[littlegirl2]

I had my daughter get the test for TB...and as we all know, our kids get the vaccine and WILL test positive. I have also learned from reading posts from all you experts that it needs to be over a certain size, etc. Well, I went today to get it looked at and they said she needed a chest x-ray because it was over the 10 mm. Then the Dr. said that even if the chest x-ray is clear...they need to report this to the department of health? and said they would decide on medication or not? Does this make sense? If the chest x-ray is clear...why would she still need meds.?
Any insight is greatly appreciated!!

[DeeVee]

Yes, they will report it to the health dept. And most likely they will prescribe 9 months of INH (isoniazid). That is because if the welt is over 10mm in diameter, it is most likely caused by actual exposure to TB. The BCG vaccine alone would not produce such a large mark. A clear chest x-ray means there is no active infection, but a positive test means she could develop the disease later in life. And the BCG vaccine does not prevent TB - it can mitigate its seriousness should the disease develop, but does not prevent it.

DD was on the meds and had no side effects. We crushed the pill and put it in applesauce or yogurt twice per week. I had to report how many doses she had every month to the health dept. Once she finished up, I got a little card saying she completed her course of treatment and need not be tested or treated ever again.

There is another test, TB interferon Gold (I think), but its accuracy has not been proven in children, and we were advised not to waste our time with it.

Hope that info helps! If she needs the meds, it is no big deal once you work it into your routine.

[avoel]

Originally Posted by DeeVee

Once she finished up, I got a little card saying she completed her course of treatment and need not be tested or treated ever again.

As a pediatrician I would take issue with this statement. I would agree that repeating the skin test again is not advisable because the reaction can get larger with repeated tests and at some point may scar (although in kids post treatment it is also possible to revert to a negative skin test as well). But, if you know for sure your child is actually exposed to TB in the future or ever has symptoms consistent with the disease, having been treated for the latent form as an infant should never prevent being treated again later in life if the need or suspicion arises.

[maak]

The chest xray will help to determine if your child has latent also called inactive tb or else the more serious active tb and therefore how many antibiotics your baby will need. If the chest xray is not normal and there are signs of active tb she will need to take multiple drugs. If she is just ppd postive with a normal chest xray then the child is usually assumed to have been exposed to tb and to have latent tb and is given just one tb drug called isoniazid or INH to help prevent full blown tb developing. My pediatrician did not recommend doing PPD on my child as he feels there are so many false positives in babies who recently recieved the tb vaccine called BCG as my dd had. I know this is controversial as coming from latin america she is at increased risk for tb but I felt ok with this.

[mommytoEli]

I had my daughter get the test for TB...and as we all know, our kids get the vaccine and WILL test positive.

not necessarily true. eli was tested about 10 months after he got home, he was NEGATIVE. a year after that, he was positive, and i believe 12 mm. the doctor said both due to the first negative test, and a new test over 10mm, he had definitely been exposed within the last 12 months.


I have also learned from reading posts from all you experts that it needs to be over a certain size, etc. Well, I went today to get it looked at and they said she needed a chest x-ray because it was over the 10 mm. Then the Dr. said that even if the chest x-ray is clear...they need to report this to the department of health?

yep, because this is called latent tb. meds will be most likely required, bc as it was explained to me, there is a chance that latent tb will become active tb, unless you are medicated. the department of health is therefore interested in the proper medication of your child.

and said they would decide on medication or not? Does this make sense? If the chest x-ray is clear...why would she still need meds.?

most of the kiddos here on tb meds (inh) had clear chest xrays, which just means the tb is latent, or inactive. just bc the tb isn't active, doesn't mean it won't become active later, so meds is the best choice for many kids. i was really worried about the meds and the side effects, but after really researching and talking to our doctor and an infectious disease specialist, i really was convinced that medicating eli was REALLY in his best interest.

Any insight is greatly appreciated!!

i'm sorry. i was so distraught after i left the doctors office, i took eli on a shopping spree at target. lol. i still feel awful for him. and giving him meds daily for 9 months is no picnic. i'm just glad that there are so many parents in the same boat that i can complain to. so vent if you need to. and be sure to ask your doctor what foods your child should avoid while on inh.

good luck. you'll survive. promise.

[hml1976]

The BCG vaccine will not necessarily cause a reaction, both of my kids had the BCG and one tests with a very small insignificant reaction and the other has zero reaction at all. Get the drugs and you'll be done with the whole issue good luck!

[mevertin]

Just wanted to echo what some of the other posters said. My 4 year old had the BCG vaccine and had a negative Mantoux and my 19 month old had the BCG and had a positive Mantoux. We are on the 7th month of meds for my little one and he has had no side-effects from the meds at all. I personally would rather take the meds and be done with it than worry about the possiblity of the TB becoming active at a later date.
Mary
mom to Bobby 11, Bridget 10, Angela 8, Eddie 4 (home from Guatemala in 2005) and Naldo 19 months (home since Feb.)

[DeeVee]

Originally Posted by avoel

ever has symptoms consistent with the disease, having been treated for the latent form as an infant should never prevent being treated again later in life if the need or suspicion arises.

Thanks for clarifying that Amy. I agree with you, I just didn't go down that road in answering the OP's question.

[Momonthefarm]

We are in the same boat and just had the same conversation with our doctor last week. In Iowa it is a state law and our daughter will take meds for 9 months. Our doctor will have to report to the Department of Health and he said we may have to fill out some forms too. Just a law and yet another hoop to jump through in this wonderful journey called parenthood!

It is a very small pill she swallows twice a day. When I had the prescription filled it was under $10.00 so not a huge financial burden. Good Luck! Renee

[w8ting4Thomas]

If you search you will see a post I made about this earlier. Don't remember when...maybe early summer???

Our DS had a "++" test too. Actually it was right on the cusp on the diameter reading for ++.

Anyway..they referred us to the health dept (again state law), but I was adamant that I was not going to have them simply prescibe Thomas something I didn't know if he needed. The woman seemed shocked by my attitude. Funny...even our Dr. told me it was no use fighting it, but when I simply asked for more information from the Health Dept as to whythey were doing this despite his history and what is known medically, they called and told me he did not have to take meds after all.

FYI - I took him to a 2nd Dr. (immunization spec) and he concurred that the Health Dept is quick to give the meds and get the case off of the desk. He told me no major concerns taking it for 9 months but why take it if an immunization specialist doesn't agree. I just don't like any meds that are not necessary.

Just another point of view.

[giovanni7460]

Giovanni did not have the vaccine in Guatemala. He came home at 10 months. He has been tested 3 times since then. Once when he was home less then 1 day. I thought all of them were on the cusp. Then my FIL came from Peru and was tested + while in the green card process. So we all had to be tested again. This time I took G to an infectious disease specialist. He was over the 10mm but with a clear x-ray. But the Dr. said he needed 9 months of meds. We are nearing our 5th month. No problems with the meds. I dont believe they reported anything to the health dept. here. They actually told me that I did not need to report it to his school. After listening to the DR. and also taking G on a shopping spree (I was so sad for him), I knew he had to go on the meds and that it was the best thing for him.
Patty