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.
The American Academy of Pediatrics (AAP) recommends that children have an immediate tuberculin skin test if:
- They have been exposed to someone with active or suspected TB
- They are immigrants from a country where TB is endemic
- They have clinical findings or a chest radiograph suggesting TB
In addition, an annual TB skin test is advised for children with HIV or living in a household with someone with HIV. Testing every 2 to 3 years is recommended for children who have been exposed to high-risk individuals and at age 4 to 6 for those living in high prevalence areas, those who travel to countries with high prevalence, and those whose parents have emigrated from countries with high prevalence of TB.
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.