[jjuliejchad]

We are very upset. Our son had a skin test for tuberculosis and it is positive. He has to go on medicine for 9 months so it does not become active and contagious. We are devastated and stressed since we don't want our older son to get it.

Has anyone else returned home to find out that their child was positive? Is this one of those things that they don't test for in Guatemala? Thanks for your help.

Julie

[momofmng]

I am sure more people will post quickly to this... but he most likely does not have TB! Guatemalan children receive the BCG vaccine in Guatemala that can sometimes trigger positive TB test results. Be sure to research this in the archives and then speak to your doctor!

Sarah

[TRBenson]

Exactly what Sarah said! Your child most likely does not have TB. It's just from the BCG Vaccine (the little shot on his shoulder, of which he probably has a scar).

[Happy123]

My husband was tested and it came back positive and no one else (myself and 2 children) ever came back positive. This was several years ago and we all have had recent TB tests.

He went on the medicine for quite some time and now can only have chest x-rays if a TB test is needed because he will always test positive according to his doctor.

Try not to worry to much I am sure it will all turn out.

[KellyMigoya]

It is because he has had the TB vaccine which almost all other countries but the US gives to its babies. My husband is from Spain and tests positive because of the vaccine and they always just do a chest x-ray to confirm and that is it. I would get a second opinion about the medication for 9 months.

[dspakowsky]

This wasn't my question... but I really appreciate all the great information. We have our fisrt well-baby appointment on 2/1, and I would have never known this!

[laburton3]

I was told by my orphanage to tell my dr that he had the vacine and that children with this vaccine will come back as positive and that if required will have to have a chest X-ray to be cleared of this.

I am sure that this is the case with your child and I would definately have the x-rays before I did any meds.

Everytime that I have told Dr that he had the vaccine they did not even do the test. Just thought you should know. Please keep us updated.

[Anne22]

FYI, Gabriel's pediatrician did not test him for TB once he saw that Gabriel had had the BCG vaccine. He explained that the BCG vaccine made it likely that Gabriel would test mildly positive for TB.

[Kaceysmama]

If he does have the scar, he has had the BCG vaccination. My Ped said that since he has had this, we should not have him tested for TB, that it would not only come up positive, but he could develop a reaction from it, as well.

If a doctor ever suspected TB, in lieu of the test, a chest x-ray should be done. Our doctor said that if/when our son goes to college, usually a TB test is required. I'm glad he explained it to us.

Call back your doctor and have them research this for themselves. I'm somewhat shocked they didn't come up with this on their own. Assuming they were presented with a list of your child's vaccinations to date?!? If they are convinced he still has TB, I would request the chest x-ray before doing any meds.

I wouldn't worry about this. Hang in there!
Good Luck,
Kris

[mamalaura]

There is a post from 12/1/05-12/2/05 titled Children on INH that I think will be helpful. Scroll down to my lenghtly reply as I was able to share some good info.

[tinaedmond]

Our DD tested positive, and altho the chest x-ray was clear, a doctor who specializes in caring for internationally adopted children still put her on INH for nine months, as a preventative measure.

Our daughter never had any reaction to the INH, and for the most part took it pretty willingly when we placed the crushed pill in applesauce, pudding, etc.

So, regardless of whether she was actually exposed or it was because of the vaccine, she's now protected against ever contracting TB.

Tina

[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..

[tricecm]

I haven't read the other posts yet, so sorry if I'm repeating what they have said but....

DON'T START THOSE MEDS YET!!! If the chest x ray is clear, take a look at the scar on the shoulder. Is it still oozing? If it's still oozing, then that is why your child tested positive. Ask your pediatrician to refer you to the infectious disease person (or ask that your pediatrician educate him/herself on 3rd world medicine and international adoption issues). Our pediatrician didn't even know what a bcg vaccine was!

Here's the thing......the only thing our pediatrician knew for sure is that the INH would deplete our childs vitamin b6 so he had to take a daily supplement, plus he had to have blood tests monthly to ensure those strong meds weren't wrecking his liver. Now......I figured if we were risking his liver I wanted to ask some questions.

We went to the infectious disease guy (who also didn't know what a bcg vaccine was, or what the scar looked like). The infectious disease guy went and made some phone calls to some colleagues and when he came back he agreed with me that the mantoux should be re-done.

Guess what? It was negative! No kidding. I knew it would be negative. Here's the other thing though-----if you start the INH while the bcg scar is still oozing, it will continue to ooze while on the medication. Our son's scar oozed until we took him off the meds (he was on it for about 6 weeks).

Both the pediatrician and the infectious disease docs were really patronizing towards me. Both of them asked me "Don't you realize that tb is a life threatening illness?" I responded to both of them by saying "I assumed that an md would know that liver failure is life threatening also." And I told both of them that it's not that I was refusing treatment, I just wanted a more thorough diagnosis and to get my questions answered. Seems reasonable.

So........as long as your child's chest xray is normal you don't have to worry about it being contaigous. Don't worry, just get some more answers. Don't let anyone railroad you into taking those strong meds without getting your questions answered!

[jjuliejchad]

I have contacted an international adoption specialist in Boston and she has confirmed that he is not contagious. That makes me feel much better. He is 3 1/2 years old and we do not have any record of vaccines prior to a year ago so I don't know if he has had the BCG or not. He has a scar that almost looks like a cigaretts burn on his shoulder. Can anyone tell me what their child's scar looks like?

Thanks again!

Julie

[gkasche]

Please do NOT start your baby on meds until you seek another opinion. My daughters are from India...each one of them received the live TB vaccine. This vaccine is not used in the U.S. They will ALWAYS test positive for TB because they have antibodies to it which are from the vaccine. A simple chest x-ray should be done and will satisfy you that he does not have TB. If he has a small scar on his shoulder...he has had the live vaccine for TB. Most all 3rd world countries still use this type. He is not in any danger. BUT...my doctor told me to never have the girls receive a TB skin test. He has seen some pretty severe skin reactions. If there is a question whether he has been exposed to TB in the future.. simply do a chest x-ray...no skin tests. Please get a second opinion on the test your son had. I didn't read all the posts before mine...but I'm sure they are giving you the same advice. Take a deep breath and love your baby...I'm sure he is fine......Karen