Tuberculosis in kids: 8 myths and facts

Many people think tuberculosis (TB) is a thing of the past. But TB infections still happen today in the U.S. and around the world – and the number of infections in Texas is increasing.

“Families are often shocked when they learn their child has what's called latent TB,” says Amanda Evans, M.D., Infectious Disease Specialist at Children's Health℠ and Associate Professor at UT Southwestern. “I tell them: This is one of the most common diagnoses in my clinic. It’s very treatable and the medications are very safe.”

Dr. Evans addresses common misconceptions about TB and shares what families can do if they’re concerned about the disease.

Myth #1: All tuberculosis infections are the same

Fact: There are two different forms of TB infections, active TB and latent TB.

• Active TB causes symptoms and can make a person very sick. It's uncommon in the U.S.

• Latent TB means you have TB bacteria in your body, but you don’t experience symptoms and can’t spread the infection. An estimated 13 million people in the U.S. have latent TB.

Myth #2: Tuberculosis is a disease of the past

Fact: Millions of people in the U.S. and around the world have TB today.

Many people learn about TB in history textbooks or stories that take place in the 1800s and 1900s. TB caused millions of deaths during that time, before we had antibiotics. Many people also died of TB in the 1990s HIV epidemic, because people with HIV are more susceptible to TB.

Thanks to modern medicine, far fewer people die of TB today. But the bacteria still exist and makes many people sick.

Myth #3: TB is genetic or a virus

Fact: Tuberculosis is not genetic or a virus – it’s a bacteria.

Scientists used to think TB was passed down in families (genetic). But we now know that's not true.

“TB is a bacteria, which means unlike viruses, we can use antibiotics to treat it,” Dr. Evans says.

Myth #4: Everyone with TB is contagious

Fact: Only people with an active tuberculosis infection is contagious.

Tuberculosis can spread when a person with an active TB infection talks, breathes or coughs.

People are more likely to get TB if they:

• Have spent time near someone with active TB.

• Were born in or frequently travel to Southeast Asia, Sub-Saharan Africa and parts Mexico and Central America.

• Live or work in places where TB is more common such as homeless shelters or jails.

Kids with weaker immune systems and those who have other medical conditions like cancer are more likely to develop active TB (rather than latent TB) if they are infected with the bacteria.

Myth #5: Everyone with tuberculosis coughs up blood or loses a lot of weight

Fact: Active tuberculosis can cause many different symptoms. Latent tuberculosis does not cause any symptoms.

Tuberculosis symptoms include:

• Coughing that lasts three weeks or more (may cough up mucus that is tinged with blood)

• Weight loss

• Fever

• Night sweats that leave a child's clothes or sheets very wet

• Swollen lymph nodes

Myth #6: TB only affects the lungs

Fact: Tuberculosis can affect many organs.

TB can infect a child or teen’s:

• Lungs

• Liver or colon (called abdominal tuberculosis)

• Uterus

• Bones and joints

• Brain and spinal cord (tuberculosis meningitis)

Myth # 7: Latent TB does not require treatment

Fact: Latent tuberculosis requires treatment because it can turn into active tuberculosis.

About 80% of people with active TB infections had latent infections that became active according to the CDC.

Latent infections are more likely to become active in children under 5, teenagers, pregnant people and elderly people. Some medications that slow down the immune system can also play a role in TB going from latent to active.

Doctors recommend treating latent TB to clear the infection and make sure it does not become active.

Treatment for latent TB typically requires a 3-4 month course of antibiotics and 6 months or longer for active TB. This is because TB bacteria grow much slower than other bacteria.

“Parents often hesitate when we tell them that their healthy-looking kid needs a three-month course of antibiotics, and that’s understandable," Dr. Evans says. “But the medications we use are very safe. And if TB becomes active it can be devastating.”

Myth #8: TB cannot be cured.

Fact: Most people who have tuberculosis can be cured.

Doctors have safe and effective medicines to treat tuberculosis in kids of all ages, including newborns.

Because TB requires a longer course of antibiotics, care teams and the health department work closely with families to make sure kids take all of their medication through regular check-ins and follow-ups.

What to do if you’re concerned about TB

If you are concerned that your child has been exposed to TB, contact your pediatrician or local health department. It's best to get your child tested soon after the exposure and then again in 8-10 weeks.

Encouraging your child to wash their hands often and keeping them home if they’re sick can also help prevent the spread of germs.

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