Nationwide Shortages of PPD Solution

For Immediate Release
April 16, 2013; 12:20pm
DPHSS Release No. 2013-025

Nationwide Shortages of PPD Solution
The Department of Public Health and Social Services (DPHSS) announces that there is a nationwide shortage of Tubersol® and Aplisol® purified protein derivative (PPD) solution. Manufacturers of PPD used in the tuberculin skin test (TST) are continuing to experience production delays. We anticipate that adequate quantities of PPD solution will not be available until several months from now, but this is only an estimate.  The shortage will affect our ability to conduct routine TB screening.

**Interferon Gamma Release Assay (IGRA) blood test that is the substitute for Tuberculin Skin Test (PPD) is not currently available on Guam.

The DPHSS is temporarily suspending TB clearance requirements for tuberculin skin tests that are mandated in the Guam Code Annotated Title 10 P.L. 26-152 Section 3329 (a) Testing for Tuberculosis (TB) and the DPHSS rules and regulations governing the issuance of Health Certificates.

Individuals who are seeking TB Clearance for employment or school are advised to delay the TB skin test (PPD) until further notice.  Because the mandated TB Clearance requirements are temporarily suspended, attendance to work or schools should not be restricted due to a lack of TB Clearance.  

During the shortage, the DPHSS TB Control Program will continue to provide TB screening services only for the following high risk categories:
contacts to a person with infectious pulmonary or laryngeal TB; persons with symptoms suggestive of TB disease; recently arrived immigrants from high-incidence countries; persons infected with HIV; persons who are immune-compromised due to disease or medical treatment.

Medical providers and medical institutions are advised to suspend routine Tuberculosis Skin Testing (PPD testing) and reserve PPD solution for those at highest risk for developing active tuberculosis.  However, if clinics do have a very good buffer stock of PPD solution and very close to its expiration date, then the solution should be utilized for routine TST screening.

Individuals/students seeking Certificate of TB Evaluation Clearance and have a documented Inactive/Latent TB Infection (LTBI) are still required to comply with the clearance requirements.

The DPHSS TB Control Program will provide public notice when sufficient PPD solution is available to resume normal operations.
If you have any questions please feel free to contact Cecilia Teresa T. Arciaga, TB/HD Control Program Manager at 735-7131/7120/3602.


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