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Tuberculosis (TB) Skin Test

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What is TB?

Tuberculosis (TB) is a serious disease caused by germs (bacteria) that spread through the air. A person with active TB disease in their lungs can spread TB disease to another person. When a person with active TB coughs, sneezes, sings or talks, they spread TB germs through the air.

TB usually affects the lungs, but can also affect other parts of the body like glands, bones, joints, kidneys, the brain and reproductive organs.

You can cure TB. In B.C., medicines to prevent or cure TB are free through Provincial TB Services and public health units. For more information on TB, see: HealthLinkBC File #51a Tuberculosis (TB) .

What is a TB Skin Test?

You can use a TB Skin Test (TST) to test for TB infection. You can do a TST to see if you have ever been exposed to TB. It tells your health care provider if your body has “seen” the TB bacteria before. A TST cannot tell how long you have been infected with TB. This test alone does not tell whether the TB bacteria are latent (dormant or sleeping) or active.

Who should get a TB Skin Test (TST)?

Visit your health care provider for a check-up if you have symptoms of TB disease, have been in contact with someone with active TB disease or want to know if you have latent TB infection.

Symptoms of active TB disease of the lungs include a cough for 2 to 3 weeks or longer, bloody spit, fever, night sweats, loss of appetite, unexplained weight loss, tiredness, chest pain and shortness of breath.

Latent TB infection (LTBI) happens when the TB germs are sleeping (dormant) in your body. If you have LTBI, you can talk with your healthcare provider about the best ways to prevent active TB disease. The TB germ may remain sleeping in your body your entire life or it can wake up, start multiplying (growing) and make you sick with active TB disease. There is no way to know if or when this will happen. The chance of this happening increases when a person’s immune system is weakened. This is because the immune system is what keeps the TB germs in a sleeping state and prevents them from multiplying.

How is a TB Skin Test done?

A TST is a two-part test.

First appointment

A healthcare practitioner uses a tiny needle to inject a small amount of a test substance called Tubersol ® under the top layer of skin on your forearm.

Second appointment 48 to 72 hours later

You must go back to the clinic 48 to 72 hours later to have a health care practitioner read your test. People with TB infections usually respond with a raised, firm reaction at the site where the Tubersol ® was injected.

Your health care provider will check the area where the skin test was given for a reaction. They will measure the induration (swelling under the skin) and tell you your test results.

What do TB Skin Test results mean?

A negative TST usually means that you do not have TB germs in your body. Most people do not need further testing.

A positive TST means you may have TB germs in your body.

• A positive TST result does not mean you can’t go to school, work or volunteering, but you may need more tests to make sure you don’t have active TB disease
• A positive TST means you do not need to have another TST in the future. Keep a record of your positive TST results as proof

The TST results, your reason for testing and your general health may mean further TB testing such as a TB blood test, chest X-ray or sputum samples.

A chest X-ray is a picture of your lungs that your health care provider examines to see if TB bacteria are growing in your lungs.

The sputum (mucous or phlegm deep in your lungs produced from coughing) is sent to a laboratory and tested to see if there are TB bacteria present. For more information, see HealthLinkBC File #51b Sputum Collection for Tuberculosis (TB) Testing .

What are the possible reactions after a TB Skin test?

You can expect some redness at the skin test site. The site may itch, but it is important that you do not scratch it, since this may cause redness or swelling that could make it hard to read the skin test. If itching is a problem, put a cold, wet face-cloth on the site. Do not cover the site with a bandage.

A strong reaction may cause mild pain or redness that can last for several weeks. Talk to your health care provider if you have a fever, swelling in your arm or swollen lymph nodes in your armpit.

It is important to stay in the clinic for 15 minutes after getting your TST because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. Anaphylaxis has been very rarely reported following a TST with Tubersol ® . These reactions can occur in people without a history of a TST. This may include hives, difficulty breathing or swelling of the throat, tongue or lips. Should this reaction occur, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine (adrenaline) and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.

It is important to always report serious or unexpected reactions to your health care provider.

Who should not get a TB Skin Test?

People with:

• Prior allergic response or severe reaction (e.g. blistering) to a TST or any allergy to the components of Tubersol®
• Documentation of a previously positive TST result
• Previous Interferon Gamma Release Assay (IGRAs) reactive (TB blood test)
• Previous active TB disease or LTBI

If you should not get a TST, then your health care provider will ask you questions about your health and decide if you need other TB tests instead.

Where can I get a TB Skin Test?

Depending on your reason for getting a TST, you may get it for free or you may have to pay if it is for school, work or volunteering. Service locations vary throughout the province. TSTs may be available at your public health unit, travel health clinic, pharmacy or doctor’s office.

Contact your local health unit to find out where you can get a TST in your area. Visit the ImmunizeBC Health Unit finder to find your local health unit’s contact information at https://immunizebc.ca/finder .

You may also find TB skin testing locations on the HealthLinkBC FIND Services and Resources Directory: www.healthlinkbc.ca/services-and-resources/find-services .

For more information

For more information about TB, including information about BC Centre for Disease Control (BCCDC) TB clinics, visit: www.bccdc.ca/health-info/diseases-conditions/tuberculosis .

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• Section 5 - Tuberculosis
• Section 5 - Typhoid & Paratyphoid Fever

Perspectives : Testing Travelers for Mycobacterium Tuberculosis Infection

Cdc yellow book 2024.

Author(s): John Jereb

Screening for asymptomatic Mycobacterium tuberculosis infections should only be carried out for travelers at risk of acquiring tuberculosis (TB) at their destinations (see Sec. 5, Part 1, Ch. 22, Tuberculosis ). Screening with a tuberculin skin test (TST) or interferon-γ release assay (IGRA) in very-low-risk travelers might produce false-positive test results, leading to unnecessary additional screening or treatment. IGRAs, which require a single blood draw, are approximately as specific as TST in people who have not been vaccinated with bacillus Calmette-Guérin (BCG) and are more specific in BCG-vaccinated populations. Moreover, TST is prone to boosting sensitivity in serial testing, necessitating a 2-step initial test for establishing a baseline, which is unneeded with IGRAs. Using screening tests in very-low-prevalence populations will probably produce more false positives than true positives.

