Screening Tests for Infants

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. TB primarily targets the lungs but may affect any area of the body. It can be spread through the air from person to person through droplets of respiratory secretions such as sputum or aerosols released by coughing, sneezing, laughing, or breathing.

Most of those who become infected with M. tuberculosis manage to confine the mycobacteria to a few cells in their lungs, where they stay alive but in an inactive form. This latent TB infection does not make the person sick or infectious and, in most cases, it does not progress to active tuberculosis. However, some people - especially those with compromised immune systems - may progress directly from initial TB infection to active tuberculosis. People who have HIV are much more likely to become sick if they contract TB. Another increasing concern is drug-resistant forms of TB that are resistant to the antibiotics typically prescribed to treat the disease.

TB is one of the world's deadliest diseases, although it is relatively uncommon in the U.S. Still, it is a large health issue among at-risk groups. Current guidelines call for targeted screening among such groups.

Recommendations

Because of their weak immune systems, infants under 2 years of age are especially susceptible to this infection. According to the American Academy of Pediatrics (AAP), immediate testing with a tuberculin skin test is advised:

• If an infant has been exposed to someone with active or suspected TB
• Is an immigrant from a country where TB is endemic or has traveled to those countries
• Has clinical findings or chest radiograph suggesting TB

Links
U.S. Centers for Disease Control and Prevention: Tuberculosis (TB) Fact Sheet
HealthyChildren.org (AAP): Tuberculosis  

Article Sources

Sources Used in Current Review

American Academy of Pediatrics. Recommendations for Preventive Pediatric Health Care. PDF available for download at http://pediatrics.aappublications.org/content/suppl/2007/12/03/120.6.1376.DC1/Preventive_Health_Care_Chart.pdf through http://pediatrics.aappublications.org. Accessed March 2012. 

Batra V. Pediatric Tuberculosis. Medscape. Available online at http://emedicine.medscape.com/article/969401-overview#aw2aab6c10 through http://emedicine.medscape.com. Accessed March 2012. 

Sources Used in Previous Reviews

U.S. Centers for Disease Control and Prevention. QuantiFERON-TB Gold Test (fact sheet). Last modified 16 Nov 2007. Available online through http://www.cdc.gov. Reaccessed 6 December 2007.

University of Iowa Health Care. Tuberculosis. Last modified 19 Oct 2006. Available online through http://www.uihealthcare.com. Reaccessed 6 Dec 2007.

D'Alessandro D and Huth L. Pediatrics common questions, quick answers: TB (tuberculosis). Last revised Apr 2002. Children’s Virtual Hospital and The University of Iowa. Available on the internet. Reaccessed 6 Dec 2007.

History of TB: the recent TB epidemic. 26 Feb 2001. New Jersey Medical School and National Tuberculosis Center, University of Medicine and Dentistry of New Jersey. Available online through http://www.umdnj.edu. Reaccessed 6 Dec 2007.

U.S. Centers for Disease Control and Prevention. Targeted tuberculin testing and treatment of latent tuberculosis infection (American Thoracic Society/CDC statement). 9 Jun 2000. MMWR 49(RR06);1-54. Available online through http://www.cdc.gov/mmwr/. Reaccessed 6 Dec 2007.

Tuberculosis. In: Caring for Your Baby and Young Child: Birth to Age 5. 1999. Bantam. Excerpt available online through http://www.medem.com. Reaccessed 6 Dec 2007.