CCC TB Questionnaire 

In Compliance with Kansas Statute KSA 2009 Supp.65-129, all Colby Community College students who have traveled, resided in for more than three months, or were born in any country where Tuberculosis (TB) is endemic as identified by the Kansas Department of Health and Environment (KDHE), must provide TB test results obtained in the United States prior to the start of the semester.  All students enrolled in classes at Colby Community College must fill out the questionnaire or provide proof of a negative TB test (that can include a TB skin test (PPD), chest x-ray results for TB or QuantiFERON TB gold test) with enrollment.  This should include on campus students, as well as off campus students. International students must have this done in the United States prior to going to classes.  Colby Community College must keep record of all questionnaires in the student files in student health.  Any student who is not in compliance is not eligible to attend classes or enroll for a subsequent semester or term or obtain an official academic transcript or diploma until the student is compliant with the requirements.

Any student with a positive TB skin test will have a QuantiFERON TB Gold test done.  They can do that through student health office, local health department or their primary care physician.  If the QuantiFERON test comes back positive they will have a chest x-ray done within 2 business days and will see the Thomas County Health Department and a primary care provider for further evaluation and treatment options.  The testing will be at the students’ expense.  The additional tests could be around $300 depending on what testing will be required. 

Read the Kansas State Regulations requiring TB testing.

DISEASE REPORTING REQUIREMENTS

State laws and regulations require that cases of tuberculosis be reported to the local or state health department. The Kansas Tuberculosis Control Program provides, free-of-charge, anti-tuberculosis medications to local health departments for the treatment of TB disease. Additionally, preventive medications for individuals with TB infection are provided at no cost to local health departments or other medical providers. In order to receive medications for a patient afflicted with TB infection, the health care provider or local health department must provide the state program information about the diagnostic screening of the patient (TB test and chest x-ray results). For individuals with active TB disease, the local health department must provide information about the diagnostic screening of the patient along with information about the patient's treatment, potential contacts to the patient, and other detailed information as requested on an ongoing basis.

What is Tuberculosis?

Tuberculosis, often referred to as TB, is a disease caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs; however TB bacteria can attack any part of the body such as the kidneys, spine, and brain. If not treated properly, TB disease can be lead to death.

How is TB spread?

Tuberculosis is spread by breathing in the Mycobacterium Tuberculosis bacteria which has been coughed or sneezed out by someone with active TB. This can happen anywhere. You may never know from whom you get the disease.

What are the symptoms of TB?

General symptoms may include feeling weak or sick, weight loss, fever, and/or night sweats. Symptoms of TB of the lungs may include cough, chest pain, and/or coughing up blood. Other symptoms depend on the particular part of the body that is affected.

Does everyone who is infected with TB bacteria get sick?

No, there are two types of TB conditions: Latent TB infection and Active TB disease. 

Latent TB infection - TB bacteria can live in your body without making you sick. For most people who breathe in the TB bacteria and become infected, the body is able to fight the bacteria to stop them from growing. People with latent TB infection do not feel sick and do not have any symptoms. The only sign of TB infection is a positive reaction to a TB test. People with latent TB infection are not infectious and cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, the person will get sick with TB disease.

Active TB Disease – TB bacteria become active if the immune system can't stop it from growing. When TB bacteria are active (multiplying in your body), this is called TB disease. TB disease will make you sick. People with TB disease may spread the bacteria to those they spend time with every day.

How will I know if I have TB?

Get a TB test. Other follow-up testing may need to be done to see if you have TB infection or TB disease.

What is the BCG vaccination?

BCG is a vaccine which has been widely used in many countries (not the United States) to provide immunity against Tuberculosis. It is usually given on the left shoulder or forearm. It is often given to babies and repeated at five to ten year intervals.

If I have already had the BCG vaccination, do I still need to undergo TB testing?

Yes, as studies have shown that the BCG vaccination is often not effective in preventing TB infection.

If I had a TB test in the past, do I still need to undergo TB testing?

If you are have lived or are from one of the countries listed on the Low incident or Exempt Tuberculosis (TB) Country List have spent more than 3 months in one of the countries on the TB Countries List, you must undergo TB testing. Students who have documentation less than a year old of having undergone TB testing in the U.S. may submit their TB results to the Office of Admissions for review to determine whether the results can be used to meet TB testing requirement. The documentation must be provided to the Admissions Office at least 6 weeks before the payment deadline of the upcoming semester to be considered for evaluation.