Travelers at risk for TB infection include those going to live in a TB-endemic country or anyone intending to spend any length of time in routine contact with patients in health care facilities or populations living in congregate settings (e.g., homeless shelters, prisons, refugee camps). People at low risk for exposure to TB, which includes most travelers, do not need to be screened before or after travel.

For travelers who anticipate a long stay or contact with a high-risk population, perform pretravel screening by using an IGRA or, when IGRA is not available, 2-step TST screening. CDC guidelines recommend testing with an IGRA (as opposed to TST) for people aged ≥5 years in low-risk populations. The American Academy of Pediatrics guidelines recommend an IGRA for children ≥2 years old; some pediatric TB experts use IGRAs for all children. If an IGRA is used for pretravel testing and there is concern for a false positive in an otherwise low-risk traveler, a second test can be used, which confirms TB infection only if both tests are positive. If the IGRA result is negative, repeat the traveler’s test 8–10 weeks after they return from their trip; however, data supporting a recommendation for regular serial testing for a long-term traveler are limited.

If TST is used for pretravel testing, use the 2-step TST for any traveler undergoing TST testing for the first time. The 2-step method is not needed for travelers who have already been tested and found to have a negative result within the previous 2 years. For the 2-step method, anyone whose baseline TST yields a negative result should be retested 1–3 weeks after the initial test; if the second test result is negative, the patient can be considered not infected. If the second test result is positive, the patient is classified as having skin test boosting, possibly because of previous M. tuberculosis infection.

The 2-step TST is recommended over single TST in this population because some people infected with M. tuberculosis years earlier (or who were sensitized by BCG or nontuberculous mycobacteria) exhibit waning delayed-type hypersensitivity to tuberculin. When skin tested years after infection, these people might have a negative initial TST result even though they had been sensitized previously. The first TST might stimulate the ability to react to subsequent tests, however, resulting in a “booster” reaction. When the test gets repeated at some future date, a positive result could be misinterpreted as a new M. tuberculosis infection (recent conversion) rather than a boosted reaction. For travelers who do not have enough time to complete a 2-step TST before departure, a single-step TST is an acceptable alternative, but an IGRA is preferred.

If the result of a pretravel test (either IGRA or 2-step TST) for M. tuberculosis infection is negative, a traveler should have a posttravel test with the same type of test used pretravel, 8–10 weeks after returning from their trip. People who have repeat TSTs should be tested with the same tuberculin purified protein derivative solution, because switching products can lead to different test results. The US Food and Drug Administration has approved 2 commercially available tuberculin solutions for skin testing: Aplisol (JHP Pharmaceuticals) and Tubersol (Sanofi Pasteur). During extended (>6 months) stays in, or repeated travel to, high-risk settings, travelers should have repeat testing every 6–12 months while traveling outside the United States and then 8–10 weeks after final return, all with the same type of test used pretravel.

In general, do not mix the types of tests used for a person. The discordance between TST and IGRA results is ≤15%; in most instances of discordance, the TST result is positive and the IGRA is negative. Multiple reasons for the discordance exist, and clinicians cannot be confident about the reason for discordance in any single person. If a clinician does decide to mix tests, going from TST to IGRA is better than the other way around, because the likelihood of a discordant result with the TST negative and the IGRA positive is much lower. Such discordant results might become unavoidable as more medical establishments switch from TSTs to IGRAs.

When testing travelers who were born or took up residence in TB-endemic areas, consider the greater background prevalence of infection in these places. In a study among 53,000 adults in Tennessee, the prevalence of a positive TST results among foreign-born participants was >11× that of US-born participants (34% vs. 3%). Confirming M. tuberculosis test status before travel would prevent the conclusion that a positive result after travel was due to recent infection.

The following authors contributed to the previous version of this chapter: Neela D. Goswami, Philip A. LoBue

Bibliography

Hagmann SH, Han PV, Stauffer WM, Miller AO, Connor BA, Hale DC. Travel-associated disease among US residents visiting US GeoSentinel clinics after return from international travel. Fam Pract. 2014;31(6):678–87.

Lewinsohn DM, Leonard MK, LoBue PA, Cohn DL, Daley CL, Desmond E, et al. American Thoracic Society/Infectious Diseases Society/Centers for Disease Control and Prevention clinical practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017;64(2):111–5.

US Preventive Services Task Force. Screening for latent TB infection in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016:316(9):962–9.

. . . perspectives chapters supplement the clinical guidance in this book with additional content, context, and expert opinion. The views expressed do not necessarily represent the official position of the Centers for Disease Control and Prevention (CDC).

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Tuberculosis Screening

What is a tuberculosis (tb) screening.

A tuberculosis screening test checks to see if you have the bacteria (germs) that cause tuberculosis (TB) in your body. TB is a bacterial infection that mainly attacks the lungs. But it can also affect other parts of the body, including the brain, spine, and kidneys. TB spreads from person to person when a someone who is sick with TB coughs or sneezes.

TB germs cause two types of conditions:

• Latent TB infection happens when you have TB germs in your body, but you're not sick because the germs aren't active. You don't have symptoms and you can't spread the disease to others. But the germs could start to grow (multiply) and make you sick in the future. So, latent TB infection is usually treated to prevent you from getting sick with active TB.
• Active TB disease means that TB germs are actively growing in your body and making you sick. If TB germs grow in your lungs or throat, you can spread the disease to other people. TB disease can almost always be cured with antibiotics. But without treatment, it can cause serious illness or even death.

