What is Tuberculosis (TB)?
Tuberculosis (TB) is a disease caused by germs that are spread from person to person through the air. TB usually affects the lungs, but it can also affect other parts of the body, such as the brain, the kidneys, or the spine. A person with TB can die if they do not get treatment. Before a person becomes a child care provider, they need to be tested for TB.
Symptoms of TB disease include feelings of sickness or weakness, weight loss, fever, and night sweats. The symptoms of TB disease of the lungs also include coughing, chest pain, and the coughing up of blood. Symptoms of TB disease in other parts of the body depend on the area affected.
There are two tests that can be used to help detect TB infection: a skin test or a special TB blood test. The Mantoux tuberculin skin test is performed by injecting a small amount of fluid (called tuberculin) into the skin in the lower part of the arm. A person given the tuberculin skin test must return within 48 to 72 hours to have a trained health care worker look for a reaction on the arm. The special TB blood test measures how the patient’s immune system reacts to the germs that cause TB.
A child care provider needs to be tested unless there is documentation of a positive test result in the past or of active TB that has been treated already. Child care providers being tested for the first time may be required to have a have a two-step test. (That is, if the first test result is negative, the skin test is repeated within one month.) Persons who have negative results from their skin tests when they start child care work should have their skin tests repeated every 2 years while the results are still negative or sooner if notified of a possible exposure to TB . When child care is being provide in the home setting, all persons aged 12 years and older who are present while the children are there should receive TB skin tests under this same schedule, even if they are not providing child care.
**Check your states or locality's child care regulations and laws. In every case, the laws and regulations of the city, county, and state in which the child care facility is located must be carefully followed even if they differ from these recommendations.
What Does a Positive Test for TB Infection Mean?
A positive test for TB infection only tells that a person has been infected with TB germs. It does not tell whether or not the person has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease.
What is Bacille Calmette–Guèrin (BCG)?
BCG is a vaccine for TB disease. BCG is used in many countries, but it is not generally recommended in the United States. BCG vaccination does not completely prevent people from getting TB. It may also cause a false positive tuberculin skin test. However, persons who have been vaccinated with BCG can be given a tuberculin skin test or special TB blood test.
Why is Latent TB Infection Treated?
If you have latent TB infection but not TB disease, your doctor may want you to take a drug to kill the TB germs and prevent you from developing TB disease. The decision about taking treatment for latent infection will be based on your chances of developing TB disease. Some people are more likely than others to develop TB disease once they have TB infection. This includes people with HIV infection, people who were recently exposed to someone with TB disease, and people with certain medical conditions.
How is TB Disease Treated?
TB disease can be treated by taking several drugs for 6 to 12 months. It is very important that people who have TB disease finish the medicine, and take the drugs exactly as prescribed. If they stop taking the drugs too soon, they can become sick again; if they do not take the drugs correctly, the germs that are still alive may become resistant to those drugs. TB that is resistant to drugs is harder and more expensive to treat. In some situations, staff of the local health department meet regularly with patients who have TB to watch them take their medications. This is called directly observed therapy (DOT). DOT helps the patient complete treatment in the least amount of time.
Research shows that TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can stay in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected; this is called latent TB infection.
To help stop the spread of germs:
Teach your kids how to help prevent the spread of germs. There is never a tissue near when you need it! Coughing or sneezing spread (or literally spray) germs and infect others. Children need to be taught to cough into the crook of their arm, into their sleeve, or even in their hand, and then to immediately wash their hands. Some providers/teachers have turned "cover your cough" into a game or type of positive reinforcement when kids are caught covering their cough correctly. Older kids may even create health posters and other lessons that can be posted in the classroom and even at home. How can you help young children remember to take the steps to prevent passing these diseases on to others? We tell our children to wash their hands and cover their cough and sneezes but they don't always remember.