Three factors—
tuberculosis (TB) in immigrants,
human immunodeficiency virus (HIV), and drug resistance—have made tuberculosis more of a threat in the United States in recent years. Increases in the number of cases and outbreaks of this infectious disease have been a concern since the late 1990s. Tuberculosis is still relatively rare in this country, but it is a large health issue among at-risk groups. Current guidelines call for targeted screening among such groups. Children who are exposed to those who fall into high risk groups may also be screened.
The infection may be detected via a tuberculin skin test and/or a blood test. The U.S. Centers for Disease Control and Prevention (CDC) note that more data are needed on the blood test’s effectiveness in children and those with HIV or acquired immunodeficiency syndrome (AIDS).
Although the CDC discourage routine screening of low-risk populations, students are often required to be tested before the first day of school.
Persons who have had contact with an individual who has suspected or confirmed TB and persons with or at risk for HIV infection are the CDC’s highest screening priority.
If a child has been exposed to a high-risk adult, he or she should be tested. The American Academy of Family Physicians’ high-risk category includes those with close contact to a person with known or suspected TB, health care workers, immigrants from countries with a high rate of this disease (generally, less industrialized, developing nations), people with HIV, alcoholics, users of injection drugs or other illicit substances, residents of long-term care facilities (such as nursing homes, mental health facilities, prisons, AIDS care facilities, and homeless shelters), and those considered medically underserved or low-income.
Links
CDC: TB fact sheet
University of Iowa’s Virtual Children’s Hospital: Tuberculosis (TB)
Sources
S1
US Centers for Disease Control and Prevention. QuantiFERON-TB Gold Test (fact sheet). Last modified 16 Nov 2007. Available online at http://www.cdc.gov. Accessed 6 Dec 2007.
S2
Children’s Virtual Hospital and The University of Iowa. Pediatrics common questions, quick answers: TB (tuberculosis). Last revised Apr 2002. D’Alessandro D and Huth L. Available online at http://lib.cpums.edu.cn. Accessed 26 Jul 2004 and 6 Dec 2007.
S3
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 online at http://www.umdnj.edu. Accessed 26 Jul 2004 and 6 Dec 2007.
S4
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 online at http://www.cdc.gov/mmwr/. Accessed 21 Jul 2004 and 6 Dec 2007.
S5
University of Iowa Health Care. Tuberculosis. Last modified 19 Oct 2006. Available online at http://www.uihealthcare.com. Last accessed 6 Dec 2007.
S6
Tuberculosis. In: Caring for Your Baby and Young Child: Birth to Age 5. 1999. Bantam. Excerpt available online at http://www.medem.com. Accessed 26 Jul 2004 and 6 Dec 2007.
S7
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(RR-11);18-34. Available online at http://www.cdc.gov/mmwr/. Accessed 21 Jul 2004 and 28 Jan 2008.
