Screening Tests for Teens (Ages 13-18)
Tuberculosis
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
The American Academy of Pediatrics (AAP) recommends that children and teens 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 those with HIV or who live in a household with someone with HIV as well as for incarcerated adolescents. Testing every 2 to 3 years is recommended for those who have been exposed to high-risk individuals and at age 11 to 16 for older children 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.
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
US Centers for Disease Control and Prevention. QuantiFERON-TB Gold Test (fact sheet). Last modified 16 Nov 2007. Available on the Internet at http://www.cdc.gov/tb/pubs/tbfactsheets/QFT.htm through http://www.cdc.gov. Accessed 6 Dec 2007.
US Centers for Disease Control and Prevention. Trends in Tuberculosis – United States, 2007. Available on the Internet at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5711a2.htm through http://www.cdc.gov.
New Jersey Medical School and National Tuberculosis Center, University of Medicine and Dentistry of New Jersey. History of TB: the recent TB epidemic. 26 Feb 2001. Available on the Internet at http://www.umdnj.edu/globaltb/tbhistory.htm through http://www.umdnj.edu. Accessed 26 Jul 2004 and 6 Dec 2007.
D’Alessandro D and Huth L. Children’s Virtual Hospital and The University of Iowa. Pediatrics common questions, quick answers: TB (tuberculosis). Last revised Apr 2002. Available on the Internet at http://lib.cpums.edu.cn/jiepou/tupu/atlas/www.vh.org/pediatric/patient/pediatrics/cqqa/tb.html through http://lib.cpums.edu.cn. Accessed 26 Jul 2004 and 6 Dec 2007.
Screening for tuberculosis and tuberculosis infection in high-risk populations: recommendations of the advisory council for the elimination of tuberculosis. 8 Sep 1995. MMWR 44(RR11);18-34. Available on the Internet at http://www.cdc.gov/mmwr/preview/mmwrhtml/00038873.htm through http://www.cdc.gov. Accessed 21 Jul 2004 and 28 Jan 2008.
US 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 on the Internet at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4906a1.htm through http://www.cdc.gov. Accessed 21 Jul 2004 and 6 Dec 2007.
University of Iowa Health Care. Tuberculosis. Last modified 19 Oct 2006. Available on the Internet at http:// www.uihealthcare.com/topics/infectiousdiseases/infe4731.html through http:// www.uihealthcare.com. Last accessed 6 Dec 2007.
Tuberculosis. In: Caring for Your Baby and Young Child: Birth to Age 5. 1999. Bantam. Excerpt on the Internet at http://www.medem.com/medlb/article_detaillb.cfm?article_ID=ZZZ1BN54FDC&sub_cat=573 through http://www.medem.com. Accessed 26 Jul 2004 and 6 Dec 2007.
