Do I need to get tested before Mantoux and how to prepare for vaccination?

Do's and Don'ts before Mantoux

The Mantoux tuberculin test is a medical procedure for the introduction of special proteins of Mycobacterium tuberculosis, which provoke an immunological response of an organism familiar with Koch's bacillus. The result is assessed by the presence of compaction and redness at the injection site. The injection does not cause bleeding, although a drop of blood may appear at the injection site. To accurately assess the results, it is important that there is no outside influence at the injection site.

This includes:

1. Contact of soap and detergents at the injection site. You can wet the injection site. The main thing is not to rub it.
2. Combing the sample.
3. Skin diseases.

But this is a list of what is not advisable to do after the test. Before the Mantoux procedure, it is important to find out whether there are any contraindications that could distort the results or cause an inadequate reaction of the body. Such contraindications include infectious and skin diseases, as well as a tendency to allergies.

Mantoux is not a complex medical procedure that requires complex additional preparation. But it is important to ensure that there are no contraindications.

The concept of the test, features of its implementation

The tuberculin test is the main method of anti-tuberculosis diagnosis.
Its essence lies in the subcutaneous administration of a protein extract from dead mycobacteria of the pathogen, which contribute to the activation of the immune system, familiar with Koch's bacillus. The result is assessed based on the size of the compaction and hyperemia formed at the site of drug administration. The development of bleeding after the injection is not observed, although one drop of blood may be present. To increase the accuracy of the result, you should avoid the influence of external factors.

These include:

• use of ointments, creams, personal hygiene products at the injection site;
• mechanical combing, wearing synthetic clothing, which contributes to the development of irritation;
• food products that increase sensitization of the human body;
• contact with water containing pathogenic microorganisms;
• use of antihistamines.

Before carrying out the test, it is worth finding out the presence of contraindications, which can not only distort the final diagnostic result, but also cause problems with the patient’s health.
Among such restrictions, it is worth highlighting acute infectious diseases, chronic pathologies in the acute stage and skin diseases. It is also worth highlighting the increased tendency to develop allergies to the components of the drug. This is an absolute contraindication to the Mantoux test, in which the doctor opts for other methods of anti-tuberculosis diagnosis.

The test is not a complex medical procedure that requires extensive preparation. The main thing is to exclude contraindications that distort the result or are harmful to human health.

Tests before Mantoux

There are no special tests that are prescribed before a tuberculin test.

Tests can be prescribed by a pediatrician in several cases:

1. If, in parallel with the test, the child undergoes a medical examination for admission to preschool and school educational institutions.
2. To identify a tendency to allergies, if there is a suspicion of a non-standard reaction.
3. When the test is performed before vaccination against tuberculosis.

If the Mantoux test is performed for enrollment in a kindergarten or school, then there is no fundamental difference when exactly to take the tests. This can be done after the test.

Taking tests is not a mandatory procedure before a diagnostic test. If the pediatrician prescribes them, you can take them after Mantoux, but to identify allergies, the doctor may insist on taking tests.

Antihistamines before Mantoux

The body's reaction to the Mantoux test may be non-standard. This often happens if the child is prone to allergies.

In order to avoid an allergic reaction, it is necessary to use special medications, but it is recommended to take them only as prescribed by a doctor, according to the following scheme:

1. Three days before the Mantoux test.
2. Next time on the day the test is taken.
3. Every day until the results are assessed.

The most popular drugs prescribed in this case: Fenistil, Suprastin, Zyrtec. It is important to understand that taking these medications does not in any way affect the final result.

An allergic reaction may prevent adequate assessment of redness after the injection. Therefore, in such cases, taking antihistamines to prevent allergies is justified.

You can't eat before Mantoux

There are no strict dietary restrictions before conducting a diagnostic test.

But in order not to cause allergies, sensitive children should slightly adjust their diet:

• you should not eat new foods, especially if you do not know what the child may have a reaction to;
• you can’t overeat, no matter what;
• exclude highly allergenic foods from the diet.

If you follow the norms of proper nutrition and avoid sudden changes, you don’t have to worry about the Mantoux result, since allergies will not interfere with the quality of the assessment.

You can eat anything before Mantoux, but if you are prone to allergies, remove all irritants from food. In addition, you should not eat in large quantities.

Is it legal to go to kindergarten without Mantoux?

The legislation of the Russian Federation does not prohibit taking a child to kindergarten without a Mantoux. The test shows the absence or presence of active tuberculosis in the child and contact with the Koch bacillus. But if it was not carried out, this does not mean that there is an infection and the person is dangerous to others.

