Tuberculosis
- Topics
- Basic TB Facts
- Treatment
- Testing & Diagnosis
- TB & HIV Coinfection
- Infection Control & Prevention
- Drug-Resistant TB
- TB in Specific Populations
- African-American Community
- Correctional Facilities
- Table of Contents
- Introduction
- Strengthen TB Information Systems and Program Assessment
- Strengthen TB Environmental Controls and Isolation Practices
- Provide More Comprehensive and Timely Screening and Diagnostic Evaluations
- Develop and Strengthen Contact Investigation Protocols
- Increase HIV Counseling and Testing
- Increase Staff Training
- Strengthen Collaboration Between Health Departments and Jails
- International Travelers
- Pregnancy
- Disaster Responders
- Children
- Vaccines & Immunizations
- Laboratory Information
- Drug Susceptibility Testing
- The Uses of Nucleic Acid Amplification Tests for the Diagnosis of TB
- Rapid Molecular Testing to Detect Drug-Resistant TB in the US
- Executive Summary
- Introduction
- Background on Tests for Molecular Detection of DR
- General Considerations and Principles for a Molecular DR Testing Service�
- Possible Scenarios and Scope of Testing for a Molecular DR Testing Service
- Research Needs
- General Recommendations of the Expert Panel
- Communication Plan for the Report
- Recommendations
- References
- Panel Members and CDC Participants
- Appendix 1
- Appendix 2
- Appendix 3
- Interim Laboratory Biosafety Guidance for XDR Mycobacterium tuberculosis strains
- Molecular Detection of Drug Resistance (MDDR)
- Research
- TB Epidemiologic Studies Consortium
- Background
- Infrastructure
- Research Projects
- Publications
- Meetings
- Directory
- TBESC Committee Members
- Translating Research into Practice (TRIP)
- Contact TBESC
- Prospective Evaluation of Immunogenetic and Immunologic Markers for Susceptibility to Tuberculosis Infection and Progression from M. Tuberculosisinfection to active TB
- Zero Tolerance for Pediatric TB
- Models for Incorporating HIV Counseling, Testing, and Referral into Tuberculosis Contact Investigations
- Prevalence of Latent TB Infection Among High Risk Populations in the United States
- Regional Capacity-Building in Low-Incidence Areas
- Use of Network Analysis Methods to Characterize M. tuberculosis Transmission Patterns Among Women and Other High-Risk Populations
- An Analysis of Molecular Epidemiology of Multi-Drug Resistant M. tuberculosisin the United States
- Missed Opportunities for TB Prevention in Foreign-Born Population in the United States and Canada
- New Model for Assessing TB Surveillance and Action Performance and Cost
- Addressing TB Among African Americans in the Southeast: Identifying and Overcoming Barriers to Treatment Adherence for Latent TB Infection and TB Disease
- Assessing the TB Knowledge, Attitudes, Beliefs, and Practices Among Private Providers Serving Foreign-born Populations at Risk for TB
- Factors Associated with Acceptance of, Adherence to and Toxicity From Treatment for Latent TB Infection and Pilot Study of Treatment for Latent TB Infection Effectiveness
- Culturally Appropriate TB Educational Materials for Leaders and Staff of Hispanic Service Organizations
- Enhancing TB Programs� Capacity for Self-Evaluation: Testing New Tools and Developing an Evaluation Toolkit
- African Refugee Women�s Health Improvement Project
- Evaluation of the TK Medium: A New Rapid Solid Culture System for Tuberculosis
- Evaluation of New Interferon-y Release Assays in the Diagnosis of Latent TB Infection in Health Care Workers
- Request for Proposal
- TB Trials Consortium
- Behavioral & Social Science Research
- TB Epidemiologic Studies Consortium
- Data & Statistics
- Education & Training
- Resources for TB Programs
- Publications & Products
- Fact Sheets
- General
- Fact sheets - Spanish
- TB - General Information
- The Difference Between Latent TB Infection and Active TB Disease
- Diferencia entre la infección de tuberculosis latente y enfermedad de tuberculosis activa
- A Global Perspective on TB
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Bovine Tuberculosis in Humans
- Tuberculosis Information for International Travelers
- TB Can Be Treated
- Exposure to TB
- TB and HIV/AIDS
- You Can Prevent TB
- Testing for TB
- Tuberculosis: informaci�n general
- Diferencia entre la infecci�n de tuberculosis latente y enfermedad de tuberculosis activa
- Informaci�n sobre la tuberculosis para los viajeros internacionales
- Exposición a la tuberculosis
- Usted puede prevenir la tuberculosis
