The Legislature has passed a bill authored by Assemblyman Das Williams, D-Carpinteria, that would replace the currently mandated tuberculosis (TB) examination with a TB risk assessment and follow-up TB exams, based on the results of that assessment.
Assembly Bill 1667 is now headed to the governor’s desk to be considered for a signature.
“By replacing the exam with a risk assessment and a follow-up TB test, AB 1667 addresses two problems that California currently faces: false positives and shortages of TB tests,” Williams said. “My bill is consistent with guidelines from numerous expert bodies, including the Center for Disease Control and Prevention, and will allow the tuberculosis control programs to work most effectively to detect and control tuberculosis in California.”
TB is a disease caused by germs that are spread from person to person through the air. It usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys or the spine. The primary test for TB infection is the Mantoux tuberculin skin test (TST). When TST is applied in low incidence populations, its positive predictive value means that there are a high number of false positives.
School employees and volunteers are not considered high-risk populations, according to the Health Officers Association of California, the sponsor of AB 1667. An estimated 20 percent of teachers in California falsely test positive. These false positives can lead to the administration of unnecessary tests and potentially toxic TB infection treatment regimes, which pose preventable risks for those with false positive TST results.
“Targeted screening will also demonstrate to be more cost-effective while still protecting our state’s teachers, volunteers, school employees and children from tuberculosis,” Williams said.
AB 1667 does not affect any protocol that county health offices and other public health officials may use for testing when a known case of tuberculosis exists. If there was a person found to have active TB in a particular region, this bill would aid in that situation by making more TSTs available for targeted testing in the area.
— Jeannette Sanchez-Palacios is the district director for Assemblyman Das Williams.