How ChoiceOne is Going to Help Combat the Shortage of Testing for Tuberculosis

GA Team


If you’ve traveled to foreign countries or received any type of drug testing when starting a new job, you’re likely familiar with the tuberculosis skin test. For those who may be unaware, the TB skin test is performed by clinical personnel who injects a small amount of fluid (called tuberculin) into the skin on the lower part of the arm. Then, the person given the TB skin test must return within two to three days to have a trained health care worker review the arm for any sort of reaction.

Did you know there are two types of methods used for detecting Mycobacterium tuberculosis infection? The two ways are skin tests and blood tests.

There is a sincere importance behind why we are talking about TB testing. Just several weeks ago, the Centers for Disease Control and Prevention (CDC) addressed a 3 to 10-month nationwide shortage of APLISOL®, a product of Par Pharmaceuticals. APLISOL® is one of two purified-protein derivative (PPD) tuberculin antigens that are licensed by the United States Food and Drug Administration (FDA) for use in performing tuberculin skin tests.

The manufacturer notified CDC that they anticipate a supply interruption of APLISOL® 5 mL (50 tests) beginning in June 2019, followed by a supply interruption of APLISOL® 1 mL (10 tests) in November 2019. The expected shortage of APLISOL® 1 mL (10 tests) could occur before November 2019, if demand increases before then.

Due to the impending nationwide shortage of skin tests for tuberculosis, effective immediately ChoiceOne Urgent Care has decided to offer the QuantiFERON Gold blood test. The CDC has recommended three general approaches to prevent a decrease in TB testing capability because of the expected shortage of APLISOL®, and one of those recommendations is a blood test.

“ChoiceOne offers a superior patient experience and will ensure that patients receive high-quality health care in all the centers located in the Maryland and Georgia. With this blood test, patients will be able to obtain results quicker than with TB skin tests, making it a far more convenient option for many folks,” said ChoiceOne Chief Medical Officer and Chief Operating Officer Dr. Scott Burger.

CDC recommends TB screening for certain at-risk patients, such as:

  • People who live or work in high-risk congregate settings (e.g., nursing homes, colleges)
  • Healthcare workers who care for patients at increased risk for TB
  • People who have spent time with someone who has TB
  • People who are immunocompromised
  • People who are high-risk substance users
  • Foreign-born persons, especially from countries with high TB incidence or prevalence

Please click here to obtain self-pay pricing information. Lastly, if you would like to visit a ChoiceOne center, click here to find the nearest location.


  1. CDC Health Alert Network. Nationwide shortage of tuberculin skin test antigens: CDC recommendations for patient care and public health practice. Atlanta, GA: US Department of Health and Human Services, CDC; 2019.
  2. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis 2017;64:e1–33. CrossRefexternal icon PubMedexternal icon
  3. Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K; IGRA Expert Committee; CDC. Updated guidelines for using interferon gamma release assays to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recomm Rep 2010;59(No. RR-5). PubMedexternal icon
  4. Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America clinical practice guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis 2016;63:e147–95. CrossRefexternal icon PubMedexternal icon
  5. Villarino ME, Burman W, Wang YC, et al. Comparable specificity of 2 commercial tuberculin reagents in persons at low risk for tuberculous infection. JAMA 1999;281:169–71. CrossRefexternal icon PubMedexternal icon
  6. American Thoracic Society; CDC. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Recomm Rep 2000;49(No. RR-6). PubMedexternal icon
  7. CDC. Guidelines for the investigation of contacts of persons with infectious tuberculosis; recommendations from the National Tuberculosis Controllers Association and CDC, and guidelines for using the QuantiFERON®-TB Gold test for detecting Mycobacterium tuberculosis infection, United States. MMWR Recomm Rep 2005;54(No. RR-15).
  8. Bibbins-Domingo K, Grossman DC, Curry SJ, et al. ; US Preventive Services Task Force. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force recommendation statement. JAMA 2016;316:962–9. CrossRefexternal icon PubMedexternal icon
  9. Sosa LE, Njie GJ, Lobato MN, et al. . Tuberculosis screening, testing, and treatment of U.S. health care personnel: recommendations from the National Tuberculosis Controllers Association and CDC, 2019. MMWR Morb Mortal Wkly Rep 2019;68:439–43. CrossRefexternal icon PubMedexternal icon

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