As of July 1, 2012, Los Angeles County Department of Public Health discontinued the previously required universal tuberculosis (TB) testing for students entering grades K-12.  It has been replaced with a universal screening and targeted testing approach. The new screening is now incorporated into the required physical exam for rising first graders.  Universal TB Screening is a risk-based assessment, and allows physicians to screen only those students who meet one of the risk factors identified by the American Academy of Pediatrics. 

Risk factors include:

• Birth in a region of the world with endemic TB (e.g., Asia, Middle East, Africa, Latin America, and countries of the former Soviet Union)
• Travel to a high-incidence country for an extended period of time (i.e., at least one week)
• Exposure to persons with confirmed or suspected TB disease
• Close contact with someone who has had a positive test for TB infection

The new approach will allow physicians to focus on high-risk children, and avoid exposing children at low risk to unnecessary false positives, chest X-rays, and costly preventative treatments with potentially risky side effects.  It is important to note that this change will not impact California’s TB screening requirements for preschool children, teachers, or volunteers. 

Further reading:

• Rx for Prevention:  Universal TB Testing of School-Aged Children Not Required
• LA County Tuberculosis Control Program