Mantoux test

In layperson's terms: a Tuberculosis (TB) test.

Summary: You go to a doctor or clinic, answer some questions, get pricked on the arm, then go back three days later so they can check your arm and sign your form. There's no blood involved; it is less painful than a paper-cut.

Your doctor or nurse will give specific instructions for the test. The customary procedure is:

A tiny amount of dead purified TB is injected just barely under the top layer of skin, usually on the upper left arm. A fine needle may be used, or a special "tine tool" which is 4 very-short sharp pins on a holder. About 3 days later, the area is checked for excessive reddening or swelling, which may imply exposure to TB.

A TB test is less than a pin-prick on the first visit. On the second visit, a nurse will look at your arm. Hopefully, the result will clearly be Negative (you are OK). In rare cases, a clear plastic guide with coin-size circles will be held over the site to check the size of the wheal. If it does not look good, you will surely be asked to consult a health professional.

TB can spread through the air. TB in a crowded school is very bad news, so a current TB certificate is required for most people in contact with school children.

Most cases of unsuspected TB may be treated effectively.

If you have had TB and been cured, the Mantoux test may give a false positive. A doctor can use other tests to establish your real TB status.

Good site for lots of TB info- New Jersey Medical School National Tuberculosis Center

School Nurse TB Handbook

From: The Hutchinson Encyclopedia:

Mantoux test -
In medicine, test used to diagnose tuberculosis. A small dose of tuberculin, a product obtained from killed Mycobacterium tuberculosis cells, is injected into the superficial layers of the skin. Reddening and inflammation of the skin will occur if the individual has been exposed to M. tuberculosis. This reaction does not confirm that the individual is suffering from active tuberculosis.

abridged from: The Hutchinson Encyclopedia:

Tuberculosis -
(TB) formerly known as consumption or phthisis.
Infectious disease caused by the bacillus Mycobacterium tuberculosis. It takes several forms, of which pulmonary [in the lungs] tuberculosis is by far the most common. The bacterium is mostly kept in check by the body's immune system; about 5% of those infected develop the disease. There are 7 million new cases of TB annually worldwide (1998) and 3 million deaths.
In pulmonary TB, a patch of inflammation develops in the lung, with formation of an abscess. Often, this heals spontaneously, leaving only scar tissue. The dangers are of rapid spread through both lungs (what used to be called 'galloping consumption') or the development of miliary tuberculosis (spreading in the bloodstream to other sites) or tuberculous meningitis.
Over the last 15 years there has been a sharp resurgence in countries where the disease was in decline. The increase has been most marked in deprived inner city areas, particularly in the USA.

[adapted] from a fact-sheet by The New Children’s Hospital:

The Mantoux skin test
Disclaimer: This fact/info sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for [you or] your child.

The Mantoux skin test is used to see if a person has been infected with the bacteria that causes tuberculosis (TB). This test is given by an injection under the skin, usually in the left arm. [Your or] Your child’s doctor may have asked for a test to be done in both arms.

Results of the test

A positive reaction is measured by the size of the lump (induration) that forms where the injection was put into the arm. This lump occurs over the next two to three days.

[you or] Your child may have a positive skin test reaction if they:

  • have had tuberculosis before and have been cured
  • have been exposed to the tuberculosis bacteria or have been immunised for tuberculosis (BCG)
  • have tuberculosis.

A negative result may actually be incorrect (false negative) if your child is:

  • taking medicine to lower your immunity eg. steroids or chemotherapy drugs
  • has a viral illness eg. measles, mumps or rubella
  • has recently been vaccinated with live viruses
  • is very sick.

After the test

If [you or] your child has a Mantoux test, you will need to come back in three days to have the result of the test checked. Scratching the test site will cause an infection, so it is best not to touch it. Bandaids, bandages and ointments can affect the test results, so it is important to keep the skin clear and uncovered (long sleeves and jumpers [sweaters] can be worn). If [you or] your child gets blisters around the spot where the injection was given, do not break them.

[you or] Your child may do all normal daily activities eg. playing sports, having a shower, going to school. If you know you have had a positive Mantoux test before or have been immunised for TB please let the person doing the test know. If you have any questions ask the person who is doing the test.

Remember

  • A positive result does not necessarily mean you have tuberculosis.
  • If you are worried about the test after you leave, please [consult your doctor or nurse].

Point of local interest: The first antituberculosis drug, streptomycin, was discovered and developed at Rutgers University by Selman Waksman in 1944. He won the Nobel Prize for Medicine, and the Star of the Rising Sun (from the emperor of Japan), for this discovery. Profits from streptomycin and Waksman's other discoveries established the Waksman Institute of Microbiology at Rutgers. His wife established a music scholarship at Douglass College.

However, the tuberculosis of today is descended from those few TB germs that survived the streptomycin-based anti-TB campaigns of the 1950s and 1960s, so the old drugs are no longer effective. While TB nearly vanished in the US in the 1970s, new strains resistant to old drugs are now on the rise and must be taken seriously.

researched by Paul Reid

Music Students Handbook