BCG Vaccine and The Mantoux Test
The role of Mantoux testing in people who have been vaccinated is disputed. The US recommends tuberculin skin testing is not contraindicated for BCG-vaccinated persons, and prior BCG vaccination should not influence the interpretation of the test. The UK recommends interferon-γ testing should be used to help interpret positive Mantoux tests, and serial tuberculin skin testing must not be done in people who have had prior BCG vaccinations. In general, the US recommendation results in a much larger number of people being falsely diagnosed with latent tuberculosis, while the UK approach probably misses patients with latent tuberculosis who should be treated.
According to the US guidelines, latent tuberculosis infection diagnosis and treatment is considered for any BCG-vaccinated person whose skin test is 10 mm or greater, if any of these circumstances are present:
- Was in contact with another person with infectious TB
- Was born or has lived in a high TB prevalence country
- Is continually exposed to populations where TB prevalence is high
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