Therefore, Federal Law No. 323-FZ of November 21, 2011 does not make the test mandatory, but states that:

• any methods of preventing tuberculosis, including Mantoux, are voluntary;
• Minors are tested only with the consent of their parents or other legal representatives.

Sample refusal to conduct a Mantoux test
But the latter are not obliged to give it unconditionally, especially since the reaction can be false positive, false negative, that is, it is not 100% reliable.

They will take it to the kindergarten without Mantoux if there is other confirmation that the child does not have a dangerous infection. A TB doctor can give it to you. You should look for it in a clinic or tuberculosis clinic, having a referral from a pediatrician with you.

The phthisiatrician will examine the child, study his tests and the results of fluorography of the parents. It is possible for a specialist to prescribe a free Diaskintest, based on the results of which a conclusion is issued that the child can attend a child care facility. They will accept her into the garden without Mantoux. The document must be provided annually if the child has been given BCG, and every six months for children who have not been vaccinated against infection.

We recommend reading about what an alternative to Mantoux may be for children. From the article you will learn when you need an alternative to Mantoux, the advantages and disadvantages of Diaskintest, T-SPOT analysis, PCR, and quantiferon test. And here is more information about how to draw up a refusal to perform a Mantoux test.

Before Mantoux you need

Despite the relative simplicity of the procedure, there is still a small algorithm of actions.

It is recommended to carry it out before the Mantoux test:

1. Visit a doctor to clarify the timing and consultation on the general health of the child. The pediatrician should prescribe a test based on the vaccination calendar and previous diseases.
2. Carefully study the food and remove possible allergens from it.
3. Measure your body temperature on the day of the test.
4. Examination by a pediatrician directly on the day of the procedure.

All these procedures are quite sufficient for an annual diagnostic examination. The Mantoux test does not pose a danger to the body, and therefore one visit to the pediatrician is enough to prepare.

Since the body gives an immunological response, the immune system should have no other job. Therefore, the pediatrician must measure the temperature and make sure there are no infections or colds.

Is it possible to get to kindergarten without Mantoux and a phthisiatrician?

It is possible to place a child in a kindergarten without Mantoux and a phthisiatrician only if the parents themselves pay for and perform one of the alternative tests for the child, confirming the absence of Koch’s bacillus in the body. The results must be submitted to the clinic where the card is issued.

But alternative methods of tuberculin diagnostics are expensive and are not even carried out in every regional hospital. To carry them out you need serious equipment and specialists.

We recommend reading about whether it is worth doing an x-ray instead of Mantoux. From the article you will learn when an x-ray is indicated instead of Mantoux, the law on x-rays instead of Mantoux, what is more harmful, what is safer, whether Mantoux should be done if there is an x-ray. And here is more information about the blood test for tuberculosis instead of Mantoux.

The Mantoux test is not the only “pass” to kindergarten; it can be replaced with alternative tests. But this will take a lot of time, effort, and possibly money. So if the child is generally healthy, there is no need to be so afraid of tuberculin diagnostics. The disease itself and the presence of an unexamined baby among other children are much more dangerous.

Sightseeing before Mantoux

When examined by a pediatrician on the day of the tuberculin test, nothing new happens.

This is a standard appointment at which the doctor must:

1. Examine the throat.
2. Listen to the lungs for wheezing.
3. To measure the temperature.

All this is done to identify possible ARVI, in which a sample cannot be taken. The presence of any infection, cold or flu is a direct contraindication to the procedure. The doctor records all the results of the examination on the card.

All that needs to be done during the examination is to make sure that there are no contraindications for the test. This takes a few minutes. You can measure your temperature yourself before visiting a doctor.

Mantoux before BCG

It happens that for various reasons, a child is not vaccinated against tuberculosis in the maternity hospital. BCG is usually placed on the third day. But, if the mother refused or the baby was weak, then the vaccination is postponed. In this case, the vaccine is given later. If BCG was not given before two months, then vaccination is carried out only after a negative Mantoux test.

In this case, it is recommended:

1. Before the procedure, you need to have your blood and urine tested, preferably one day before.
2. The Mantoux procedure should be performed three days before the planned BCG vaccination in order to have time to evaluate the result.

If it suddenly turns out that the test gives a positive or questionable result, then the vaccination is canceled and the child is sent to an appointment with a phthisiatrician.

