The conundrum of prior bacille calmette-guerin vaccination in children of temporary residents in the United States.

Bacille Calmette-Guerin (BCG) is one of the most widely used vaccines throughout the world. Children of temporary residents in the United States frequently undergo tuberculin skin testing as part of their health maintenance visits. Management of those children with a positive skin test can lead to doctor-parent disagreements, because of differences in tuberculosis (TB) policies between the United States and other countries that routinely administer BCG vaccine. Two British specialists compare their approach with that of the United States. They also discuss the potential for specific diagnosis of latent TB infection with interferon-based TB diagnostic blood testing, to distinguish positive skin tests caused solely by BCG vaccination.