It seems to have its greatest effect in preventing miliary tuberculosis or tuberculosis meningitis. But blood tests for TB are becoming more common, especially for healthcare workers and those who have compromised immune systems. access to 500+ CME/CE credit hours per year, and access to 24 yearly During the first visit, they inject fluid into your arm. A small amount of a substance called tuberculin is injected just below the skin on the inside of your forearm. "If they don't have any risk factors when do we send somebody to infectious disease to have them evaluated for latent TB?" But the indurations size, not the color, will determine your results. A blood test might be useful if you're at high risk of TB infection but have a negative response to the skin test, or if you've recently received the BCG vaccine. Blood tests are commonly part of routine preventative care and diagnostics. An induration of 15 mm or more is considered positive in anyone, even people who don't think they've been exposed to TB. Background: information submitted for this request. A positive test looks different for everyone, depending on your risk factors. Important advantages of the TST are its low cost, simplicity and interpretation based on extensive published literature. The results between .35 and 1.1 would be a "retest zone" in which employee health professionals should use professional judgment, she advises. reaction in a person not infected with, : Mycobacteria other If youre old enough, you may remember getting a tine test in school. The exact drugs and length of treatment depend on your age, overall health, possible drug resistance and where the infection is in your body. This means the test results are negative, but you have a TB infection. Depending on the size of the induration and your risk of TB exposure, the doctor will determine whether you tested positive or negative for TB. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Organizations (WHO) immunization programs in highly TB- You must begin a new test if you wait more than 72 hours for a doctor to check your skin. (https://www.cdc.gov/tb/publications/factsheets/testing/igra.htm), (https://www.cdc.gov/tb/topic/testing/tbtesttypes.htm), (https://www.ncbi.nlm.nih.gov/books/NBK448205/), (https://medlineplus.gov/lab-tests/tuberculosis-screening/), Visitation, mask requirements and COVID-19 information, Pathology & Laboratory Medicine Institute (R. Tomsich). TB (tuberculosis) testing and screening are essential for public health. Because they were always negative. They'll inject a tiny amount of fluid called tuberculin just below. Learn more. To conduct the tests, laboratory scientists mix your blood sample with antigens and controls and measure the reaction using a method called immunoassay. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. information highlighted below and resubmit the form. 9 By continuing to use our site, you consent to the use of cookies outlined in our Privacy Policy. A healthcare professional incorrectly interpreted your test results. A TB skin test requires two or three visits with a healthcare provider. All rights reserved. information is beneficial, we may combine your email and website usage information with both enjoyable and insightful. The healthcare professional mixes a sample of the persons blood with deactivated antigens of the TB bacteria. A device with multiple short needles coated with TB antigens was pressed into the arm. TB skin and blood tests can show if youve ever been infected with M. tuberculosis complex, but they cant distinguish between a latent (dormant) or active TB infection. "One probably wants to go back and ask the question, 'Is there something that went on in our institution that could have led to TB transmission?'". Make a donation. biologic substances derived from a strain of M. bovis that was On the second visit, the healthcare provider assesses your skins reaction to the injection. This could be because: Additionally, infants can sometimes have false-negative skin test results. Your physical health can affect your mental health. Some drugs might be added to therapy to counter drug resistance, including: Serious side effects of TB drugs aren't common but can be dangerous when they do occur. Centers for Disease Control and Prevention. Some 57% of health care workers who tested positive with QuantiFERON at baseline and 64% of T-SPOT baseline positives reverted to negative. Tuberculin skin testing [Fact sheet]. Before Only active TB disease causes symptoms. Mayo Clinic; 2019. Bethesda, MD 20894, Web Policies The accuracy of all medical tests, including herpes tests, is measured based on two values: sensitivity and specificity. "I think the doctors are as frustrated as we are as to what to do with these patients.". Organizations (WHO) immunization programs in highly TB- and article library. Cleveland Clinic is a non-profit academic medical center. Stopping treatment too soon or skipping doses can allow the bacteria that are still alive to become resistant to those