- La tuberculosis puede ser tratada
- Tuberculosis y VIH/SIDA
- Usted puede prevenir la tuberculosis
- Pruebas para detectar la tuberculosis
- Data & Statistics
- A Global Perspective on TB
- Trends in Tuberculosis – United States
- The Revised Report of Verified Case of Tuberculosis
- The National Tuberculosis Indicators Project (NTIP)
- National Tuberculosis Indicators Project (NTIP): Frequently Asked Questions
- TB Genotyping
- TB Genotyping Information Management System (TB GIMS)
- Drug-Resistant TB
- Multidrug-Resistant Tuberculosis (MDR TB)
- Extensively Drug-Resistant Tuberculosis (XDR TB)
- CDC’s Role in Preventing Extensively Drug-Resistant Tuberculosis (XDR TB)
- Tuberculosis multirresistente (MDR)
- Tuberculosis extremadamente resistente (XDR)
- El papel de los CDC en la prevenci�n de la tuberculosis extremadamente resistente (XDR)
- Infection Control & Prevention
- TB in Specific Populations
- Tuberculosis Information for Employers in Non-Healthcare Settings
- Tuberculosis in Minorities
- Tuberculosis Information for International Travelers
- TB and HIV/AIDS
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tuberculosis in Blacks
- Tuberculosis and Pregnancy
- Tuberculosis y embarazo
- Treatment
- TB Can Be Treated
- Treatment of Latent TB Infection
- Treatment of Latent Tuberculosis Infection: Maximizing Adherence
- Treatment Options for Latent Tuberculosis Infection
- Treatment of Drug-Resistant Tuberculosis
- Treatment of Drug-Susceptible Tuberculosis Disease in Persons Not Infected with HIV
- Treatment of Drug-Susceptible Tuberculosis Disease in HIV-Infected Persons
- Tratamiento de la infecci�n de tuberculosis latente
- Testing & Diagnosis
- TB Can Be Treated
- Testing for TB
- Recommendations for Human Immunodeficiency Virus (HIV) Screening in Tuberculosis (TB) Clinics
- Interferon-Gamma Release Assays (IGRAs)
- Tuberculin Skin Testing
- Diagnosis of Tuberculosis Disease
- Targeted Tuberculin Testing and Interpreting Tuberculin Skin Test Results
- Prueba cutánea de la tuberculina
- Diagnóstico de la tuberculosis activa
- Vaccines & Immunizations
- General
- Guidelines
- Guides & Toolkits
- Core Curriculum
- Self-Study Modules
- Report of Verified Case of Tuberculosis (RVCT)
- Forging Partnerships to Eliminate TB
- Understanding the TB Cohort Review Process
- Latent Tuberculosis Infection: A Guide for Primary Health Care Providers
- Effective TB Interviewing for Contact Investigation
- Mantoux Tuberculin Skin Testing Products
- Ethnographic Guides
- Newsletters
- Pamphlets, Brochures, Booklets
- Posters
- Mantoux Tuberculin Skin Test Wall Chart
- World TB Day
- Afiches
- 2011 Poster (English)
- 2011 Poster (Spanish)
- 2010 Poster (English)
- 2010 Poster (Spanish)
- 2008 Poster (English)
- 2008 Poster (Spanish)
- 2006 Poster (English)
- 2004 Poster (English)
- 2004 Poster (Spanish)
- 2003 Poster (English)
- 2003 Poster (Spanish)
- 2003 Now is the Time Poster (English)
- 2003 Now is the Time Poster (Spanish)
- Think TB
- Stop TB
- Reports & Articles
- Morbidity and Mortality Weekly Reports (MMWRs)
- Contact Investigations
- Control and Elimination
- Data & Statistics
- Drug-Resistant Tuberculosis
- Infection Control & Prevention
- Laboratory
- TB in Specific Populations
- Foreign-Born
- High-Risk Settings
- Homeless
- International
- Occupational Groups
- Travel
- TB & HIV
- Testing & Diagnosis
- Treatment
- LTBI Updates
- Vaccines & Immunizations
- World TB Day
- DTBE Authored Journal Articles
- Tuberculosis Laboratory Aggregate Reports
- Morbidity and Mortality Weekly Reports (MMWRs)
- Slide Sets
- Core Curriculum
- Self-Study Modules
- Prevention and Control of Tuberculosis in Correctional and Detention Facilities
- Guidelines for Preventing the Transmission of M. TB in Health care Settings
- Investigation of Contacts of Persons with Infectious TB
- Text-Only version
- Introduction
- Decisions to Initiate a Contact Investigation
- Investigating the Index Patient and Sites of Transmission
- Assigning Priorities to Contacts
- Diagnostic and Public Health Evaluation of Contacts
- Medical Treatment for Contacts with LTBI
- When to Expand a Contact Investigation
- Communicating Through the News Media
- Data Management and Evaluation of Contact Investigations
- Confidentiality and Consent in Contact Investigations
- Staff Training for Contact Investigations
- Contact Investigations in Special Circumstances
- Source-Case Investigations
- Cultural Competency and Social Network Analysis
- Resources
