Tuberculin testing for children

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. TB bacteria are spread from person to person through the air. The TB bacteria are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. People nearby may breathe in these bacteria and become infected.                 

Who is at risk

• Children living in a household with an adult who has active tuberculosis or has a high risk of contracting TB
• Children infected with HIV or another condition that weakens the immune system
• Children born in a country that has a high prevalence of TB
• Children visiting a country where TB is endemic and who have extended contact with people who live there

Symptoms

• Cough
• Feelings of sickness or weakness, lethargy, and/or reduced playfulness
• Weight loss or failure to thrive
• Fever
• Night sweats

What you can do

• Cover your mouth and nose with a tissue when you cough.
• Children below five years of age should spend as little time as possible in the same living spaces as TB patients.

Preventive service at no cost

Test adolescents and children <= 21 years of age based on recognition of high-risk factors.

Why screening is important

In the absence of symptoms, usually the only sign of TB infection is a positive reaction to the TB skin test or TB blood test. TB skin testing is considered safe in children, and is preferred over TB blood tests for children less than 5 years of age.

What the screening is

The test is performed in your pediatrician's office by injecting a purified, inactive piece of TB germ into the skin of the forearm. If there has been an infection, your child's skin will swell and redden at the injection site. Your pediatrician will check the skin forty-eight to seventy-two hours after the injection, and measure the diameter of the reaction. This skin test will reveal past infection by the bacteria, even if the child has had no symptoms and even if his body has fought the disease successfully.

Treatment

If your child's skin test for TB turns positive: A chest X-ray will be ordered to determine if there is evidence of active or past infection in the lungs. If the X-ray does indicate the possibility of active infection, the pediatrician also will search for the TB bacteria in your child's cough secretions or in his stomach. This is done in order to determine the type of treatment.

If your child's skin test turns positive, but he does not have symptoms or signs of active tuberculosis infection: He still is infected. In order to prevent the infection from becoming active, your pediatrician will prescribe a medication called isoniazid (INH). This medication must be taken by mouth once a day every day for a minimum of nine months.

For an active tuberculosis infection: Your pediatrician will prescribe three or four medications. You will have to give these to your child for six to twelve months. Your child may have to be hospitalized initially for the treatment to be started, although most of it can be carried out at home.

Additional tips

Talk to your child’s pediatrician before your trip.