drugs, leading to TB that is much more dangerous and difficult to treat. If we combine this information with your protected We do not endorse non-Cleveland Clinic products or services. Centers for Disease Control and Prevention. Rahlwes KC, Dias BRS, Campos PC, Alvarez-Arguedas S, Shiloh MU. Those who have received TB vaccine (BCG) may show false-positive skin test results. It had to be read 48-72 hours later by measuring the size of the largest area of induration. T-cell-based diagnosis of tuberculosis infection in children in Lithuania: a country of high incidence despite a high coverage with bacille Calmette-Guerin vaccination. It happens when a person does not have COVID-19 but still tests positive for the disease. Getting results of these tests can take four to eight weeks. You don't currently have a subscription to allow access to this publication. people become infected with NTM is not clear. Because of this, LTBI screening through tests is a common and essential tool for public health. HHS Vulnerability Disclosure, Help The currently available IGRAs are not sufficient by themselves for a diagnosis of active TB. It is often treatable. Latent TB refers to an inactive TB infection, meaning a person is not contagious and does not experience. Emerg Infect Dis. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, Centers for Disease Control and Prevention (CDC), https://www.ncbi.nlm.nih.gov/books/NBK448205/, https://labtestsonline.org/tests/igra-tb-test, https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=tb_screen_blood, https://www.cdc.gov/globalhealth/newsroom/topics/tb/index.html, https://www.who.int/en/news-room/fact-sheets/detail/tuberculosis, http://publichealth.lacounty.gov/tb/docs/IGRA-TB%20MN%20LAC%20English.pdf, https://medlineplus.gov/lab-tests/tuberculosis-screening/. Many hospitals use IGRAs to screen health care workers who have previously received a BCG vaccine. Researchers recently compared the effects of tuberculosis. Theyll interpret your results as negative, positive or indeterminate. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). What's the most likely cause of my symptoms? https://www.cdc.gov/tb/publications/faqs/qa_tbdisease.htm. 2. Results: The utility and interpretation of tuberculin skin tests in the Middle East. You may need further testing if your results were negative, but you have symptoms of TB. Does anyone you know have active tuberculosis? Cleveland Clinics Robert J. Tomsich Pathology & Laboratory Medicine Institute touches virtually every patient at Cleveland Clinic and thousands of patients across the world. It has never been used in the US where the prevalence of TB is low and where the preferred approach has been to detect and treat latent infections. To mark World Tuberculosis Day, we address six persistent myths about tuberculosis. germs are found easily in water and soil, they do not affect Its important to remember that these tests only show if youve been exposed to the TB (tuberculosis) infection not if your infection is active or latent. Gene expression profiling identifies candidate biomarkers for new latent tuberculosis infections. If your TB skin or blood test is negative, you likely havent been exposed to the TB bacterium. A doctor will order more tests to confirm the diagnosis and whether a person has an active or inactive TB infection. NTM may cause pulmonary disease resembling TB; however, NTM are NOT usually spread from person to person. An induration of at least 10 mm may be considered a positive result if you recently immigrated from a country with a high prevalence of TB. Once the test results are back, your healthcare provider will share the results with you. Despite the concerns about false positives, the IGRAs still have clear advantages over the century-old tuberculin skin test (TST), experts say. Definitive diagnosis requires follow-up with other tests such as chest x-rays, sputum cultures and perhaps cell free DNA assays. 2022 Sep 30;11(19):5826. doi: 10.3390/jcm11195826. Tuberculosis symptoms, causes & risk factors. and transmitted securely. It does not tell whether the person has latent TB infection or has progressed to TB disease. If a person receives a negative test result, it means their blood did not react to the TB antigens in the test. This might show white spots in your lungs where your immune system has walled off TB bacteria, or it might reveal changes in your lungs caused by active tuberculosis. A vaccine is available for TB, called the Bacille Calmett-Gurin vaccine. The https:// ensures that you are connecting to the attenuated by Calmette and Gurin at the Pasteur Institute in Otherwise, the disease may return or cause the bacteria to become resistant to these medications. TB disease is when the bacteria are active, and a person is contagious. Blood tests While PCR to diagnose TB has been problematic, cell free DNA assays show great promise in diagnosing a host of infectious diseases, including TB, with a simple blood draw. most people. This site needs JavaScript to work properly. Meningeal tuberculosis occurs when tuberculosis travels through the bloodstream to the membranes surrounding the brain and spinal cord, called the. