Tuberculosis

Tuberculosis (TB) is a contagious disease, caused by the bacteria Mycobacterium tuberculosis. The bacteria usually attack the lungs, but can attack any organ in the body. Recommended treatment depends on whether a person has:

  • Latent TB infection – has no symptoms and can't spread the TB bacteria to others; has potential to develop active TB disease if not treated
  • Active TB disease – has symptoms such as a fever, cough, weight loss; these persons may be able to spread the germ to others. Needs treatment to cure the disease.

How Is TB Diagnosed?

TB infection is most commonly diagnosed by a TB skin test or TB blood test. If either of the tests is positive, additional tests are needed to see if the person has a latent TB infection or an active TB disease. These tests may include a chest x-ray and laboratory tests.

What Head Start and Child Care Programs Should Know About Tuberculosis

See PDF version: What Head Start Programs Should Know About Tuberculosis

How Does TB Spread to Others?

TB is spread in the air when a person with active TB disease of the lung or throat coughs, sneezes, or speaks. The germs can be inhaled by someone else and they can become infected. TB is often spread between people who spend time together every day. TB in children usually comes from being around adults with active TB disease.

TB cannot be spread by sharing a drinking glass or eating utensils, shaking someone's hand, or touching furniture. Not everyone exposed to someone with TB disease will become infected.

Who Is at Risk for TB Infection and TB Disease?

Anyone who spends time with someone with active TB disease of the lungs or throat can become infected. Many people who have latent TB infection never develop TB disease. But some people who get infected are more likely to develop TB disease. These include:

  • Infants and young children.
  • Having been recently infected with TB bacteria (in the last two years).
  • Crowded environments (for example, Head Start and Child Care centers).
  • Rooms with windows that don't open.
  • Close contacts of a person with active TB.
  • Having a weakened immune system.

How Can Programs Limit the Spread of Tuberculosis?

Early childhood programs that encourage staff screening and exclude active TB disease cases reduce the risk of spread.

Work with parents to make sure that children in the center are up-to-date on their Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) schedule and immunizations. If a case of TB is identified within a center, the child or adult should be excluded and receive further testing and medical treatment, if necessary.

Implications for Head Start and Child Care Programs

  • All children and staff should be tested for TB infection if there has been an exposure to a person with active TB disease within the center or at home.
  • Children and staff with active TB disease should be excluded from the Head Start or child care center until treatment is started, and the doctor determines the child or staff member is no longer infectious.
  • Staff absences may be a challenge to Head Start or child care providers. Absences may be related to staff illness or may be caused by worried employees who fear being exposed to TB at work. TB testing of exposed staff (by either TB skin testing or the TB blood test), and education about TB can help prevent absences from work due to fear.
  • Programs should review their emergency plans and staff availability to ensure adequate coverage, if needed.

How to Talk to Children about TB

If children have questions, take time to listen and answer their questions.

  • Be honest. Answer questions based on the facts and as age-appropriate.
  • Speak in a calm tone of voice, using reassuring words.
  • Help parents and caregivers in keeping children updated on their immunizations and their state Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) schedule.

Where Can I Learn More?

What Parents Should Know About Tuberculosis

See PDF version: What Head Start Parents Should Know About Tuberculosis

How Does TB Spread to Others?

TB is spread in the air when a person with active TB disease coughs, sneezes, or speaks. The germs can be inhaled by someone else and they become infected. TB is often spread between people who spend time together every day. TB in children usually comes from being around adults with active TB disease.

TB cannot be spread by sharing a drinking glass or eating utensils, shaking someone's hand, or touching furniture. Not everyone exposed to someone with TB disease will become infected.

Who Is at Risk for TB Infection and TB Disease?

Anyone who spends time with someone with active TB disease can become infected. Many people who have latent TB infection never develop TB disease. But some people who get infected are more likely to develop TB disease. These include:

  • Infants and young children.
  • Having been recently infected with TB bacteria (in the last two years).
  • Crowded environments (for example, Head Start and Child Care centers).
  • Rooms with windows that don't open
  • Close contacts of a person with active TB.
  • Having a weakened immune system.

How to Stop the Spread of Tuberculosis?

  • Your child should be tested for TB infection if there has been possible contact with someone with active TB disease at the center or at home, even if your child has been tested before.
  • If your child has latent TB infection, make sure to finish the recommended treatment from your child's doctor. You will need to keep your child at home until your doctor approves your child's return to the center.
  • If your child has active TB disease, they may have to go to the hospital for care and treatment. Once discharged, you will need to keep your child at home until your doctor approves your child's return to the center.
  • Adults and children at home with active TB disease should cover coughs and sneezes with a tissue; tissues should be thrown away in a sealed plastic bag. Adults with active TB disease should not go to work or school, and avoid close contact with others. Those with active TB should sleep in a bedroom away from other family members; they should air out their room often to the outside of the building.
  • Make sure your children are up-to-date on their immunization schedule.

Should a Child with TB Infection be Excluded from Head Start or Child Care?

Children found to have TB infection should be seen by a health care provider to determine if the child has latent TB infection or active TB disease. If the child has latent TB infection, the health care provider may prescribe treatment to prevent the infection from becoming disease. A child with latent TB infection can't transmit germs to others, the child can return to Head Start or child care. It is important for the child to complete all the medication as prescribed to prevent developing active TB disease.

A child diagnosed with active TB disease must stay out of the center until treatment is started, and the doctor determines the child isn't contagious. The Head Start center or child care provider will ask for a note from the child's doctor to your child's return.

How to Talk to Children about Tuberculosis

  • If your child has questions, take time to listen and answer their questions factually and honestly.
  • Speak in a calm tone of voice.

Where Can I Learn More?

Tuberculosis. HHS/ACF/OHS. 2016. English.

Last Reviewed: April 2016

Last Updated: April 12, 2016