Tuberculosis in Kids and Teens

Overview

What Is Tuberculosis?

Tuberculosis (TB) is a disease caused by a type of bacteria called Mycobacterium tuberculosis. It’s contagious, meaning it spreads from person to person. TB mainly infects the lungs, but it can affect other organs.

TB was one of the worst diseases of the 19th century. It became much rarer as living conditions and medical care got better in the United States. But it's making a comeback today, especially among people in crowded living situations (like shelters or prisons), people who travel to areas of the world with many cases of TB, and people whose immune systems are weakened — for instance, from HIV infection.

Top Things to Know

TB is a contagious disease that can make people very sick.
Symptoms can include cough, fever, weight loss, night sweats, and feeling tired.
TB is treated with antibiotics over several months.
To help stop the spread of TB, take the prescribed medicines and stay away from others.

Signs & Symptoms

What are the Signs & Symptoms of Tuberculosis in Kids & Teens?

When people first get TB, they often don’t have any signs of the infection. It can take weeks to years to develop symptoms, and some people never do. This is because the immune system can often keep the infection under control. But if the immune system is weakened or is stressed by trying to fight another illness, the TB infection can become active and cause symptoms. Someone with TB disease might have:

coughing, often for 2 to 3 weeks or longer (and might cough up blood)
night sweats
fever or chills
tiredness
loss of appetite
chest pain
unexplained weight loss

Some people, especially young children, might have only a fever or weight loss without a cough.

Are There Different Stages of Tuberculosis?

Not everyone who gets infected with TB gets sick. That's why doctors label TB with one of these stages:

Latent TB infection. This is when people are infected with TB bacteria, but they don't feel sick or have symptoms yet and can't pass it to others. But if the people aren’t treated, they can develop TB symptoms and spread the disease to others.
TB disease. This is when people infected with TB bacteria become sick and have symptoms. They can spread TB to others. Kids younger than age 5 who are infected are more likely to get sick with TB disease. It also tends to be more serious in infants and young children.

When Should I Call the Doctor?

Call the doctor if anyone in your family has:

had contact with someone who has TB
a long-lasting fever
night sweats
a cough that’s long lasting or brings up blood
unexplained weight loss

Causes & Prevention

Is Tuberculosis Contagious?

TB is contagious. When someone with untreated TB coughs, sneezes, speaks, or sings, droplets with the bacteria go into the air. Inhaling these infected droplets is how a person gets TB. The disease is most likely to spread in indoor spaces where people are close to each other.

Kids are more likely to get TB if they live with a person who has it, are from a country where TB is common, live in a large group setting like a homeless shelter, or have a weak immune system (the body's defense against infections). This includes children with diabetes, HIV, or those taking medicines that weaken the immune system.

You can't catch TB germs by shaking hands, kissing, or sharing food, utensils (like forks), cups, or toothbrushes. TB also doesn’t spread by touching an item someone with TB has touched, like a toilet, clothes, or bedding.

Can Tuberculosis Be Prevented?

The best way to prevent the spread of TB is for those who are infected to be treated, and to stay away from others while they’re contagious. To prevent the spread of other germs, encourage everyone in your family to:

Wash their hands well and often.
Sneeze or cough into a tissue or their elbow, not into their hands.
Use separate towels, drinking glasses, and eating utensils rather than sharing these items.
Avoid contact with those who are sick.

There’s a TB vaccine, but it’s mainly used in countries where the disease is common. Kids in the United States don’t tend to get the shot unless there’s a high chance of catching TB. To learn more, talk with your doctor.

How Is Tuberculosis Diagnosed?

Doctors screen for both latent TB infections and TB disease by doing a:

Tuberculin skin test (TST). This is how doctors usually test young kids for TB. It's done in two steps. First, a small amount of fluid (called tuberculin) is injected into the skin on the lower part of the arm. It just feels like a pinch. Then, your child returns 48 to 72 hours later, so that a doctor or nurse can check the skin for a reaction. A raised, hard area or swelling means there are TB bacteria in the body.
Blood test. Doctors take a blood sample to be checked in a lab for TB bacteria.

Someone with a positive skin or blood test will need a chest X-ray and possibly other testing to see if they have a latent TB infection or TB disease.

How Is Tuberculosis Treated?

Most kids and teens with TB can be cared for at home. Doctors usually treat TB with oral (taken by mouth) antibiotics. Killing all the TB bacteria takes time, though, so most people need to take medicine for several months. Latent TB treatment tends to include fewer medicines and last a shorter time than TB disease treatment.

It's important to take the antibiotics for as long as the doctor says to, even if your child has no symptoms or feels better. That’s the best way to kill the harmful bacteria. Stopping treatment too soon or skipping doses can give the remaining bacteria a chance to become resistant to the antibiotic. (This means the bacteria change so the medicine doesn’t work as well anymore.) Drug resistance can lead to more dangerous types of TB that are harder to treat.