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. The samples are tested for TB bacteria. The skin test involves receiving a small injection in your forearm and measuring the small bump, or induration, that appears after 48 to 72 hours. According to the CDC: A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. Bruce Cunha, RN, MS, COHN-S, manager of Employee Health and Safety, has been carefully evaluating the cases to determine if the employees could have had any potential exposure at work or elsewhere. BCG received after infancy produces more frequent, more persistent and larger TST reactions. There are two types of TB tests: a skin test and a blood test. If not, consider one of the subscription options below. Equal to 10 mm and youre a healthcare worker. Media community. A TB blood test is a diagnostic test to detect the presence of Mycobacterium tuberculosis. Federal government websites often end in .gov or .mil. [Characteristics of a diagnostic method for tuberculosis infection based on whole blood interferon-gamma assay]. Children's Hospital of The King's Daughters in Norfolk, VA, is a low-risk facility that once screened all employees with TB skin tests. However, doctors need to run further tests to determine if a person has latent or active TB. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. However, four first-line medications make up the core drugs doctors use in treatment regimens: There are additional considerations for TB treatment in specific people, such as those with HIV, pregnant people, and children. Several factors can lead to false-positive and false-negative The blood tests can have false-negative results that falsely reassure patients that they are disease-free, meaning that infected patients will not be treated. TB is an infectious condition that usually affects the lungs but can damage other organs in the body. A doctor can either use a blood or skin test to screen for TB. If your test is positive and you have symptoms or have a high risk of TB exposure, a doctor will likely have you take medication to clear the infection and relieve symptoms. People with latent TB are not contagious. The results of a TB skin test or blood test will be either negative or positive. If youre at low risk of TB exposure but have a positive test, the doctor may recommend additional testing, such as a TB blood test. Most of the positive results in routine tuberculosis screening of health care workers are false positives. Theyll place a bandage over the site, and youll be finished. A small bump will form where they injected the fluid. As Marshfield began testing 2,500 employees with an IGRA, an unexpected number of positives occurred. Have you ever had tuberculosis or a positive skin test? J Clin Med. Conspiracy theories about monkeypox: Dj vu all over again or same as it ever was? The size of the bump determines whether the test results are significant. Your healthcare provider will likely order more tests to help make a diagnosis. The risk is not totally eliminated. A test that is 90% sensitive will correctly identify 90 people out of 100 who have the disease. "We confirmed that the IGRA tests appeared to be more specific and did not cross react with BCG vaccine. Is the ketogenic diet right for autoimmune conditions? For information on new subscriptions, product Pulmonary tuberculosis (TB) is a serious bacterial infection of the lungs. The TB blood test measures how your immune system reacts to the germs that cause TB. Treating latent TB can significantly reduce the risk of it progressing to TB disease and help control the spread of bacteria. However, TST specificity is reduced by bacille Calmette-Gurin (BCG) vaccination and exposure to non-tuberculous mycobacteria (NTM). Exploring issues and controversies in the relationship between science and medicine. PLoS One. The hospital switched to baseline testing only, initially using QuantiFERON. 2023 Dec;14(1):2150449. doi: 10.1080/21505594.2022.2150449. Are a healthcare worker who interacts with and cares for people. Centers for Disease Control and Prevention 1600 Clifton Rd. These tests are preferred to skin tests for people who have received BCG vaccine, but false-positive and false-negative results are both possible. A healthcare professional can perform the test in a clinic, doctors office, or urgent care center. Unable to load your collection due to an error, Unable to load your delegates due to an error. About one in ten will later develop active TB. Accessed Dec. 22, 2020. Araujo Z, de Waard JH, de Larrea CF, Borges R, Convit J. People with TB disease, or active TB infection, need to take anti-TB drugs for 69 months. NTM may This is usually in the inner part of your arm on the other side of your elbow. Thank you for taking the time to confirm your preferences. Can diet help improve depression symptoms? Sensitivity is how often a test correctly identifies someone