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My Child Has:
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Tuberculosis (TB)
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Tuberculosis (TB) is a chronic bacterial infection that usually infects the lungs, although other parts of the body are sometimes involved.
There are two stages of TB:
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TB infection occurs when a person has a small number of TB germs in their body, but their immune system prevents the germs from causing any problems.
People with TB infection:
- don't feel sick
- usually have a positive skin test reaction
- can develop TB disease if they do not receive treatment for their TB infection
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TB disease occurs when a person has a large number of TB germs living in their body and the germs are causing harm. Usually the person feels sick, and they often can spread TB germs to others. TB disease can be found in any part of the body but it usually affects the lungs.
The most common symptoms of TB disease are:
- coughing
- fever
- loss of appetite
- weight loss
- weakness
- night sweats
- feeling very tired
If not treated properly, TB disease can be fatal. TB disease was once the leading cause of death in the United States.
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A person is at risk for TB if they've ever had contact with a person who has had TB infection. Some people who are at increased risk for TB include:
- people born in less industrialized areas (i.e., Latin America, Asia, and Africa)
- medically underserved population usually in urban areas including children under the age of four
- homeless people
- people who abuse alcohol
- people who use intravenous drugs
- the elderly
- people in group settings, such as nursing homes
- healthcare workers who come in contact with high-risk populations
- people with weak immune systems (especially those with HIV infection)
- people with other medical risk factors such as diabetes and severe kidney disease
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TB is spread through the air from one person to another. The germs are put into the air when a person with TB disease of the lungs coughs or sneezes. People nearby can breathe in the TB germs and become infected.
When a person breathes in TB germs, the bacteria can settle in the lungs and begin to grow. From there, they can move through the blood to other parts of the body, such as the kidney, spine, and brain.
TB in the lungs or throat can be spread to other people. TB in other parts of the body, such as the kidney or spine, is usually not infectious.
People with TB disease are most likely to spread it to people they spend time with every day. This includes family members, friends, and coworkers.
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TB skin test:
TB is usually diagnosed with a TB skin test. In this test, a doctor or nurse injects a small amount of testing fluid (called tuberculin or PPD) just under the skin on the under side of the forearm. After two or three days, the test is checked. If a certain size bump has developed, the test may be positive for TB infection.
A positive TB skin test means your child:
- may have TB infection
- will need additional tests such as a chest x-ray and sputum test
- may need to take medication
It does not mean your child can spread TB germs to others.
QFT Gold test:
The QuantiFERON-TBŪ Gold (QFT) test is a blood test that can determine if your child has been infected with TB. With this test, your child only needs to visit the doctor once, to have some blood drawn. You are then notified when the results become available, which can be as soon as the next day.
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TB infection:
Your child will need to take medicine to keep him/her from getting TB disease and becoming sick. Isoniazid (INH) is the medicine used most often. It normally takes six to nine months for the medicine to kill the TB germs.
TB disease:
Your child will need to take several different medicines. This is because there are a lot of germs to be killed. Taking several medicines will do a better job of killing all of the germs and preventing them from becoming resistant to the medicines.
The most common medicines used to cure TB disease are:
- isoniazid (INH)
- rifampin (RIF)
- ethambutol
- pyrazinamide
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BCG is a vaccine for TB. This vaccine is not widely used in the United States, but it is often given to infants and small children in other countries where TB is common. BCG vaccine does not always protect people from getting TB.
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The side effects listed below are serious. If your child has any of these symptoms, call your doctor immediately:
- no appetite
- nausea
- vomiting
- yellowish skin or eyes
- fever for three or more days
- abdominal pain
- tingling fingers or toes
- skin rash
- easy bleeding
- aching joints
- dizziness
- tingling or numbness around the mouth
- easy bruising
- blurred or changed vision
- ringing in the ears
- hearing loss
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TB bacteria die very slowly. It takes at least six months for the medicine to kill all the TB germs. Your child will probably start feeling well after only a few weeks of treatment. But the TB bacteria are still alive. Your child must continue to take their medicine until all the TB bacteria are dead.
If your child stops taking their medicine or they aren't taking their medicine regularly, this can be very dangerous. The TB bacteria will grow again and your child will remain sick. The bacteria may also become resistant to the medicines your child is taking. New, different medicines may be needed to kill the TB bacteria if the old medicines no longer work. These new medicines must be taken for a longer time and usually have more serious side effects.
It is very important that your child takes his or her medicine the way your doctor or nurse has prescribed.
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If your child forgets to take their pills one day, skip that dose and have them take the next scheduled dose. Notify your doctor or nurse when this occurs.
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The most important thing is to make sure your child takes all of their medicine, exactly as directed by your doctor or nurse. You also need to attend all of your follow-up clinic appointments. Your doctor or nurse needs to see how your child is doing.
Also, make sure your child:
- always covers their mouth with a tissue when they cough, sneeze, or laugh. Put the tissue in a closed bag and throw it away
- stays home from school
- avoids close contact with others
- sleeps in a bedroom away from other family members
- airs out their room. TB spreads in small closed spaces where air doesn't move.
Remember, TB is spread through the air. People cannot get infected with TB bacteria through handshakes, sitting on toilet seats, or sharing dishes and utensils with someone who has TB.
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Sometimes TB bacteria become resistant to two or more of the most important medicines: INH and RIF. This is called multidrug-resistant TB, or MDR TB. This is a very serious problem.
People with MDR TB disease must be treated with special medicines. These medicines are not as good as the usual medicines for TB and they may cause more side effects. Also, most people with MDR TB disease must see a TB expert who can closely observe their treatment to make sure it is working.
People who have spent time with someone sick with MDR TB disease can become infected with these multidrug-resistant bacteria. If they have a positive skin test reaction, they may be given medicine to keep them from developing MDR TB disease. This is very important for people who are at high risk of developing MDR TB disease, such as children and HIV-infected people.
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