15 August 05
TB Test Results
The nurse summoned a group of us. She asked for my name and then touched the TB-test mark on my arm - a pink circle, barely a centimetre in diameter. She wrote down the number 2. “You’re a two” she said.
“What does that mean?” I asked.
“You’re alright. You’re not a five.”
“What does that mean?”
“You need to stay away from people with coughs.”
“Alright. Thanks.”
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Copyright © 2004-2005 Shaun P. Attwood
Assuming this was the Manoux skin test, the results are read by indicating the size of the swelling in mm. So Jon's swelling from the test was 2 mm. 5mm is the mimimum reaction to indicate someone with impaired immune systems is positive for TB. For a "normal" healthy person, with no immune problems, past IV drug use, malnutriton or as a member of certian ethnic groups, the reaction is 15mm.
ReplyDeleteA regular test is not harmful, but you are bein injected with a controlled amount of the TB bacteria. TB is an airborne disease and is common in crowded living conditions such as prisons, nursing homes, shelters, with poorly ventilated areas.
ReplyDeleteThe risk of an adverse reaction is very low. Occasionally, a TB test will have a large reaction in which the arm swells and is uncomfortable. A sore might develop where the injection was given, or a fever could occur, but these are extremely rare.
I do not know AZ law but most states have laws that people in such hi-risk areas be tested for TB.
The test likely was the Mantoux (not Manoux) test, since that is the same one most places use. The way it works is you are injected with a small amount of Tuberculin (a protein extract from the bacteria, NOT the living bacteria. Tuberculin test, Mantoux test, and PPD - purified protein derivative - are all synonymous).
ReplyDelete48 to 72 hours later, the test is "read." The induration (raised bump, NOT the redness) is measured in diameter (across your arm, not going up, there tends to be a larger diameter in this direction).
For those not in high risk groups, >15mm is considered positive. For those in high risk groups (diabetics, kidney failure patients, healthcare workers), >10mm is considered positive. For those with HIV, on corticosteroid therapy (antiinflamatory steroids, not androgens), or those in contact with those with active TB on a regular basis - you fall in this one probably - >5mm is a positive result.
After a positive test, chest x-rays and cultures are indicated, because a Mantoux test is prone to both false positives and negatives.
The rationale here is if you are infected or exposed to a significant amount of TB, you will have a pronounced immune
response to the proteins in the TB bacterium.
ReplyDeleteI meant Mantoux, it was a typo.
ReplyDeleteEven if you pop a positive to the test it's not a death sentence. These days it can be managed pretty effectively with drugs. I've been positive for years now and only had one really "active" phase where I was ill with it.
ReplyDeleteAssuming it was the 'Heaf' test (a cirucle of five needles) then type 2 is fine - type 3 start worrying - type 4 swells up and hurts like hell - at that point I'd consider controlled panic.
ReplyDeleteI was ended up with a type 4 heaf and 4 months of TB medication and that was just with working in London.