What alternatives are there to the TB skin test?

Question

I understand that Asian babies frequently produce false positives, resulting in a lot of hassle and extra tests and follow-up visits. With that in mind, I am looking for an alternative to the TB skin test to avoid a problem before it springs up.

Answer 1

The only alternative I know of is a chest x-ray.

Answer 2

I've never heard of Asian babies in general producing false negatives (which of course doesn't mean it's not possible).  What I HAVE heard of is people from Asian countries - China for certain - having been immunized against TB.  Once you've been exposed to the bacterium that causes the disease or have received the immunization, you'll generate a positive result to the skin test.  This is usually followed up by antibiotics and chest x-rays.  If you haven't had the immunization and haven't been exposed to the bacterium, then you shouldn't generate a positive result.

So basically, as long as the baby hasn't been immunized against TB, you shouldn't have to worry about a false positive.  If they have been immunized, then yes, they should generate a positive result to the skin test for the rest of their lives unless their immune system stops working.  You should be able to explain to the baby's doctor that the baby was immunized; they'll probably want to check once to make sure the baby doesn't actually have TB, and then hopefully they'll just keep that info on record.  And if you're curious, I was told that the USA doesn't use the TB vaccine very often because the incidence of TB is lower here.