- Epidemiology of Pediatric Tuberculosis in the United States
- Text-Only version
- Introduction
- Pediatric TB Cases by Age and Race
- Pediatric TB Cases by Origin of Birth
- Pediatric Cases, Percentages and Rates by States
- Pediatric TB Cases by Case Verification Criterion and Site of Disease
- Pediatric TB Cases in Specific Groups
- Pediatric TB Cases Case Completion
- Slide 1
- Slide 2
- Slide 3
- Slide 4
- Slide 5
- Slide 6
- Slide 7
- Slide 8
- Slide 9
- Slide 10
- Slide 11
- Slide 12
- Slide 13
- Slide 14
- Slide 15
- Slide 16
- Slide 17
- Slide 18
- Slide 19
- Slide 20
- Slide 21
- Slide 22
- Slide 23
- Slide 24
- Slide 25
- Slide 26
- Slide 27
- Slide 28
- Slide 29
- Slide 30
- Slide 31
- Treatment of TB
- Targeted Tuberculosis Testing and Treatment of Latent Tuberculosis Infection
- CD Roms
- Electronic Tools & Resources
- Web-Based Courses & Webinars
- Fact Sheets
- Global TB
- Events
- Links
- About Us
- Mission Statement and Activities
- Organization Chart
- Advisory Groups
- Federal TB Task Force
- Table of Contents
- Executive Summary
- Introduction
- Chronology in the Development of This Report
- Strategies for Maintaining Control of TB
- Strategies for Accelerating the Decline of TB
- Activities for Developing New Tools
- Global U.S. Actions
- Assessing the Impact of Actions Taken
- Federal TB Task Force Members and Others Involved in the Development of This Report
- Glossary
- References
- Federal TB Task Force Roster
- Table of Contents
- Executive Summary
- Introduction
- How to Eliminate TB? – The IOM Report
- Why Eliminate TB? – Rationale for Elimination
- Who Will Lead? – CDC's Response
- Goal I: Maintain control of TB
- Goal II: Accelerate the decline
- Goal III: Create new tools
- Goal IV: Reduce the global burden of TB
- Goal V: Summon and sustain support
- Goal VI: Track progress
- References
- Federal TB Task Force
- Funding
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Children
TB in Children in the United States
TB disease in children under 15 years of age (also called pediatric tuberculosis) is a public health problem of special significance because it is a marker for recent transmission of TB. Also of special significance, infants and young children are more likely than older children and adults to develop life-threatening forms of TB disease (e.g., disseminated TB, TB meningitis). Among children, the greatest numbers of TB cases are seen in children less than 5 years of age, and in adolescents older than 10 years of age.
Basic TB Facts
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.
People with TB disease of the lungs or throat can spread bacteria to others with whom they spend time every day. However, children are less likely to spread TB bacteria to others. This is because the forms of TB disease most commonly seen in children are usually less infectious than the forms seen in adults.
Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions exist: latent TB infection and TB disease.
More: Basic TB Facts
Latent TB Infection
Persons with latent TB infection:
- Usually have a skin test or blood test indicating TB infection;
- Have TB bacteria in their bodies, but the bacteria are not active;
- Are not sick and do not have symptoms;
- Cannot spread bacteria to others; and
- Are often given medicine to prevent them from developing TB disease.
TB Disease
If TB bacteria become active in the body and multiply, the person will get sick with TB disease.
Persons with TB disease:
- Usually have a skin test or blood test indicating TB infection;
- Are sick from TB bacteria that are active (meaning that they are multiplying and destroying tissue in their body);
- Usually have symptoms of TB disease; and
- Must be given medicine to treat TB disease.
Once infected with TB bacteria, children are more likely to get sick with TB disease and to get sick more quickly than adults. In comparison to children, TB disease in adults is usually due to past TB infection that becomes active years later, when a person’s immune system becomes weak for some reason (e.g., HIV infection, diabetes).
Confirming the diagnosis of TB disease in children with a laboratory test can be challenging. This is because:
- It is difficult to collect sputum specimens from infants and young children; and
- The laboratory tests used to find TB in sputum are less likely to have a positive result in children; this is due to the fact that children are more likely to have TB disease caused by a smaller number of bacteria (paucibacillary disease).
