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Lafene Health Center

Tuberculosis Prevention Policy

Tuberculosis (“TB”) continues to be a highly infectious, potentially life threatening disease. Because of the increase in TB worldwide, in response to the Centers for Disease Control and Prevention’s (CDC) recommendations regarding strategies for TB control, and based upon KAR 28-1-30, KAR 28-1-31, KSA 65-129e and KSA 65-129f, Kansas State University (“K-State”) has implemented the following prevention and testing requirements and recommendations for the public health and safety of its community.

I. Definitions of Terms Used in Policy; Interpretation to Promote Public Health.

A. Student: Any individual who has been admitted to K-State where the course of studies will require physical attendance in a classroom setting with one or more persons.

B. High Risk: A country with High Incidence TB rates.

        1.    “High Incidence” areas are defined as areas with reported or estimated incidence of ≥ 20 cases of TB per 100,000 population.*

*Source: World Health Organization (For future updates, refer to http://www.who.int/tb/country/data/profiles/en/index.html)

C. Due to public health risks and concerns that have a greater likelihood of occurrence in certain countries (see, i.e., High Risk country definition above) and due to differences in testing and screening requirements, and vaccination practices, in other countries as compared to the United States, there are certain requirements for tuberculosis screening and testing that apply differently based on where persons were born and where they have lived. The healthcare professionals at Lafene Health Center shall utilize their professional judgment and resources in determining which screening and testing requirements and recommendations are necessary for a particular person. The Medical Director of Lafene Health Center has the authority for decisions under this policy. Maintenance of public health is the goal of this policy, and the provisions below are to be interpreted and implemented to attain that goal.

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II. TB Screening/Notification by Student.

  1. Written Screening. All newly admitted or readmitted students are required by Kansas Statute 65-129e to complete TB screening the semester they are entering or re-entering K-State prior to attending classes. The TB screening consists of four questions and is completed through iSIS. The initial screening may indicate a need for additional screening and/or testing for some students. Those students will be informed of such need and requirement, and must complete the additional required screening and/or testing as deemed necessary by the healthcare professionals at Lafene.
  2. Verbal Screening. All students entering graduate school who were born in, or resided in or have traveled for more than three months in/to a High-Risk country, who were previously enrolled as undergraduates at K-State, are required to undergo a verbal screening at Lafene Health Center prior to attending classes as a graduate student, even if previously tested and/or screened as an undergraduate. Depending on the results of the screening, additional testing may be required.
  3. Required Notification by Student. If after initial entry and screening, a student develops TB symptoms, has a positive TB test, or travels to or resides in a High Risk country for more than 3 months, such student shall provide notice to a healthcare professional at Lafene and follow any screening and/or testing requirements deemed necessary by healthcare professionals at Lafene.
  4. Previous Test Results. If any student has had TB testing since entering or being in the U.S. and has not returned to a High-Risk country, a copy of the test and results must be obtained and entered into the patient’s medical record at Lafene Health Center and will be considered in determining what screening and/or testing is necessary for that particular student.  
  5. Important: Prior to attending any classes, each student must inform the health center staff if he or she has EVER had a positive TB skin test or has EVER been treated for TB.

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III. TB Testing Requirements.

All new and current students, who (1) were born in, or resided in or traveled to for more than three months, a High Risk country at any time; (2) have signs and symptoms of active tuberculosis, or (3) have been in contact with a person who has been diagnosed with active tuberculosis, are subject to required additional screening/assessment and/or testing, except when the Lafene healthcare professionals determine that previous tuberculosis testing in the United States, subsequent to the contact with the High Risk country, is sufficient. Lafene healthcare professionals will use their professional judgment to determine what testing is required for a particular student. The healthcare professionals will take into consideration initial screening responses, responses on the follow-up risk assessment questionnaire, other medical history information including but not limited to vaccines, and the history, type, and/or frequency of contact within a High Risk Country. Initial required testing may include one or more of the following:

(a)  Tuberculin skin testing;

(b)  Interferon gamma release assay;

(c)   Chest radiograph;

(d)  Sputum evaluation;

(e)  Physical exam;

(f)   Review of signs and symptoms.

*Additional follow-up testing, the type which may or may not be listed above, also may be required.

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IV. Testing Recommendations.

TB testing is recommended for spouses, accompanying adults, and children of students who are subject to additional screening and testing, as described above in Section III. Such persons may be referred to be evaluated at the Riley County Health Department. Additionally, if in the professional judgment of one or more Lafene healthcare professionals, a student is not required to get testing, the professional(s) may still recommend that the student undergo additional testing (for example, but in no way to limit the professional judgment and corresponding decisions of Lafene healthcare professionals, when a student is not born in a High Risk country but he/she has brief contact within a high risk country). If a person undergoes recommended screening and/or testing, further testing may be required of that person, depending on the results.

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V. Enforcement.

A student attending class prior to completion of all required screening and testing is a violation of Kansas law. Additionally, failure to complete the screening and/or testing applicable to a particular student will result in an "academic hold". Lafene Health Center staff will place an academic hold through iSIS on students who are required to undergo screening and/or testing. This hold will be removed only upon completion of all screening and testing requirements. Students will be able to enroll in K-State courses when the hold is removed.

This testing must be completed in the United States. Test results from outside the United States will not be accepted. In accordance with the Kansas Department of Health and Environment (KDHE) guidance and mandates, chest films or x-ray reports from other countries shall not be accepted for diagnostic purposes. If the student is tested for TB in the United States prior to arriving at K-State, he/she should bring an official copy of the test and results to Lafene Health Center or the International Student TB testing session.

Lafene Health Center staff will provide notification to KDHE if a student is found to have latent TB infection or active TB.

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VI. Tuberculosis testing/treatment and cost; Insurance.

There is a charge for the blood or skin test, and any additional testing and/or screening necessary. If an abnormality is found during TB testing, further evaluation is necessary requiring additional testing and perhaps medical visits. There are charges for these services and health insurance will often help pay for these. However, the student will be responsible for payment of at least some and possibly all of the charges.

A word of caution for international students: Healthcare is very expensive in the United States. International students who enroll as first-time students at Kansas State University are required to have health insurance. (See www.k-state.edu/isss/current/healthinsurance.html) Insurance plan specifics for the Kansas Board of Regents sponsored policy are at Statewide Student Insurance Program.

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Adopted November 28, 2000 (Effective August 1, 2001) Revised: 07/2013



Testing screening required

To access the TB screening:
  1. Sign in using iSIS (K-State's Student Information System).
  2. Click on Student Center.
  3. In the section labeled ‘Academics’, click on the dropdown box labeled ‘other academic…’
  4. Click on the link for TB screening.
  5. The link will only be available for those students required to complete the screening.

iSIS

Testing requirements

Testing recommendations

Enforcement

High-risk countries defined

Tuberculosis testing/treatment and cost

Internet resources