A TB screening test checks to see if you have TB germs in your body. But it can't show whether you have a latent TB infection or active TB disease. If a TB screening test finds signs of TB germs, you'll need other tests to find out which type of TB you have so you can get the right treatment.

There are two types of TB tests used for screening: a TB skin test and a TB blood test. Your health care provider or your local health department can let you know which test is best for you.

Other names: TB test, TB skin test, purified protein derivative (PPD) test, latent TB infection test, Mantoux tuberculin skin test; IGRA test, TB blood test

What is it used for?

TB screening is used to look for signs of TB germs in people who have been exposed to someone with active TB disease or who have a high risk of exposure. The screening can show whether you have TB germs in your body and need more testing. It does not show if you have a latent infection or active disease.

Why do I need a TB screening?

You may need a TB skin test or TB blood test if you were exposed to someone with active TB disease or if you have a high risk of exposure.

Your risk of exposure is higher if you:

• Are a health care worker
• Work or live in a place where TB is more common, such as jails, nursing homes, and shelters for people without homes
• Were born in or often travel to countries where TB disease is common

You may need a TB screening test if have symptoms of active TB disease, including:

• A cough that lasts longer than three weeks
• Coughing up blood or sputum (a thick mucus from the lungs)
• Night sweats (heavy sweating during sleep)
• Losing weight without trying
• Loss of appetite
• Weakness or fatigue

You may need a TB screening test if you have a health condition that increase your risk for getting active TB disease. These conditions include:

• HIV or another disease that weakens your immune system
• Having an organ transplant
• Use of illegal drugs that are injected with needles

What happens during a TB screening?

You may get a TB screening test at your provider's office, a health clinic, or hospital. You will have either be a TB skin test or a TB blood test, depending on your health and medical history. TB skin tests are used more often, but blood tests for TB are becoming more common.

For a TB skin test (also called a Mantoux tuberculin skin test), you will need two visits to complete the test. The first visit is for doing the test and the second visit is for reading the results.

On the first visit:

• A health care professional will use a tiny needle to place a small amount of fluid under the skin in the lower part of your arm. The fluid is called tuberculin. It contains a protein that comes from the bacteria that cause TB. It cannot make you sick.
• The fluid will make a small bump on your arm.
• The test spot will be left uncovered.
• You will need to avoid touching the test spot or putting lotions on it. It's okay to get it wet. If it itches, you can put an ice cube or cold cloth on it.

After two to three days, you will return for the second visit. A health care professional will look at the test spot on your arm to see if your skin reacted. If there is a bump of hard skin, the professional will measure the bump. The meaning of the bump depends on how large it is, your risk of exposure to TB germs, and your risk for developing active TB disease. The professional will let you know whether or not the bump means that you're likely to have TB germs in your body.

For a TB test in blood (also called an IGRA test), a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't any special preparations for TB skin test or a TB blood test.

Are there any risks to the test?

There is very little risk to having a TB skin test or blood test. For a TB skin test, you may feel a pinch when the fluid is placed under your skin.

For a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Your TB skin or blood test results will usually be positive or negative.

A positive result means that you have been infected with TB bacteria. You will need more tests to find out if you have a latent TB infection or TB disease. These tests may include a chest x-ray or a sputum culture . If you had a positive result on a TB skin test, you may have a TB blood test to confirm the result.

A negative result means that your skin or blood did not react to the test. You are unlikely to have a latent TB infection or TB disease. But you may still need more testing if you:

• Have symptoms of TB
• Were tested sooner than six to eight weeks after an exposure to TB
• Had a TB skin test after being around someone with TB disease

Sometimes a TB blood test result will be "borderline," which means the test could not show for sure whether you have a TB infection. If this happens, you will likely be tested again.

Overall, TB screening tests tend to be accurate. But TB blood tests are more accurate than TB skin tests. Your provider will consider whether anything about your health history might affect the accuracy of your test results.

If you have questions about your results, talk with your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results .

Is there anything else I need to know about a TB screening?

Both active TB disease and latent TB infections should be treated. The treatment for both conditions is antibiotics . To make sure you get rid of all the TB germs in your body, you'll need to follow the directions for taking your medicine. Treatment may last a few months to a year. Stopping treatment too soon can cause the infection to come back and make it harder to treat.

