positive mantoux, child care center...HELP!!!!?

Question

I have a history of negative mantoux tests, decades. In mid-August I had a negative mantoux, and then last week I had a mantoux test for another job. I had immediate intense itching, eyes burning, scratchy, developed hives on my neck on the car ride home. I have gone to an infectious disease dr, they did AFB cultures, when can I get the results? My current job, started in September is at a daycare center, w/ +/-100 children and >100 families involved. Employees are not required to have mantoux tests in child care centers in MN. I am very concerned someone is spreading TB at the child care center, but the health dept. is not!! I have had very little contact with anyone other than the children and employees there. Kids (some adopted from russia, india, etc)and adults have been coughing since I started working there. Was it the allergic reaction that caused the positive TB test, or a booster effect, or? If you have kids in child care centers, make sure all workers are screened!!

It was a transdermal PPD Mantoux, not a multi-pronged test. Induration measured 22 X 21 mm. Adopted children from foreign countries are cleared by a physician in that country, not the U.S. MN is a state that no longer screens children, uless there are symptoms that would indicate the test. There are many symptoms of TB, but most common are cold symptoms and a cough that lasts greater than 2 - 3 weeks, sometimes blood streaked, fatigue, night sweats, low fever. How many times do you think doctors see children with cold symptoms? It's just a cold, right?

Just because there is medication available that could hopefully kill it off, should we not try to prevent the spread of the disease? I had two mantoux tests within that time 1.) for a state license I needed, and 2.) for a new job that required it within 30 days of hire. False positives are possible from a booster effect, go to your favorite search engine and type in "tuberculosis booster effect."
Many misconceptions w/TB.

Answer 1

Generally they don't do Mantoux testing anymore because it is notoriously inaccurate. They usually prefer to do an IPPD, which is the needle beneath the skin, rather than the old multi-poke prod. You don't describe a positive reaction, you describe an allergic reaction. You could have had an interaction with any number of things, even the soap you used to bath in that day or your perfume. There is no booster effect in TB testing, the bacilli used are dead. It is simply a test for antibodies, and you either have them or you don't. If you do, all it means is that you have been exposed to TB somewhere- and it's anyone's guess where that was. It doesn't mean you have TB either. Most healthy adults can actually fight off TB, which leaves you with just the antibodies. In some cases, TB can go into a suspended animation state, and live in a cell in the body. Usually a lung cell, that's what they prefer- but any cell will do. It waits there until you are not so healthy and your immune system is busy, and wakes up. TB is also slow growing as a rule, so it's not something that will kill you in months. It's more like years and years. Once they determine you don't actually have active TB, they give you medication for a year, which can kill it in the inactive state IF it's present somewhere in your body. Even if you have active TB, it's treatable. They made a big deal of the drug resistant variety, but failed to make as big a deal about that being really rare to get. And TB isn't that easy to catch either. The kids you are taking care of have all been screened for TB already- it was required before they could enter the US. It's not unusual to see kids and adults in a daycare setting with chronic coughs and colds. Day care centers are germ soups, kids are cold carriers at the best of times, and more suseptible to it than adults. We already had our share when we were younger, and now enjoy a certain resistance kids are still getting.
The next logical step in your treatment should be an x-ray to make sure you don't have active TB lesions on the lungs, and then probably an IPPD. If the chest x-ray and IPPD are negative, then you can relax- because you don't have TB. You probably don't, in all likelyhood. The AFB culture can take a month or more, as I said, TB is some seriously slow growing stuff. Just remind yourself, you are living in an industrialized country with good sanitation and not in the middle of some tropical jungle here. Minnesota is not a hotbed of TB. Chances are you are fine, and don't have TB. And even if you actually do, it's not a death sentence. You can be treated, easily enough, and move on to whatever is next in life.

Answer 2

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Answer 3

Your mantoux test wasn't necessarily positive. It sounds more like you had an allergic reaction to something in the test itself. A positive mantoux test will appear as a bubble at the sit of injection 48-72 hours after it's given. It does not cause itchy watery eyes, or hives, unless you are allergic to it. You need to let your Doc. know your symptoms, becasue from now on, you shouldn't have anymore mantoux tests. Instead, you'll have to get a chest x-ray. I know, you're probably thinking "well how can I be allergic, if I already had one, and didn't have a reaction to that?" The answer is that allergic reactions never manifest on the first dose of anything... it's almost always the second, though sometimes it could be the third or 4th dose of something. And, even if the test is positive, it doesn't necessarily mean that you have TB, only that you've been exposed to it.

Answer 4

How come you have so many tests? As far as I know, a positive means one of two things : You have the decease in an advanced stage, or you were expose to it. In your case, must be the last one.