Tuberculosis

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Author: 
Adoptive Families Association of BC
Source: 
Special Needs Database

Definition
Tuberculosis (TB) is a highly infectious disease caused by the organism Mycobacterium Tuberculosis.

Causes
TB is caused by an infection of Mycobacterium Tuberculosis. Malnutrition, crowding, poverty, and weak immune systems like those of infants and young children, all increase the likelihood of infection and its spread. TB is highly transmittable as it is spread through the air by coughing, sneezing, speaking, etc. For this reason, crowded areas such as orphanages are prime areas for transmission.

Characteristics
It is possible to be infected with TB and never become ill. In fact, approximately 90% of infections result in no symptoms. Different factors contribute to this including strength of immune system, age, nutrition, and environment. 

By the time symptoms appear the infection may have been incubated in the patient’s body for up to three months.

Initial symptoms include:

  • Weight loss
  • Reduced activity
  • Fever
  • Increased tiredness
  • Night sweats
  • or sometimes, in the absence of a fever, the patient could be showing pulmonary distress including wheezing, shallow breathing and coughing.

However, TB is not only a pulmonary disease. It can move into other areas of the body including:

  • Joints
  • Lymph nodes
  • Genitourinary tract (kidneys, bladder, urethra)
  • Pericardium (the membrane protecting the heart)
  • Central nervous system (TB Meningitis)
  • Abdomen
  • Bones (Skeletal TB)
  • Skin

These are referred to as extrapulmonary tuberculosis and it may take 12 months or longer for them to show symptoms.

Treatment
Diagnosis is made through the Tuberculosis Skin Test (TST).  If the test comes back positive, further examination is done to confirm if the disease is active or not. Even if the disease is determined to be inactive, isoniazid (INH) may be administered if there is any risk that the disease may become active.

Risks of inactive TB becoming active are increased in:

  • Children under 4 years old
  • Individuals infected with HIV
  • Individuals with other medical conditions including malnutrition
  • Those living and working indoors in close proximity with large groups of people; ie: orphanage, jail, hospital

If the tuberculosis is determined to be active it is entirely treatable, although recovery does take a long time. Without medication TB can be deadly; however with treatment it is almost always curable. Most patients are prescribed a total of four different medications to be taken simultaneously for at least six months.  These medications are usually isoniazid, rifampin, ethambutol, and pyrazinamide.  Also, there is a short two week quarantine period until the disease is no longer transmittable.

Complications
If medication for TB is discontinued before complete, the disease can return.  Unfortunately, it usually returns as Multidrug-Resistant Tuberculosis, a dangerous mutated form of the original. Fortunately this form of TB is still treatable as it is not immune to all four different medications, but it is very important to continue taking the medication for the full time period allotted by your physician.


This resource is by no means intended as a substitute for a doctor's advice or diagnosis. Any concerns you may have with regard to your child's health and development should be discussed with a professional in an appropriate field.