• American Lung Association [Internet]. Chicago: American Lung Association; c2022. Tuberculosis Symptoms and Diagnosis; [updated 2020 Mar 9; cited 2022 Oct 6]; [about 2 screens]. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/symptoms-diagnosis
• American Lung Association [Internet]. Chicago: American Lung Association; c2022. Tuberculosis Symptoms and Diagnosis; [updated 2020 Apr 8; cited 2022 Oct 6]; [about 4 screens]. Available from: https://www.lung.org/lung-health-diseases/lung-disease-lookup/tuberculosis/treating-and-managing
• American Lung Association [Internet]. Chicago: American Lung Association; c2022. Tuberculosis (TB); [cited 2022 Oct 6]; [about 2 screens]. Available from: https://www.lung.org/lung-health-and-diseases/lung-disease-lookup/tuberculosis
• Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Fact Sheets: Tuberculosis: General Information; [updated 2011 Oct 28; cited 2022 Oct 6]; [about 4 screens]. Available from: https://www.cdc.gov/tb/publications/factsheets/general/tb.htm
• Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Tuberculosis Facts: Testing for TB; [updated 2016 May 11; cited 2022 Oct 6]; [about 3 screens]. Available from: https://www.cdc.gov/tb/publications/factseries/skintest_eng.htm
• Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Tuberculosis: Signs and Symptoms; [updated 2022 May 3; cited 2022 Oct 6]; [about 1 screen]. Available from: https://www.cdc.gov/tb/topic/basics/signsandsymptoms.htm
• Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Tuberculosis: Who Should be Tested; [updated 2016 Apr 14; cited 2022 Oct 6]; [about 1 screens]. Available from: https://www.cdc.gov/tb/topic/testing/whobetested.htm
• Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2022. Tuberculosis: Diagnosis and treatment; [cited 2022 Oct 6]; [about 7 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/tuberculosis/diagnosis-treatment/drc-20351256
• Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2022. Tuberculosis: Symptoms and causes; [cited 2022 Oct 6]; [about 8 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/tuberculosis/symptoms-causes/syc-20351250
• Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2022. Tuberculosis (TB); [reviewed 2022 Sep; cited 2022 Oct 6]; [about 16 screens]. Available from: https://www.merckmanuals.com/home/infections/tuberculosis-and-related-infections/tuberculosis-tb
• National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [updated 2022 Mar 24; cited 2022 Oct 6]; [about 7 screens]. Available from: https://www.nhlbi.nih.gov/health/blood-tests
• Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. IGRA TB Test; [modified 2021 Nov 9; cited 2022 Oct 6]; [about 10 screens]. Available from: https://www.testing.com/tests/igra-tb-test/
• Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. Sputum; [cited 2022 Oct 6]; [about 1 screen]. Available from: https://www.testing.com/glossary/#sputum
• Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. TB Skin Test; [modified 2021 Nov 9; cited 2022 Oct 6]; [about 9 screens]. Available from: https://www.testing.com/tests/tb-skin-test/
• UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida; c2022. PPD skin test: Overview; [updated 2019 Nov 9; cited 2022 Oct 6]; [about 3 screens]. Available from: https://ufhealth.org/ppd-skin-test
• University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: TB Screening (Skin); [cited 2022 Oct 6]; [about 5 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=tb_screen_skin
• University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: TB Screening (Whole Blood); [cited 2022 Oct 6]; [about 5 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=tb_screen_blood

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Get an appointment at AITC Immunization & Travel Clinic

We provide travel health visits, vaccinations, TB testing, and blood tests. Appointment only.

Make an appointment

You can make an appointment online or by calling (415) 554-2625.

We have 5 types of appointments.  

Before book online, we highly recommend you to read the information about " How to choose the correct appointment type to book ", further down this page.

Language Support

We want to help you communicate with our clinic team.  Select what language you prefer when you make an appointment- we have Chinese and Spanish speaking staff and can obtain translation support for other languages.  

If you have impaired vision or hearing or you use American Sign Language (ASL), please let us know in advance by calling 415-554-2625 or email us at [email protected]  before making an appointment.  We will make arrangements for your visit, and it will be no cost to you.

Prepare for your appointment

•   Check our prices . We do not accept insurance.
• Arrive 15 minutes before your appointment time. Bring any immunization records that you have. Make sure you have eaten and are well hydrated. If this is a travel health visit, prepare your full itinerary including layovers, and be aware that late arrivals may have to reschedule. Expect to stay one hour with the nurse.
• Check in at the front desk. You will be asked to complete some forms. Fill them out before the visit to save time. Find the forms further down this page.
• After registering, you will see our clinician.
• The wait time is generally a few minutes, but can be shorter or longer. We do our best to keep the wait time as short as possible.
• When it is your turn, our clinician will see you for evaluation and recommendations, then will give you a total fee, give you the injections and ask you to pay at the front desk for service(s) you have received.
• Some services such as TB skin test may require you to return to our clinic a few days later for the result. Please check with our clinician for more details.

AITC Immunization and Travel Clinic Home Page

Fill out these forms before your visit to save time at the clinic.

• Form for flu vaccination only visit
• Form for TB testing only visit
• Registration form (used for the first visit in over 1 year, or ever)
• Medical history form (for all travel health visits, and any patient who has not come to AITC in the past year)

Policies and notices

Minor policy.

For minors who have not yet reached their 18th birthday, the parent or legal guardian is expected to accompany the minor to the AITC visit and sign consent for treatment in person.  There are limited exceptions:

• Minors age 12 years and up can consent to receive a hepatitis B or HPV vaccine as STD prevention ( CA Family Code 6926 )
• Minors age 15 years and up can consent to medical services if they meet the definition of a self-sufficient minor ( CA Family Code 6922 )
• Minors can consent to medical services as an Emancipated Minor if they can document marriage, service in the armed forces, or a court order
• Guidance on Administering Mpox Vaccines  to Minor Patients 12 years and older
• Guidance on Administering COVID-19 Vaccines  to Minor Patients 12 years and older

Open Payments Notice

Open payments is a publicly accessible database of payments to promote transparency by requiring applicable manufacturers of drugs, devices, and biological or medical supplies to annually report to CMS certain payments made to physicians, and certain advanced practice providers.

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided on this notice. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.

The link to the Open Payments web page can be found here:  https://openpaymentsdata.cms.gov/

Special cases

How to choose the correct appointment type to book.

Note : We do not accept insurance, including Medicare or Medical

All below appointments are available

• This appointment is for ONE person who is planning international travel. The first part of the visit is a travel consultation by our travel nurse. Vaccine(s) will be given after consultation.
• For appointments for minors, please read our  minor policy.
• MPX1 PATIENT ONLINE for MPOX 1st DOSE Visit 
• For individuals who received the 1st dose at least 28 days ago
• Click  here  for blood test services and fees.
• Blood test visit can include routine vaccination(s).
• TB skin tests are placed on Mon, Tues, Weds, or Fri only.
• Required vaccines for SFUSD students (Age between 4 and 18 years old)
• Note : We do not offer TB skin tests on Thursdays, Fridays before long weekends, and on Tuesdays or Wednesdays before Thanksgiving Day.
• Completion of Hepatitis B, rabies, and other pre-approved vaccine series; the need for an HPV vaccine; obtaining a replacement card for your US or international vaccines.
• We only offer MODERNA Bivalent Booster for 5 years old and above. This vaccine is for individuals who have completed the primary series at least 2 months ago OR received their last booster of monovalent COVID vaccine at least 2 months ago. Please click  HERE  for our policy for minor visits.

