- Was your child born outside the United States? (circle one)
| Yes | No |
- If yes, where?
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- If the child was born in Africa, Asia, Latin America, or Eastern Europe, a test for TB infection (TST or IGRA) should be performed.
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- Has your child traveled outside the United States? (circle one)
| Yes | No |
- If yes, where did the child travel, with whom did the child stay, and how long did the child travel?
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- If the child stayed with friends or family members in Africa, Asia, Latin America, or Eastern Europe for ≥1 week cumulatively, a test for TB infection (TST or IGRA) should be performed.
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- Has your child been exposed to anyone with TB disease? (circle one)
| Yes | No |
- If yes, this question should be followed by questions to determine if the person had TB disease or TB infection, when the exposure occurred, and what the nature of the contact was.
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- If confirmed that the child has been exposed to someone with suspected or known TB disease, a test for TB infection (TST or IGRA) should be performed. If it is determined that a child had contact with a person with TB disease, notify the local health department per local reporting guidelines.
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- Does your child have close contact with a person who has a positive TST or IGRA? (circle one)
| Yes | No |
- If yes, follow-up questions as above (question 3).
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Depending on local epidemiology and priorities, risk-assessment questionnaires can include the following additional questions: - Does your child spend time with anyone who has been in jail (or prison) or a shelter, uses illegal drugs, or has HIV?
- Has your child consumed raw milk or unpasteurized cheese?
- Does your child have a household member who was born outside the United States?
- Does your child have a household member who has traveled outside the United States?
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