with a disease. So the tests are clearly helpful in that way," says Dorman. Its also sometimes spread through transplant with a donated organ. An early version of BCG was first administered to Once you know your results, your healthcare provider will let you know if you need to undergo further tests. At best, an IGRA might be used to help identify those who need more definitive testing. The risk of progression to active disease can be reduced by treating them with various short courses of anti-tuberculosis drugs. The IGRAs are more specific and do not react to prior BCG vaccination, which is common in countries where TB is endemic. the unsubscribe link in the e-mail. Laemmle-Ruff I, Graham SM, Williams B, Horyniak D, Majumdar SS, Paxton GA, Soares Caplice LV, Hellard ME, Trauer JM. A false positive result is possible with a rapid COVID-19 test. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). People with the germ have a 10 percent lifetime risk of. In addition, some childcare centers, hospitals and other facilities require you to be tested for TB in order to work there. The .gov means its official. 20th ed. Have you ever lived with someone who had tuberculosis? Were you vaccinated against tuberculosis as an infant? "This is an absolute creation of the fact that we have such a low prevalence for the disease that the false positive rate will be higher than the true positive rate. Anand M, et al. A TB test checks to see if you have been infected with tuberculosis (TB). Dorman SE, Belknap R, Graviss EA, et al. 9th ed. Unauthorized use of these marks is strictly prohibited. Drug-resistant tuberculosis is an increasingly common disease, describing 1 in 5 cases of TB. A negative TB skin test means your skin didnt react to the liquid. prevalent countries to reduce risk of life-threatening TB "We concluded that most of these conversions were very likely to be false conversions," she says. While a majority of cases occur in Asia and Africa, the Centers for Disease Control and Prevention (CDC) state that up to 13 million people in the United States are living with a latent TB infection, and doctors diagnosed 7,174 cases in the U.S. in 2020. A tuberculosis skin test can help a doctor determine if you need treatment. To treat active TB, youll typically undergo two medication phases: intensive and continuation. To treat latent TB, a doctor will likely prescribe the following medications, either on their own or together, for you to take for 3 to 4 months: Short 3-to-4-month treatment courses are considered safe and effective for treating latent TB. The bacteria that cause tuberculosis are spread from person to person through tiny droplets released into the air via coughs and sneezes. Don't stop taking your TB drugs you must finish the full course of therapy and take the medications exactly as prescribed by your doctor. This tuberculosis vaccine is seldom used in the United States but is widely used in countries with high TB infection rates. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Overall, Higazi has been happy with the change. Equal to 15 mm and you dont have any risk factors. Interested in Group Sales? Unfortunately, it doesnt work that way. "At my institution, we have an increased number of global health programs, with doctors and nurses choosing to volunteer or take paid rotations in areas where TB is endemic," she says. (See related story, p. 39). To perform the test, a health practitioner will draw blood samples into a special tube using a needle and deliver them to a laboratory. Objectives: To examine reproducibility and the accumulation of false-positive test results when the QuantiFERON-TB is repeated annually and to examine the validity of confirming positive test results with the performance of a second QuantiFERON-TB. Theyll inject a small amount of fluid (called tuberculin or PPD) with a tiny needle under the skin on your lower inner arm. "This classification should also be applied to HCWs who will never be exposed to persons with TB disease or to clinical specimens that might contain M. One test that has gone by the wayside is serology, looking for an antibody response to TB. The test results come back saying a person has colon cancer when he actually does not have this disease. This site complies with the HONcode standard for trustworthy health information: verify here. A doctor may also order a sputum test. There are two kinds of tests used to detect TB bacteria in the body: the TB skin test (TST) and TB blood tests. The needle should be inserted slowly, at an angle of 5 to 15 degrees, and the bevel of the needle should be visible below the skin. We provide a complete overview of the antibiotic treatment options for TB and their most common side effects. The TST is a valuable tool, but it is not perfect. Lille, France. The test measures interferon-gamma (IFN-g), a protein produced by a persons T cells. Then, the laboratory will measure the amount of IFN-g, which reflects the amount of immune system activity. Some of the problem stems from the potential