If none of the above apply to your situation or you have any questions about the visit type, please call us at 415-554-2625.

Find out more about our travel health visits

We are experts in travel medicine. To prepare for your trip, we offer a travel health visit—your personal preventive health care session with an experienced AITC travel & immunization nurse. Your nurse will gather information and make recommendations, and you can ask questions and participate in decision-making.

We recommend making the appointment for 4-6 weeks prior to your departure in case several doses of a vaccine are required.

Travel vaccines and medications

• We stock all FDA-approved vaccines for international travel.
• We offer prescriptions for travel-related conditions: malaria, travelers’ diarrhea, high altitude illness, anaphylaxis. AITC will send a prescription to a pharmacy of your choice, where you can purchase the medication.

Additional travel-related services

• International Certificates of Vaccination
• Yellow Fever vaccine certification or medical waiver
• For travelers who suspect they have contracted a disease while traveling, we offer referral to a specialist in tropical medicine or infectious diseases

During the travel health visit, the nurse will:

• Review your travel plans closely, noting activities, places, and season of travel
• Point out disease risks specific to your trip, based on our comprehensive, up-to-date, global database
• Note your medications, allergies, medical conditions, and past vaccines
• Recommend vaccines & medications customized for your trip, and discuss the risks & benefits of each
• Assess your malaria risk, and recommend a malaria prevention drug if needed
• Tell you which vaccines you do not need
• If cost is an issue, help you prioritize decisions to achieve the most cost-effective plan
• Advise you how to stay healthy and avoid or manage common travel health problems
• Administer your vaccines comfortably
• Provide the AITC Handbook—24 pages of travel health advice you can fold up and take with you
• Ensure your medication prescriptions are transmitted to the pharmacy of your choice.
• Answer your questions

Get info for SFUSD students

SFUSD students who already have a regular pediatric doctor or clinic must contact their regular doctor or clinic. AITC is available for SFUSD K-12 students who do not have a regular doctor or clinic.

Costs: SFUSD students who have Medi-Cal, or are uninsured, are eligible for free vaccines. Others may need to purchase vaccines at AITC on a sliding scale.

Parent(s)/Guardian(s) needs to bring (a) the SFUSD letter (b) the child’s Medi-Cal card (c) the child’s immunization records (issued from in the USA or from other countries) to the visit.

Get a copy of your AITC medical records

If your visit was after February 21, 2022, contact DPH Health Information Management at (628) 206-8622.

If your visit was before February 20, 2022, complete and sign this form and give it to AITC.

Get more info about immunizations and travel health

Immunizations

• Immunization Action Coalition Comprehensive vaccine information in a friendly, easy-to-read format. Don’t miss the IAC’s Vaccinations for Adults page.
• Centers for Disease Control Vaccines & Immunizations Home Page A wealth of information, including adult and child vaccination schedules, vaccine availability, vaccine information statements, vaccine safety

Travel Health

• Travel Health Preparation Online Health risks you may encounter during your trip, vaccine recommendations, and disease prevention information, organized by destination.  Easier to navigate and more detailed than the CDC Travelers’ Health site.  The service is free but you will be asked to register online to use the site.
• Centers for Disease Control – Travelers’ Health Information about vaccinations, diseases, and CDC’s vaccination recommendations for the countries you will be visiting.  Current disease outbreaks around the world, regulations for traveling with pets, suggestions for special needs travelers, and more.
• World Health Organization (WHO) Detailed country profiles and epidemiological information about diseases and outbreaks.
• International Association for Medical Assistance to Travelers (IAMAT) A network of physicians, hospitals, and clinics available to IAMAT members anywhere in the world.  Doctors who speak English and have had medical training in North America or Europe.  IAMAT inspects clinics to ensure standards of care.  Free membership.

More Travel Resources

• International Trade Administration The US Commercial Service is a federal agency that helps small- to medium-sized companies establish international markets for their products and services.  There’s an office in downtown San Francisco.
• Intellicast Weather Global weather forecasting.
• Lonely Planet Lonely Planet publishes over 650 travel guidebooks.  Lots of information online, too.
• U.S. Department of State – Bureau of Consular Affairs Passport information, travel warnings, public announcements, consular information, health information, and more.

AITC Immunization & Travel Clinic

Mon to Fri, 9:00 am to 4:00 pm Closed for lunch 12 pm - 1pm

We are closed weekends and holidays .

Find more information about how to get to our clinic .

Check prices and find out if you qualify for low-cost or free vaccines

Make a tax-deductible donation.

Last updated April 18, 2024

Departments

• Student Life
• Coronavirus Updates
• Adult Patient Care
• Children's Health
• Hollings Cancer Center
• Research at MUSC

Student Health

• Current Students
• Consult International Travel

ALL YOUR HEALTH INSURANCE QUESTIONS ANSWERED HERE

Student health services, musc student health services.

30 Bee Street Floor: 1st Floor Suite: 102 MSC Code: 980 Charleston, SC 29425

Get Directions

Main: 843-792-3664

View Details

Student Health Clinic Hours

M-F 8:00 am to 5:00 pm

After hours

In case of a medical emergency, call 911 or go to the nearest hospital. For medical issues that cannot wait until the next business day, contact an urgent care center.

Consultation for International Travel

Student Health Services (SHS) provides MUSC students planning international travel with information about the countries they are planning to visit, evaluates individual health care needs and risks, and provides appropriate immunizations (for a fee.) Please note, not all required  vaccines are available at SHS. Student anticipating travel should make an appointment a minimum of eight weeks prior to travel to allow time for counseling and administration of immunizations. 

Additional information can be found on the  Centers for Disease Control and Prevention (CDC) travel information site.  

Pre-Travel Vaccines:

Hepatitis A Vaccine

Hepatitis b vaccine, typhoid vaccine, meningitis vaccine.