How will I be tested for TB?

There are two tests that can be used to help detect if a person has TB: a skin test or a special blood test. 

Mantoux tuberculin skin test: The TB skin test (Mantoux tuberculin skin test) is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm.

TB blood test: TB blood tests (also called interferon-gamma release assays or IGRAs) measure how the immune system reacts to the bacteria that cause TB. Only one visit is required. This will be required if you have had the BCG Vaccination or a previous positive test.

Should I have a TB skin Test or a TB blood test?

You are required to undergo a TB blood test, if you:

- Are from a country not on the list of Exempt or Low incident /Tb Countries.

- Had the BCG vaccination.

Using the TB skin test on individuals who have had the BCG vaccine can sometimes lead to false positive testing results, meaning the person is thought to have the TB bacteria when, in fact, he/she does not. Unlike the skin test, the TB blood test is NOT affected by the BCG vaccination. Because the TB blood test is more accurate, it is required that students who have had the BCG vaccine or who are from high risk countries for TB be tested using this method.

Where should I go to be tested?

You should be tested at your local County Health Department or your personal health care provider.

What is the cost of a TB test?

You are required to pay the cost of TB testing and any follow up medical expenses related to TB testing.

Estimated cost in this area vary among College Clinics, Public Health Departments, (check for local area), and local medical providers. You will need to make your own payment arrangements.

If you have a positive TB test you will be required to have a chest x-ray. Since chest x-rays are not provided at county health departments, you will need to go to a private health clinic to have one done.

For I-20 students: The cost of a chest X-ray is your responsibility. Students who have health insurance should check for coverage for TB testing and chest x-rays with their health insurance representative since  most insurance policies will cover the cost.

When should I go for my TB test?

If you are an international student, you are required to submit your TB test results and chest x-ray results (if required) before attending fall / spring semesters in the school year.

If you are a resident of the United States, the students deadline is a week prior to classes.

Those who do not meet this deadline will be dropped from all classes. The TB testing procedure can take up to 3 weeks to complete. It is recommended to begin this process in May for the fall semester, and by October for the winter/spring semester.

What does a negative, positive or an indeterminate TB result mean?

If the evaluating screening is negative: (GOOD)
This means you are most likely not infected with TB. Once you bring the result of a negative TB test to the Student Health  office, the hold you have on your account for TB testing will be updated. Further testing for TB will only be required of you if you are still at this college two years from the time you were last tested.

If is a TB skin test or X Ray is positive: (Chest x-ray needed)*
This means that most likely you are infected with the TB bacterium (germ). If you are not sick, then the infection is probably latent TB Infection (LTBI) or inactive TB. People with latent TB infection are not infectious and cannot spread TB bacteria to others. However, if TB bacteria become active in the body and multiply, you will get sick with TB disease.

If the test result is indeterminate:
This means that the infection status with the TB bacterium could not be determined. It does not mean the test failed. You may be required to have a chest X-ray or have another TB blood test if you get an indeterminate result.

*If you have a positive TB skin test result (your enrollment account will be put on hold), you must then go for a chest X-ray and have the physician who orders the chest X-ray report a certificate of health results. When this completed form is submitted to the college admissions department, the hold you have on your account for TB testing be updated.

Will I need to take medication if I have a positive TB test result?

Most people who have a positive TB result have latent TB infection, which cannot be transmitted and does not cause symptoms. A 6 to 9 month course of treatment with antibiotics may be recommended by the county health department or your doctor to kill the tuberculosis infection. If you don't take the medication, the bacteria will remain in your lungs, and you will always be in danger of getting active tuberculosis. If you choose not to take the course of treatment recommended by the county health department or your doctor, you will need to submit a yearly chest x-ray report to the admission/student life in order to avoid having your classes dropped in the semester your chest x-ray is due. 

Active TB disease can be transmitted and is very serious, sometimes causing permanent damage and even death. It is curable with appropriate medication and treatment. You be placed in isolation if you are determined to be infectious until the medications have an opportunity to begin working and make you non-infectious.

County health departments provide free treatment medication to all students identified as having latent TB infection or active TB disease. A certificate of health will be required after treatment for a positive treatment has been implemented.

Follow Up on Active TB Disease Cases

CCC will cooperate with the local health department and KDHE in assuring a complete contact investigation is completed if an infectious student or campus community member is diagnosed. This will involve full collaboration on planning and evaluating the risks and cooperating with all parties involved in the investigation to minimize risks to others in the campus community.