TB skin tests are useful for detecting TB germs in the body, they cannot distinguish between active and latent infections. Other factors, such as prior vaccination or individual risk factors, can also impact the accuracy of the results. Therefore, it is important to consider the limitations of TB skin tests and follow up with additional tests to confirm the presence of an active TB infection.
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TB symptoms and risk factors
Tuberculosis (TB) is a bacterial infection that often affects the lungs, but it can also spread to other parts of the body, including the joints, spine, brain, and kidneys. It is caused by Mycobacterium tuberculosis (MTB) bacteria, which are spread through the air when people with active TB cough, sneeze, speak, or spit. Transmission is most likely to occur from people with active TB, as those with latent TB are not thought to be contagious.
TB symptoms vary depending on the stage of the infection. Most people do not experience any symptoms during the primary infection stage, but some may exhibit flu-like symptoms. Typical symptoms of active TB include a chronic cough with blood-containing mucus, fever, night sweats, and weight loss. If TB infects other organs, it can cause a wide range of symptoms.
Certain factors increase the risk of contracting TB or developing active TB disease. The most significant risk factor globally is concurrent human immunodeficiency virus (HIV) infection, with people living with HIV being 16 times more likely to fall ill with TB. Environmental factors, such as air pollution, exposure to smoke, and occupational exposure to dust or particulates, can also increase the risk by weakening the body's protective mechanisms.
Living or working conditions that facilitate close contact with others, such as living with someone with active TB, residing in crowded places, or working in healthcare, increase the likelihood of TB transmission. Traveling to or living in areas with a high incidence of TB, including specific regions in Latin America, Africa, Asia, and the Pacific Islands, also elevates the risk.
Individuals with weakened immune systems, including those with HIV/AIDS, are at a higher risk of contracting TB. Additionally, the use of immunosuppressant medications, such as chemotherapy or drugs for autoimmune conditions, can decrease immune response and make individuals more susceptible to TB infection.
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