• Tdap/Td Booster

Yellow Fever

Rabies vaccine, cholera vaccine.

Other Travel Considerations:

• Mosquito Repellent
• Malaria Prophylaxis
• Traveler's Diarrhea
• Altitude Sickness
• Health Insurance
• Blood Borne Pathogen Exposures
• Travel Alerts

Common Pre-Travel Vaccines Include:

Hepatitis A is common in areas of the world with poor sanitation.  It can be spread from person –to-person or from sewage- contaminated food/drink (water, ice, shellfish, fruits/vegetables that are raw or inadequately cooked).   The Hepatitis A vaccine is a 2 dose series and is highly effective at preventing infection.  The first vaccine should ideally be given at least one month before travel to allow time to develop protective antibodies.  For durable, long lasting protection, the second and final vaccine should be given 6-12 months later – studies indicate that after the second dose, protective immunity may persist for 25 years or more.  return to top

Hepatitis B is a viral pathogen that can be transmitted from exposure to blood or blood -containing body fluids.  Infections can be transmitted through healthcare related occupational exposures (needle sticks, etc.), sexual exposure to an infected source, and from contaminated needles (tattooing, acupuncture).   Most healthcare students have completed the hepatitis B vaccine series and should know if they developed the desired immunity from the vaccine (immune Hepatitis B Surface Antibody titer).   Completion of the hepatitis B vaccine series (3 vaccines) and knowledge of one’s hepatitis B immune status is important for students who will be engaged in activities that place them at risk for bloodborne pathogen exposure while participating on medical rotations/mission work in foreign countries.  return to top

“Typhoid Fever” is a bacterial infection caused by Salmonella Typhi.  It is found in areas of the world with poor sanitation and can be spread from person-to-person contact, as well as from sewage-contaminated food and water.  Untreated infections can be fatal in up to 30% of persons.   There are 2 vaccines available that provide about 50-80% protection from infection:  (1) Typhoid Injectable Vaccine is a dead vaccine that needs to be administered at least 2 weeks before travel.  A booster dose is recommended after 2 years.  (2) Oral Typhoid Vaccine is a live, attenuated strain of Salmonella that consists of 4 capsules, 1 given every other day, with the 4th and final dose being completed at least 7 days before travel.   A booster dose is recommended after 5 years.   return to top

Neisseria meningitides can cause bacterial meningitis.  It is a found worldwide, but the highest incidence is found in the “meningitis belt” of sub-Saharan Africa.   In previously vaccinated persons who will be visiting an area of the world that is endemic for meningococcal infection, a booster dose is recommended if it has been 5 or more years since the last vaccine. return to top

Tdap/Td booster

Most children in the U.S. have received the primary Diphtheria-Pertussis-Tetanus (DPT) vaccine series. Pertussis remains endemic throughout the world (including the U.S.), and disease rates are highest in developing countries where vaccination coverage for children is low.   After completion of the childhood vaccine series, immunity wanes over time and booster doses are necessary.   A Tetanus booster (Td) should be given every 10 years.  Adults > 19 years old should receive single dose of the acellular pertussis vaccine (Tdap) instead of the Td vaccine.  After this adult Tdap “booster”, they should return to receiving Td boosters at 10 year intervals. return to top

Yellow fever is a viral infection transmitted by mosquitos.  It is endemic in sub-Saharan Africa and tropical South America.  While most of the travel vaccines are recommended to protect your health, the Yellow Fever Vaccine is required for entry by certain countries.  The vaccine is administered by certified Yellow Fever Vaccine clinics and needs to be given at least 10 days before travel.  return to top

Rabies is a fatal viral infection that is transmitted through bites/scratches from infected mammals (dogs, bats, other carnivores).   Pre-exposure vaccination is recommended for travelers who will be involved in outdoor activities that will bring them in contact with potentially infected animals (hiking, biking, caving, adventure travel).  The vaccine series consists of 3 intramuscular injections given on days 0, 7, and 21 or 28.   Even for fully vaccinated individuals, it is still necessary to seek immediate medical attention after a bite from a potentially rabid animal.  return to top

Cholera is a bacterial infection that can cause acute diarrhea with profound GI fluid losses.  It can be transmitted from contaminated food/water, as well as from person-to-person contact.   It is primarily found in resource-limited parts of the world where there is poor sanitation and limited access to clean water.   A single-dose oral cholera vaccine was approved on June 2016 which is up to 90% effective in preventing cholera.  Cholera in travelers is rare and is not recommended for most foreign travel.   The cholera vaccine should be considered for travel to areas of the world reporting active cholera transmission.  The vaccine should be given at least 10 days before travel.  return to top  

Other travel considerations include:

Mosquito Repellent:   If there is transmission of mosquito- borne viral infections (including Zika, Chikungunya, Dengue, Malaria) reported in the areas you will visit, regular use of an effective mosquito repellent is recommended for all travelers.  Effective agents include: DEET 20-30%, Oil of Lemon Eucalyptus 30%, and Picaridin 20%.   Certain “natural” repellents do NOT provide effective protection and should be avoided (including cedar, cinnamon, citronella, clove, geranium, lemongrass, rosemary, and peppermint).  For further info on finding the right repellent:

• U.S.  Environmental Protection Agency:   https://www.epa.gov/insect-repellents/find-insect-repellent-right-you
• CDC: http://www.cdc.gov/chikungunya/pdfs/fs_mosquito_bite_prevention_travelers.pdf

return to top

Malaria Prophylaxis  – Malaria transmission occurs throughout the world, including areas of Africa, Latin America, Caribbean, Asia, Eastern Europe, and the South Pacific.  Flu-like symptoms (fever, chills, muscle aches, headache) can occur as early as 1- 2 weeks after the bite of an infected female Anopheles mosquito.   Preventive measures include regular use of an effective mosquito repellent and anti-malarial medications. If anti-malarial medication is recommended, your provider will discuss effective medication options that are specific to the area of the world you will be traveling.    return to top

