[csw]

Hi
A few things..relax....even if the child has active pulmonary TB with a positive CXR a child is NOT contagious in any way.,never..a daycare or school does not even need to be notified if there is a child who comes up positive. It affects the lungs in a different way than adults. There is no need for anyone else in your family to be concerned about catching this..kids are not contagious.

That being said..as has been mentioned..babies get the BCG vaccine in Guatemala, generally at birth, but my daughter didn't get it till she was 7 months old. It is not very effective against pulmonary TB, but is fairly effective against disseminated TB like TB meningitis etc..the worst kind..so..that is why some underdeveloped countries still give the BCG vaccine to protect against the meningitis etc..

Your child should have a red, blistery looking bump on his arm (maybe leg or buttocks) or if the vaccine was awhile back maybe a scar already..

You should also have it in the shot records from Guatemala..if not..you can email the doc (if you used Dr. Montiel) and he can tell you if you child got it or not..

Please do not put your child on 9 months of INH without getting furthur proof. There is a 2nd generation blood test called Quantiferon TB-Gold that is FDA approved and the CDC has guidelines on it. Our daughters PPD was 10-11mm induration (raised, red area)..this used to be considered negative in light of BCG esp, the cut off used to be 15 I believe. now they treat it as positive. If the CXR is negative, with a positive PPD, it means one of 2 things..the child was exposed to TB or they had a BCG vaccine...anyways..
most doc's are not up to date on the latest research. If you are in the Northeast..you can make an apt at the National TB Center in Newark, New Jersey for the blood test. We saw Dr. McSherry. Ana had the blood test that was $90 and insurance paid all but $4. There are TB centers like this located all throughout the USA.

It is important to make sure the child gets the blood test done (if you don't want the antibx) because the chance is highest the first year or two after exposure for a child to convert from latent to active TB. After 2 years the risk goes way down to as I recall 5% like that of an adult. Generally an adult would convert if they were immunosuppressed in some way or elderly..
The INH is thought of to be "safe" but there are cases of liver problems even in kids with healthy livers. No drug is 100% safe. Our doc said he see's about 2 cases a year where the child has severe liver problems on INH.
We didn't want to take that risk.

If you need any more info, feel free to PM me..