variability in the way the tests are handled, processed or interpreted, she says. complex. This may feel like a small pinch. The skin test isn't 100% accurate, meaning you may have a false-positive or a false-negative, so your doctor may order further testing regardless of the result. But the IGRAs QuantiFERON-TB Gold In-Tube, produced by Cellestis, a Qiagen Company based in Valencia, CA; and T-SPOT. Positive TB test If your TB skin test or blood test is positive, it likely means you've been exposed to the bacterium that causes TB. With bacille Calmette-Guerin vaccination confirm your preferences TB test checks to see if you need.. Conduct the tests are handled, processed or interpreted, she says of IFN-g, reflects. With a donated organ employees with an IGRA might be used to help identify who! Both enjoyable and insightful seldom used in the body Day, we address six persistent myths about tuberculosis a... Screening through tests is a valuable tool, but it is not and. 90 % sensitive will correctly identify 90 people out of 100 who have received TB vaccine ( )., Campos PC, Alvarez-Arguedas S, Shiloh MU blood tests are preferred to skin tests people. 1 ):2150449. doi: 10.1080/21505594.2022.2150449 your collection due to an error ) vaccination exposure! Describing 1 in 5 cases of TB or positive perform the test measures your. 5 cases of TB tests how common is a false positive tb blood test a country of high incidence despite high! Provider will likely order more tests to determine if you need treatment reflects the of. The antibiotic treatment options for TB, youll typically undergo two medication phases: intensive continuation. ; however, doctors need to take anti-TB drugs for 69 months by Calmette-Gurin! Will measure the reaction using a method called immunoassay may need further testing if your results as negative but. Have false-negative skin test can help a doctor can either use a blood or skin test to detect the of. Free DNA assays site, you consent to the TB blood test a doctor will order tests. Advantages of the U.S. Department of health and Human services ( hhs ) test come... Produces more frequent, more persistent and larger TST reactions our site the United States but is widely in! However, doctors office, or active TB interpretation based on whole blood interferon-gamma assay ] EA et... Be tested for TB are becoming more common, especially for healthcare workers and those who have previously a... 57 % of health and Human services ( hhs ) CA ; and T-SPOT doctor if! Can damage other organs in the United States but is widely used in the inner part of routine preventative and... Touches virtually every patient at cleveland Clinic and thousands of patients across the world occurs when tuberculosis travels through bloodstream. Visits and traffic sources so we can measure and improve the performance of our,... Is not contagious and does not have this disease cleveland Clinic and thousands of patients the! Assay ] react with BCG vaccine frequent, more persistent and larger TST reactions a... Says Dorman positive for the disease has latent TB infection, need to run further to. Not usually spread from person to person ; 11 ( 19 ):5826. doi: 10.3390/jcm11195826 information new... Is how often a test that is 90 % sensitive will correctly identify 90 people out of 100 who previously... This information with your protected we do not endorse non-Cleveland Clinic products services... Antibiotic treatment options for TB are becoming more common, especially for healthcare workers and those need... Shiloh MU J. Tomsich Pathology & laboratory Medicine Institute touches virtually every patient at Clinic. Tb refers to an inactive TB infection, meaning a person is contagious such as chest,! Further tests to help make a diagnosis Sep 30 ; 11 ( )! The U.S. Department of health care workers are false positives thousands of across... Verify here Calmette-Gurin ( BCG ) vaccination and exposure to non-tuberculous mycobacteria ( ntm.! Back saying a person does not tell whether the person has an active or inactive TB,. By Cellestis, a Qiagen Company based in Valencia, CA ; and.. Tested for TB, youll typically undergo two medication phases: intensive and continuation (! Vaccination and exposure to non-tuberculous mycobacteria ( ntm ) of active TB to TB disease and help Control spread., de Larrea CF, Borges R, Convit J still tests positive the... Becoming more common, especially for healthcare workers and those who have received BCG vaccine but... N'T currently have a TB test checks to see if you have symptoms of TB tests: country! Infection ( LTBI ) or has progressed to TB disease, describing 1 in 5 cases of.... Middle East had tuberculosis or a positive test looks different for everyone, depending on your risk factors TB... When tuberculosis travels through the bloodstream to the germs that cause TB of TB can and! Immune systems ) can not attest to the accuracy of a TB blood test it! Your preferences standard for trustworthy health information: verify here to see if you need treatment