• https://wwwnc.cdc.gov/travel/yellowbook/2018/infectious-diseases-related-to-travel/malaria

Traveler’s Diarrhea  - Diarrhea is the most common travel-related illness and is common in areas of the world with poor sanitation and substandard water treatment.  The majority of cases are transmitted from contaminated food or drink, so one can lessen their chances of getting ill by eating food that is cooked and served hot.  Avoiding unwashed or unpeeled raw fruit/vegetables/fresh salsa is also recommended.   Many travelers carry a short course of antibiotics, which when used early, can shorten the severity and duration of the illness.   If the area you will be visiting has poor sanitation standards, you can discuss with your provider whether or not it is necessary to bring a course of antibiotics.    return to top

• https://wwwnc.cdc.gov/travel/page/travelers-diarrhea

TB Testing  - If you will be delivering medical care in areas of the world with increased incidence of tuberculosis (hospitals, prisons, homeless shelters), make sure your TB skin test is current before travel, and return for a repeat TB skin test 8-10 weeks after return.  Most TB infections will be asymptomatic (Latent TB Infection or LTBI) and will only be discovered on subsequent TB testing.    return to top

Altitude Sickness  -  Low oxygen pressures found at high altitudes can lead to hypoxia with subsequent high altitude illness symptoms which include headache, nausea, and fatigue.  For example, at 10,000 ft., the oxygen pressure (pO2) of inspired air is only 69% that of the oxygen pressure found at sea-level.  Altitude sickness can occur when flying directly to destinations with high altitudes (> 8,000 feet) with no opportunity to acclimatize over several days.  There are medications available such as Acetazolamide to help prevent altitude sickness. The usual dosage is 125 or 250 mg twice daily starting 24 hours before ascent and continuing for 48 hours after arrival at altitude. Since Acetazolamide is a diuretic, it is important to maintain proper hydration while taking it by drinking enough water for your urine to run clear to pale yellow.    return to top

• https://wwwnc.cdc.gov/travel/page/travel-to-high-altitudes

Health Insurance  – make sure your insurance plan provides medical coverage for foreign countries, including medical evacuation benefits.    If your foreign travel is MUSC school-related, you can visit the MUSC Global Health site and register your travel for additional travel assistance:  

• MUSC Global Travel

  return to top

Blood Borne Pathogen Exposures  – students who will be traveling to resource-limited areas of the world who will be engaged in clinical activities that place them at risk for an occupational blood exposure (needle stick, blood splash to eye, etc.) should ensure that a contingency plan is in place to appropriately manage such exposures.  The medical director of the trip should ensure that there is: (1) A qualified individual on-site who can conduct the appropriate assessment and management of an occupational exposure.  (2) Appropriate supervision of participants during any exposure prone procedure.  (3) Appropriate personal protective equipment (gloves, gowns, eyewear) available. (4) Availability of immediate lab testing of the source patient’s blood (HIV, Hepatitis C, Hepatitis B) in the event of an exposure. (5) Availability of anti-viral medications to initiate within 1-2 hours of an HIV exposure.   

Travel Alerts  – check for travel alerts to the place (s) you will be traveling. Additional information can be found at:                                                                                                                              

• CDC:  https://wwwnc.cdc.gov/travel/notices
• World Health Organization:   http://www.who.int/ith/en/

Additional resources for vaccine requirements/recommendations and preventive measures include:

• CDC:  https://wwwnc.cdc.gov/travel/
• World Health Organization:  http://www.who.int/ith/vaccines/en/
• American Public Health Association Website:  https://www.apha.org/topics-and-issues/vaccines

Regional: South Carolina Department of Health and Environmental Control (Regional Information):   http://www.scdhec.gov/index.htm

Local: MUSC Center for Global Health

Tuberculosis (TB) Testing

What is tb.

Tuberculosis (TB) is a bacteria that mainly affects the lungs. TB is spread through the air from one person to another. Not everyone infected with TB becomes sick. This is called latent TB infection . People with latent TB infection have no symptoms, can’t spread TB to others, and will likely have a positive TB skin or blood test. If they do not receive treatment, they may develop TB disease . People with TB disease are sick and may spread TB to others. Symptoms include a cough lasting over 3 weeks, coughing up blood, fever, night sweats, unexplained fatigue, or weight loss. Please talk to your healthcare provider if you are experiencing symptoms.

Who should get TB testing?

TB tests are generally not needed for people with a low risk of exposure to TB. 

Consider testing if you have any of the following risk factors:

• Close contact with someone who has TB disease
• Born or lived in a country where TB disease is common (most countries outside of the United States, Canada, Australia, New Zealand, or Northern or Western Europe)
• Travel to a country where TB disease is common for at least 1 month
• Live or work in correctional facilities, long-term care facilities, nursing homes, or homeless shelters 
• Health care workers  

How do I get TB testing?

There are two types of TB tests: the TB skin test and the TB blood test. TB blood tests are the preferred method for testing as it only requires a single trip to the laboratory. TB blood tests are also recommended for those who have received the BCG vaccine.  

You can get a TB blood test at the Tang Center. Self-order a test using the instructions below: 

• Login to your eTang portal
• Select "Messages" from the menu on the left
• Select "New Message," then "Order lab tests" and select 'Continue.'
• Select "Order TB Blood Test" and select 'Continue.'
• Follow the instructions.
• Once you receive an auto-reply from the Laboratory confirming that the test has been ordered,  you can go to the LAB FRONT DESK and let them know you ordered this test on eTang. 

You will receive the results and follow-up advice, if needed, within one week of the test. You can view and download the test report on eTang, by clicking on the Health Records tab > Lab Results > View Report. Notifications for negative (normal) results will no longer be sent.

