Recommendations and Rationale Chest X-Ray Films for Employment. In the absence of clinical symptoms, repeated chest x-ray films have not been shown to be of sufficient clinical value or productivity to justify their continued use. Routine Repeated Chest X-Ray Examinations of Tuberculin Reactors and Patients with Tuberculosis. Surveillance directed at specific subpopulations and segments of the community may still be of benefit. Recommendations and Rationale Immigrants and Refugees.
Tuberculosis remains a global problem of enormous magnitude.
Newly arrived immigrants having known or suspected tuberculosis should be under health department surveillance. Surveillance for tuberculous infection in children should no longer be routine in the United States and Canada. Surveillance primarily during the first five years of life may be indicated for children from high-risk population groups, such as immigrants, undocumented or illegal aliens, some minority groups, and families from disadvantaged socioeconomic backgrounds. Tuberculin testing is mandatory in children of any age who have contact with a known or suspected case of tuberculosis or those with clinical findings such as lymphadenitis, pleural effusion, poorly resolving pneumonia, encephalitis, or sporadic aseptic meningitis. When tuberculosis or a significant risk of transmission of tuberculosis is known or suspected within an enclosed institutional environment, management has a legal responsibility to institute measures to protect its employees, agents, and recipients of service and to establish procedures for surveillance and containment.