Shortage suspends TB clearances for some

Tuberculosis clearance requirements for certain school and health workers have been temporarily suspended due to a nationwide shortage of testing solution needed for skin testing, the state Department of Health announced.

The temporary suspension of TB clearance requirements covers school personnel, students, food handlers and workers in health care, domiciliary care, day care and residential care facilities who fall under Hawaii Administrative Rules Title 11, Chapter 164.

“With limited supplies of testing solution available due to nationwide production delays that began late last year, we anticipate people may have some difficulty getting tested for TB at this time,” said Dr. Richard Brostrom, TB control branch chief. “TB clearance requirements will be suspended until further notice, and our state TB clinics will be limiting testing to specific high-risk groups to prioritize and extend current supplies.”

TB testing at state clinics will be limited to:

* People with signs and symptoms of active TB disease.

* People exposed to an infectious case of TB.

* High-risk immigrants referred from the Honolulu Quarantine Station.

* People with immunodeficiencies.

* People who require TB screening due to medical treatment.

All others seeking TB clearance are advised to contact their private health care provider or health center.

Health Department services related to the evaluation and treatment of people suspected or confirmed to have active TB are not affected by the shortage. Services for this group will continue without change.

The shortage involves Tubersol and Aplisol purified protein derivative solution. Manufacturers of the derivative have been experiencing delays in production since November.

It is estimated that adequate supplies of the solution will be available several months from now.

The Health Department anticipates the temporary suspension of state TB clearance requirements may be in effect for up to 120 days or until the shortage has ended. Public notice will be issued when the suspension is lifted and a grace period or catch-up date will be announced for individuals whose TB clearance was postponed to meet their requirement.

Hospitals and medical providers in Hawaii have received detailed recommendations from the Health Department on steps to take during the shortage. For more information on tuberculosis or TB testing, call the Hawaii TB Control Program at (808) 832-5731 or go to

The Health Department’s TB Control Branch provides prevention, detection, treatment and educational services to reduce the incidence of TB in Hawaii. Program activities include diagnosis, treatment, case investigation, preventive therapy for persons at high risk and direct testing services.

Each year, the Health Department conducts roughly 50,000 tuberculosis skin tests and provides treatment to approximately 120 individuals identified with TB.