State Temporarily Suspends Tuberculosis (TB) Clearance Requirements Due to Nationwide Shortage of Testing Solution

The Hawaii State Department of Health (DOH) is announcing the state’s temporary suspension of tuberculosis (TB) clearance requirements that are mandated in Hawaii Administrative Rules, Title 11, Chapter 164, for school personnel, students, food handlers, and workers in health care, domiciliary care, daycare, and residential care facilities. Beginning today, the state will not restrict attendance at work or school due to the absence of a TB clearance. The suspension is in response to a nationwide shortage of testing solution required for tuberculin skin testing.

Department of Health“With limited supplies of testing solution available due to nationwide production delays that began late last year, we anticipate people may have some difficulty getting tested for TB at this time,” said Dr. Richard Brostrom, TB Control Branch Chief. “TB clearance requirements will be suspended until further notice, and our state TB clinics will be limiting testing to specific high-risk groups to prioritize and extend current supplies.”

Because of the shortage of Tubersol® and Aplisol® purified protein derivative (PPD) solution, DOH is limiting TB testing available at state clinics to specific high-risk groups until further notice. These groups include:
• Persons with signs and symptoms of active TB disease
• Contacts exposed to an infectious case of TB
• High-risk immigrants referred from the Honolulu Quarantine Station
• Persons with immunodeficiencies
• Persons who require TB screening due to medical treatment

All other individuals seeking a TB clearance are advised to contact their private health care provider or health center.

DOH services related to the evaluation and treatment of persons suspected or confirmed to have active TB disease are not affected by the PPD shortage; these services will continue without change.

Manufacturers of the PPD have been experiencing delays in production since November 2012. It is estimated that adequate supplies of PPD solution will be available several months from now. DOH anticipates the temporary suspension of state TB clearance requirements may be in effect for up to 120 days or until the PPD shortage has ended. Public notice will be issued when the suspension is lifted and a grace period or catch-up date will be announced for individuals whose TB clearance was postponed to meet their requirement.

Hospitals and medical providers in Hawaii have received detailed recommendations from DOH on steps to take during the PPD shortage. For more information on tuberculosis or TB testing, the public may call the Hawaii TB Control Program at (808) 832-5731 or go to

The DOH TB Control Branch provides effective prevention, detection, treatment, and educational services to reduce the incidence of TB in Hawaii. Program activities include diagnosis, treatment, case investigation, preventive therapy for persons at high risk, and direct testing services. Each year, DOH conducts roughly 50,000 tuberculosis skin tests, and provides treatment to approximately 120 individuals identified with TB.



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