I am getting my mind wrapped around this issue of tuburculosis. Here is what I know from on line discussions, etc. If anyone has anything to add to this PLEASE DO comment!
Most children are given what is called a BCG in Ethiopia, it is a shot which is an immunization for Tuberculosis. The shot leaves a circular scar on the upper arm of the child. This is a good way to tell if your child has had it since there are so few records.
If your child has had a BCG *which took* (was effective) he or she will test positive on a regular skin scratch TB test here in the states. A more specialized test is required to see if the child actually needs treated or not. You will have to push for this. Many child DO NOT need treated. They will just show up positive all the time and not have it. I understand that a chest X ray will help to confirm this. Being treated if you do not need to be treated is not going to harm the child, but extra medications are hard on the system and they likely have a rather fragile system as it is.
Some children actually DID have Tuberculosis and because of this will test positive even though they do not have it and treatment will not be helpful. Also in this case, a chest X ray will confirm.
Wikipedia on BCG
This is the page you need to print off and take to the Doctor with info on the BCG.
http://www.cdc.gov/tb/publications/factsheets/prevention/BCG.htm
PDF version
excerpt from the above PDF document:
Testing for TB in BCG-Vaccinated Persons:
"The tuberculin skin test (TST) and blood tests to detect TB infection are not contraindicated for persons who have been vaccinated with BCG.
Tuberculin Skin Test (TST). BCG vaccination may cause a false-positive reaction to the TST, which may complicate decisions about prescribing treatment. The presence or size of a TST reaction in persons who have been vaccinated with BCG does not predict whether BCG will provide any protection against TB disease. Furthermore, the size of a TST reaction in a BCG-vaccinated person is not a factor in determining whether the reaction is caused by LTBI or the prior BCG vaccination. (See below for specific guidance on skin test results.)
TB Blood Tests. Blood tests to detect TB infection, unlike the TST, are not affected by prior BCG vaccination and are less likely to give a false-positive result."
Treatment for LTBI in BCG-Vaccinated Persons:
Treatment of LTBI substantially reduces the risk that TB infection will progress to disease. Careful assessment to rule out the possibility of TB disease is necessary before treatment for LTBI is started. Evaluation of TST reactions in persons vaccinated with BCG should be interpreted using the same criteria for those not BCG-vaccinated. Persons in the following high-risk groups should be given treatment for LTBI if their reaction to the TST is at least 5 mm of induration or they have a positive result using a TB blood test:
HIV-infected persons
Recent contacts to a TB case
Recent arrivals (less than 5 years) from high-prevalence countries
Injection drug users
Residents and employees of high-risk congregate settings (e.g., correctional facilities, nursing homes, homeless shelters, hospitals, and other health care facilities)
Children less than 4 years of age, or children and adolescents exposed to adults in high-risk categories
Monday, June 7, 2010
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