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I guess that if you are quite definite about the absence of a BCG - and I don’t know about you but we often mantoux screen in the presence of an 'I don't know' or I don’t have the documentation or the scar to prove it' - then it would be ok to go from a negative quantiferon to a BCG as both the mantoux and the quantiferon both are able to determine the absence of TB disease which is the criteria for giving the BCG safely. however, if the 'I don’t know' and 'I did but I can't find the scar' case exists then there remains the risk of serious inflamatory reactions and possible scarring if you didn't do the mantoux first and they have actually had a BCG. Ho hum.... Susan Gorton | OH Nurse Manager | Occupational Health Department | Great Ormond Street Hospital NHS Trust | Level 3, Ormond House, 26-27 Boswell St., London WC1N 3JZ |020 7450 9200 Ext 0247 | DD to OHD 020 78138554 | Direct Fax 020 78138355 | Mobile 07833294568 Please be advised that all e-mail communication relevant to assisting in the management of the OH process will be printed and entered into the individual's OH file or copied and added as an electronic note on their electronic OH record. This may therefore be disclosed under the Data Protection Act (1998). -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Needham Liz Sent: 23 March 2012 13:26 To: [log in to unmask] Subject: Re: [OCC-HEALTH] TB screening Thanks Sue, The NICE guidance appears to indicate that you can go straight from a negative Quantiferon to a BCG but this is contrary to the Green Book. As you say the more opinions you get the more confusing it becomes! Thanks for your input -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Susan Gorton Sent: 22 March 2012 16:12 To: [log in to unmask] Subject: Re: [OCC-HEALTH] TB screening As far as I am aware, Quantiferon only demonstrates the presence of active or latent TB not immunity so it has a different role in TB screening than Mantoux. Have you looked at the Nice guidelines. Most NHS TRusts that I know of that started pre-employment TB screening have abandoned it as not-effective. We are just about to be audited by our London OH group and I am sure I will fail miserably but I am not sure I am confident that the advice is sound. You know what they say about getting a consistent opinion on TB and BCG - only ask one respiratory physician... Sue Susan Gorton | OH Nurse Manager | Occupational Health Department | Great Ormond Street Hospital NHS Trust | Level 3, Ormond House, 26-27 Boswell St., London WC1N 3JZ |020 7450 9200 Ext 0247 | DD to OHD 020 78138554 | Direct Fax 020 78138355 | Mobile 07833294568 Please be advised that all e-mail communication relevant to assisting in the management of the OH process will be printed and entered into the individual's OH file or copied and added as an electronic note on their electronic OH record. This may therefore be disclosed under the Data Protection Act (1998). -----Original Message----- From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Liz Needham Sent: 22 March 2012 11:57 To: [log in to unmask] Subject: [OCC-HEALTH] TB screening Hi everyone, wonder if anyone can help regarding a query about Quantiferon/TB blood testing. I work for an NHS organisation and following the most recent NICE guidance for TB we are keen to implement Quantiferon testing and eliminate Mantoux testing if at all possible. Does anyone go straight from a negative Quantiferon test to BCG vaccination without Mantouxing? If so have there been any issues relating to this? Many thanks for your assistance. ******************************** Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH ************************************************************************ ********************************* This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it. 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Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents: to do so is strictly prohibited and may be unlawful. Thank you for your co-operation. ********************************************************************************************************* ******************************** Please remove this footer before replying. OCC-HEALTH ARCHIVES: http://www.jiscmail.ac.uk/lists/occ-health.html CONFERENCES AND STUDY DAYS: http://www.jiscmail.ac.uk/cgi-bin/filearea.cgi?LMGT1=OCC-HEALTH