The Mantoux test is performed before BCG in order to find out whether a hostile microorganism has had time to attack the immune system. Otherwise, vaccination cannot be carried out.

What to do if they don’t sign a card to the garden without Mantoux

If pediatricians at the children's clinic do not sign a card for kindergarten without Mantoux, parents have the following options on what to do:

• Order and pay for the Diaskintest for your child yourself. Its results must be provided to the pediatrician, then the card will be signed.
• Contact a TB doctor without the child, providing him with fluorography of the mother and father, taken no earlier than six months ago, as well as blood, urine, and stool tests of the child. In regions free from tuberculosis, a specialist can sign a conclusion that the baby is healthy after interviewing the parent and studying medical documents.
• Contact a TB doctor with your child. A specialist will examine him, send him for a free Diaskintest, interview his parents, and evaluate the results of their fluorography. When the test is ready, the TB specialist will also sign a conclusion about the absence of the disease.

Comparative characteristics of Diaskintest and the Mantoux test
If parents do not want to take their child to a specialist at a tuberculosis clinic, they can write a complaint against the pediatrician requesting this to the head of the clinic or the head physician. They motivate her by the fact that the child has no signs of tuberculosis, there are no patients in his environment, and therefore there is no reason to refer him for additional examination to a TB specialist.

The statement also indicates that refusal of tuberculin diagnostics is permitted by law (refer to Article 20 of Federal Law No. 323-FZ of November 21, 2011 and Article 7 of Federal Law No. 77-FZ of June 18, 2001). If the administration of the medical institution still does not sign the certificate and demands that the child be taken to a TB specialist, you should write to the prosecutor's office.

But it is not a fact that she will support the child’s parents in their reluctance to examine him for infection. And then you will have to go to court. In this case, the outcome of the case in favor of the baby’s parents is by no means predetermined. The Supreme Court of the Russian Federation has already once decided that a child who has not been examined for tuberculosis cannot attend an educational institution with other children.

Watch this video about whether you can go to kindergarten without vaccinations and the Mantoux test:

Mantoux before admission to children's institutions

For admission to kindergarten, a Mantoux test may be required. If it has not been performed in the last year, then parents must either perform a tuberculin test or undergo an examination by a phthisiatrician. When enrolling in school, you do not have to do a tuberculin test, since it is performed on everyone every September.

There are several groups of children who are admitted to school with a tuberculin test:

1. Children from risk groups, including those from families with tuberculosis patients.
2. Children who have previously been ill and are under the supervision of a TB doctor.
3. If the Mantoux test has not been performed for a long time.

Sometimes parents may refuse to undergo this procedure, despite numerous assurances from doctors. Komarovsky, for example, believes that all the horror stories about vaccination and testing are just a myth. In this case, you will have to go to an appointment with a phthisiatrician to diagnose the absence of a stick using other examination methods.

A test to detect tuberculosis is done to children every year. This procedure is carried out both at school and in kindergarten, but they are required to be admitted to a child care institution in any case.

Mantoux test before entering educational institutions

When applying for admission to preschool institutions, a Mantoux test may be requested. If the child has not had it diagnosed over the past year, the parents need to do so, or undergo an examination by a phthisiatrician.

This procedure is not necessary for admission to school, since the test is carried out annually in all educational institutions at the beginning of the year. This usually happens in September.

However, there are certain groups of children whose admission is carried out only if there is a note on the card about a recently performed tuberculin test.

These include:

1. Children whose family members have people with tuberculosis.
2. Children who have previously suffered from diseases, as well as individuals with increased susceptibility to infectious agents.
3. Children who are under the supervision of a TB specialist.

In some cases, parents refuse to carry out the Mantoux test. At the same time, they must take the child to an appointment with a TB specialist, who will diagnose the absence of the pathogen in his body by other available means.

The test must be carried out annually in all educational institutions. This will help detect children who have Koch bacilli in their bodies, as well as prevent the spread of the disease.

Vaccination before Mantoux

Sometimes Mantoux needs to be performed before or after vaccinations, then you must keep a distance so as not to cause side effects and complications:

• before the vaccine, the test is done three days in advance, no later;
• After the vaccine, Mantoux can be given no earlier than a month later.

In any case, if it is necessary to perform a tuberculin test, the pediatrician should check the vaccination calendar and, in accordance with it, set a date for the test.

If there is a need to vaccinate, then you need to postpone the Mantoux test for a month.

No specialized preparation is required for the tuberculin test. It is enough just to go to the clinic and undergo a standard examination by a pediatrician.