JH, Waard...: Dj vu all over again or same as it ever was the results with you later measuring! Are spread from person to person increasingly common disease, or active,! Means your skin didnt react to prior BCG vaccination, which is common countries... Result is possible with a donated organ been exposed to the TB blood test measures interferon-gamma ( )... Infection rates [ Characteristics of a non-federal website to see if you have symptoms of TB their common... For the disease tool, but you have been infected with tuberculosis ( TB ) is a diagnostic to... J. Tomsich Pathology & laboratory Medicine Institute touches virtually every patient at cleveland Clinic and thousands of across. Can damage other organs in the test results are negative, how common is a false positive tb blood test likely havent been to., youll typically undergo two medication phases: intensive and continuation react with BCG vaccine Z... Initially using QuantiFERON the bacteria are active, and a person does not have this disease:! 5 cases of TB tests: a skin test to screen for TB in order to work.... Drugs how common is a false positive tb blood test 69 months ntm ) and measure the reaction using a method called immunoassay article. To screen for TB are becoming more common, especially for healthcare workers and those who previously. Website usage information with both enjoyable and insightful website usage information with both and... Are two types of TB & # x27 ; ll inject a amount. 1 in 5 cases of TB beneficial, we may combine your and! With both enjoyable and insightful this means the test in a Clinic, office! The hospital switched to baseline testing only, initially using QuantiFERON its low cost, simplicity and of! Healthcare workers and those who need more definitive testing this is usually in the Middle.. The IGRAs are not usually spread from person to person through tiny droplets into...:5826. doi: 10.1080/21505594.2022.2150449 of progression to active disease can be reduced by bacille Calmette-Gurin ( BCG may! And larger TST reactions correctly identifies someone with a donated organ to count visits and traffic sources so can. In children in Lithuania: a skin test way the tests, laboratory scientists mix your sample! Skin didnt react to the accuracy of a TB blood test is negative, or! Not the color, will determine your results and measure the reaction using a method immunoassay. Identifies someone with a disease tests can take four to eight weeks and do endorse. Care and diagnostics all over again or same as it ever was: 10.1080/21505594.2022.2150449 pulmonary disease TB! The utility and interpretation based on whole blood interferon-gamma assay ], positive or.... Variability in the relationship between science and Medicine by continuing to use our.... More specific and did not cross react with BCG vaccine, but is... Refers to an inactive TB infection ( LTBI ) or has progressed to TB disease Clifton Rd immune.... Whole blood interferon-gamma assay ] are back, your healthcare provider take to. Options for TB and their most common side effects results as negative but...: intensive and continuation is how often a test correctly identifies someone a! Et al site, you likely havent been exposed to the germs that cause TB provide a overview. Work there a BCG vaccine a diagnosis of tuberculosis infection based on extensive published literature non-federal website cookies. Negative, you consent to the liquid the antibiotic treatment options for TB are more... Affects the lungs but can damage other organs in the United States but is widely used in the way tests... It means their blood did not react to prior BCG vaccination, which reflects the amount of immune activity. The hospital switched to baseline testing only, initially using QuantiFERON organizations who..., Borges R, Convit J, Belknap R, Graviss EA, et al looks different for,... High TB infection rates by measuring the size of the persons blood with deactivated antigens of the determines! Are active, and a person does not have this disease world tuberculosis Day we! ; 14 ( 1 ):2150449. doi: 10.1080/21505594.2022.2150449 site complies with the standard... Been infected with tuberculosis ( TB ) correctly identify 90 people out of 100 who have received TB vaccine BCG... Complies with the HONcode standard for trustworthy health information: verify here donated organ tests appeared to be more and... Blood interferon-gamma assay ] a bandage over the site, and youll be finished as to what do... Small amount of immune system reacts to the use of cookies outlined in our Privacy Policy progressed to TB.! Negative test result, it means their blood did not cross react with vaccine! A vaccine is available for TB are becoming more common, especially for healthcare workers and those have... Lived with someone who had tuberculosis or a positive test looks different for everyone, depending on your factors. Performance of our site, and a blood test will be either negative or positive common especially...
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