If you would like to get a TB skin test, please schedule an appointment on eTang or call the Travel/Immunization Clinic at (510) 643-7177. TB skin tests must be read in person 48-72 hours after placement. 

Faculty/staff:

Lab services at UHS are not available to faculty/staff for reasons other than occupational requirements. If you require TB testing for your employment, please speak with your supervisor or PI first, and then you may contact Occupational Health at 510-642-6891.

What to do if you have a positive TB test?

A positive TB test MUST be followed up. This will usually be by a chest x-ray. A chest x-ray can help determine the difference between active TB disease and latent TB infection. Latent TB is treatable. Treatment can prevent you from becoming sick and contagious with TB disease. Students can schedule an appointment with a TB nurse for a “Positive TB Test Visit” on eTang or by calling (510) 643-7177.

For students needing a TB form completed for employment or volunteering  

Please schedule a “TB Screening” appointment on eTang or call (510) 643-7177.

Note, as of March 2022, fees will be applied for completion of forms, other than forms required for enrollment by a University of California (UC) institution. A $15 fee will be applied for completion of non-UC forms, including forms for volunteering, working, or internships (such as the California School Employee Tuberculosis (TB) Risk Assessment Questionnaire).

Related Resources

• For information about what your TB test result means, visit https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm

Basic TB Facts (CDC) (link is external)

Latent TB Infection and TB Disease (CDC) (link is external)

Treatment Regimens for Latent TB Infection (CDC)

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How much is the cheapest flight to Elektrostal?

Prices were available within the past 7 days and start at for one-way flights and $1,341 for round trip, for the period specified. Prices and availability are subject to change. Additional terms apply.

Find Your Flights to Elektrostal VKO

Cheap flights to Elektrostal ( VKO)

Get started finding a cheap flight to Elektrostal on Expedia by either choosing a deal on this page or entering into the search bar your travel dates, origin airport, and whether you want roundtrip or one-way airfare. You can filter for flexibility, number of stops, airline, and departure/arrival times to find the best flight for you.

We recommend using the ‘Flexible Dates’ calendar at the top of the page to see the price of plane tickets on the surrounding dates. This allows you to pick the cheapest days to fly if your trip allows flexibility and score cheap flight deals to Elektrostal.

Roundtrip prices range from $1,341 - $3,972, and one-ways to Elektrostal start as low as .

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Airlines that fly to Elektrostal ( VKO)

You have several options for which airline you choose to travel with to Elektrostal. There are 10 airlines flying into VKO: Qatar Airways, LATAM Airlines Group, Turkish Airlines, Hainan Airlines, Air China, China Eastern Airlines. 

Cheap plane tickets may be available from different airlines at different times and with unique terms. It’s best to understand the details of each airline’s offer before judging its value.

For example, if you plan to check a bag or bring a carry-on, check whether the cheap airfare deal includes a baggage allowance. If not, verify whether the baggage fee is higher than the difference of other airline plane ticket deals offering free checked/carry-on baggage in exchange for a slightly higher airfare. 

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Find the best deals

At Expedia, we source many flight deals from multiple providers, so you can easily find the best deals that are right for you. A great strategy for getting the best deals can be to make sure you book and travel at the optimal times. Airfare to Elektrostal (VKO) varies throughout the year based on seasonal demand. You’ll see the lowest rates for roundtrips to VKO in October and in for one-ways.

Cancellation & flexibility

To change or cancel eligible flights, go to ‘My Trips’ and navigate to your itinerary. If you booked within the last 24-hours, you might be able to cancel your flight for free. Learn more about flight changes or cancellations from our customer service portal . Some plane tickets are available with no change fees, which you can filter for during your search.

Frequently asked questions

• The trick to having an amazing flight experience is to pack ahead. So, let’s start with the essentials: passport, official ID, cash and daily medications. Next, bring items that’ll help keep you entertained, like your laptop or a good book. It’s also smart to bring your chargers, a comfy neck pillow and a pair of earphones. And of course, be sure to toss in toiletries like a toothbrush, cleansing wipes and a clean T-shirt.
• While the list of banned items can differ between airlines, the general rule to follow is avoid carrying anything sharp, flammable or explosive. This includes things like screwdrivers, pocket knives, spray paint and flares. Sporting equipment like hockey sticks, and objects that could harm passengers, such as pepper spray and firearms, aren’t allowed in the cabin either.
• The answer to a comfortable flight can be as simple as your choice of clothing. Prepare for changes in temperature by bringing layers. This will keep you nice and warm if the cabin starts to cool down. Shoes like stilettos, flip flops and lace-up boots are best left in your suitcase. Even though they may be your favorites, go for flat, closed-toed footwear like slip-ons. Your feet will thank you for it.
• A condition by the name of DVT (deep vein thrombosis) is a potential risk on long-haul flights. It results from blood clotting due to inactivity and poor circulation. Walking up and down the aisle and doing leg and foot exercises in your seat is a great way to prevent this from happening. Wearing a good pair of compression tights or socks can also help.
• Your travel documents and ID will need to be presented to security personnel. Have them close by to avoid fumbling around for them.
• Your coat, belt, keys and other items in your pocket, like your earphones, will need to go on a tray through the X-ray machine. Make your life easier by removing them before your turn.
• For just a few minutes, you’ll have to unplug from the digital world. Your phone, laptop and any other electronic devices also need to be sent through the scanner.
• Remove liquids and gels from your hand luggage. They often need to be sent through the X-ray machine separately. Each product should be no larger than 3.4 ounces (100 milliliters) and everything must fit inside a single quart-size (one liter), clear zip-lock bag.
• There’s a possibility that you’ll be required to take your shoes off for scanning, so wearing slip-on sneakers is always a clever idea.
• Airlines won’t allow any sharp objects in the cabin. If you need to bring these kinds of items, pack them safely in your checked luggage.

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