For these reasons, the diagnosis of TB disease in children is often made without laboratory confirmation and instead based on combination of the following factors:
- Clinical signs and symptoms typically associated with TB disease,
- Positive tuberculin skin test (TST) or positive TB blood test (IGRA),
- Chest x-ray that has patterns typically associated with TB disease, and
- History of contact with a person with infectious TB disease.
Testing for TB in Children
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.
More: Testing for TB
All children with a positive test for TB infection, symptoms of TB, or a history of contact with a person with infectious TB disease should undergo a medical evaluation. Medical evaluations for TB disease include a chest x-ray and physical examination to exclude TB disease, and must be done before beginning treatment for latent TB infection.
For more information on where to get a TB test, contact your State TB Control Program.
Signs and Symptoms of TB Disease in Children
Signs and symptoms of TB disease in children include:
- Cough;
- Feelings of sickness or weakness, lethargy, and/or reduced playfulness;
- Weight loss or failure to thrive;
- Fever; and/or
- Night sweats.
The most common form of TB disease occurs in the lungs, but TB disease can affect other parts of the body as well. Symptoms of TB disease in other parts of the body depend on the area affected. Infants, young children, and immunocompromised children (e.g., children with HIV) are at the highest risk of developing the most severe forms of TB such as TB meningitis or disseminated TB disease.
Treatment
A pediatric TB expert should be involved in the treatment of TB in children and in the management of infants, young children, and immunocompromised children who have been exposed to someone with infectious TB disease. It is very important that children or anyone being treated for latent TB infection or TB disease finish the medicine and take the drugs exactly as instructed.
Latent TB Infection
Treatment is recommended for children with latent TB infection to prevent them from developing TB disease. Infants, young children, and immunocompromised children with latent TB infection or children in close contact with someone with infectious TB disease, require special consideration because they are at increased risk for getting TB disease. Consultation with a pediatric TB expert is recommended before treatment begins. Isoniazid is the anti-TB medicine that is most commonly used for treatment of latent TB infection. In children, the recommended length of treatment with isoniazid is 9 months.
TB Disease
TB disease is treated by taking several anti-TB medicines for 6 to 9 months. It is important to note that if a child stops taking the drugs before completion, the child can become sick again. If drugs are not taken correctly, the bacteria that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat, and treatment lasts much longer (up to 18 to 24 months).
More: Treatment
Vaccines
BCG, or bacille Calmette-Guerin, is a vaccine to prevent TB disease. BCG is used in many countries to prevent childhood TB disease. However, the BCG vaccine is not generally used in the United States, because of the low risk of infection with TB bacteria and the variable effectiveness of the vaccine. The BCG vaccine should only be considered for very select persons who meet specific criteria and in consultation with a TB doctor.
More: TB Vaccine (BCG)
Statistics
In the United States, a total of 11,182 cases of TB were reported in 2010, of which 670 (6%) cases were among children less than 15 years of age. Worldwide, it is estimated that there are at least 1 million cases of TB among children less than 15 years of age each year. In high TB burden settings outside of the United States, children account for an estimated 15–20% of TB cases.
Global Perspective
Related Links
- Testing for TB Infection
- The Difference Between Latent TB Infection and Active TB Disease (Fact Sheet)
- TB Blood Tests
- State TB Control Programs
- Diagnosis of Tuberculosis Disease (Fact Sheet)
- TB Vaccine (BCG)
- Treatment for Latent TB Infection and TB Disease
For Parents and their Families
- Questions and Answers about TB (Booklet)
- What Parents Need to Know About Tuberculosis (TB) Infection in Children – New Jersey Medical School Global TB Institute
- Tuberculosis Screening for International Adoptees Frequently Asked Questions (FAQs)
For Clinicians
- Epidemiology of Pediatric Tuberculosis in the United States, 1993–2008 (Slide Set)
- Tuberculosis in the United States, 2010 (Slide Set)
- TB Guidelines: Treatment
- Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children
- Red Book Online – American Academy of Pediatrics
- Pediatric TB for the Private Provider CD (ordering information) – Southeastern National Tuberculosis Center
- Pediatric Tuberculosis: An Online Presentation – Francis J. Curry National Tuberculosis Center
- Cruz AT and Starke JR. Pediatric Tuberculosis Pediatrics in Review. 2010: 31 (1): 13–26
Contact Us:
- Centers for Disease Control and Prevention
Division of Tuberculosis Elimination (DTBE)
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