A WIN! Changing Lives, Families!

For all you families waiting to travel and about to travel to go get your kids from Ethiopia, there is great news! The kids are coming home! If they are 10 or under, they can come home. No more waiting for cultures, now they can come home. Wahoo! Read below for the particulars.

As you all know, this is an issue close to our hearts. Our daughter Marta was stuck in Addis and not allowed to come home for eleven weeks, waiting on a TB culture. We fought, screamed, pushed, shoved, and prayed. And still we waited. Many others have done the same, causing much anguish and many problems. However, times are changing!

Many people have been working very hard to get the Technical Instructions changed and get our kids home. It has taken much work and pushing and researching and talking and meeting by many amazing dedicated people: lawyers, adoption professionals, doctors, families, all sorts of folks. And now, change has happened, for good! This is a big darn deal and while it would not have helped us in our situation, it will help the vast majority of most of the families who might otherwise be stuck. It is a huge step forward and worth a big cheer and shout of joy, even clapping for the CDC, who agreed to make the changes. So, without further ado:

2007 Technical Instructions for Tuberculosis Screening and Treatment Addendum: Instructions for Applicants 10 Years of Age or Younger

September 18, 2009

CDC has developed the following addendum instructions for travel clearances for 10 years of age or younger. The criteria described in these addendum Technical Instructions are based on physiologic
aspects of childhood tuberculosis disease and children’s ability to transmit tuberculosis disease.
These criteria do not apply to adults or children with tuberculosis disease associated with higher
levels of transmissibility.

Applicants 10 years of age or younger who require sputum cultures, regardless of HIV infection
status, may travel to the United States immediately after sputum smear analysis (while culture results
are pending) if none of the following conditions exist:
 Sputum smears are positive for acid-fast bacilli (AFB). If the applicant could not provide
sputum specimens and gastric aspirates were obtained, positive gastric aspirates for AFB do
not prevent travel while culture results are pending.
 Chest radiograph findings include―
o One or more cavities
o Extensive disease (e.g., particularly if involving both upper lobes)
 Respiratory symptoms include forceful and productive cough
 Known contact with a person with multidrug-resistant tuberculosis (MDR TB) who was
infectious at the time of contact

For applicants 10 years of age or younger who travel to the United States while results of cultures
are pending, panel physicians should―
 Give the applicant a Class B1 TB, Pulmonary classification
 Document that culture results are pending on the Chest X-Ray Worksheet (DS 3024 [until
September 30, 2009] or DS 3030 [beginning October 1, 2009]
 Forward culture results to DGMQ “Quality Assessment Program” via fax at 404-639-4441
so that DGMQ can forward the culture results to the receiving health departments

Panel physicians should provide the DS Forms based on the date of intended travel. If an applicant
10 years of age or younger will not travel until after culture results are to be reported (assuming they
are negative), the panel physicians should wait until that time before completing the DS Forms. If
the applicant 10 years of age or younger will travel while results of cultures are pending, the panel
physician should provide DS Forms while cultures are pending.

Panel physicians should not delay treatment on applicants 10 years of age or younger for whom
there is high suspicion of tuberculosis disease and who would benefit from therapy being started
prior to departure to the United States. Consistent with other applicants started on tuberculosis
treatment prior to travel, if therapy is started for an applicant 10 years of age or younger, the
applicant is Class A for tuberculosis. A Class A Waiver petition can be filed so that the waiver
petition could be reviewed and the applicant can travel to the United States before completion of therapy. CDC supports the filing of waiver requests for young children with tuberculosis disease so that the waiver application may be reviewed and adjudicated in a timely manner.