Tuberculosis (TB) in Children

What Parents Need to Know

Tuberculosis is caused by TB germs (bacteria) 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 lymph nodes, kidneys or the spine. The impact of undiagnosed or untreated TB in children is serious. Children are more likely than adults to develop TB disease soon after infection. They are also more likely to develop severe forms of TB disease.

Notifying People/Children Exposed to Infectious TB

Toronto Public Health notifies people who may have been exposed to TB disease.

Child Exposed to Infectious TB – Next Steps

You must take your child to a doctor as soon as possible for TB testing. All children who have been exposed to infectious TB should get a checkup for TB symptoms. They should also get a TB skin test or an Interferon Gamma Release Assay-Quantiferon blood test (IGRA-QFT) .  Any child with a positive TB test or symptoms of TB will need a chest x-ray.

A TB skin test or IGRA-QFT blood test is used to diagnose TB infection.

A TB test is done to see if there are TB germs in your child’s body.

• If the test is positive, your child has TB infection (latent). If the test is negative, your child may need to be tested again.
• It may take up to 8-10 weeks after exposure for your child‘s body to show if it has been infected or not.

Children under five years of age

• Should have a chest x-ray even with a negative skin test
• If the child does not have TB disease, they should still be given TB medicine until the repeat TB skin test is done 8-10 weeks later
• Your child needs to be treated until the repeat skin test confirms if your child has been infected or not.
• Young children need TB medicine to protect themselves as they may get very ill during these 8-10 weeks due to lower immunity in comparison to older children and adults.
• If the repeat skin test is negative, the medicine can be stopped and nothing further needs to be done.
• If it is positive, your child has TB infection (latent) and should continue taking the medicine as prescribed by the health care professional. Taking TB medication will prevent the sleeping TB germ from becoming TB disease (active).

TB Infection in Children

A child with TB infection has TB germs sleeping in their body and will have a positive TB test. The child cannot pass the germs to others but can become sick with TB disease if left untreated. Your child can continue to go to school and daycare and play with others. You should keep a record of your child’s TB test result.

Why should my child be treated for TB infection?

A child with TB infection can develop TB disease soon after being infected. Early treatment of TB infection reduces the chances of children becoming sick with TB disease.

TB disease in children can be very severe and may cause lifelong health problems, brain damage, even death. TB disease may interfere with a child’s growth and development. Children with the disease are often away from school for long periods of time, interfering with their learning and social development.

How is TB infection treated?

Children with TB infection are treated with specific TB medication. All medication for TB is free through your local public health unit. The medication is available in liquid, pill or capsule form.

Can the medicine cause any problems?

TB medications are considered very safe, but some medicines may have side effects.
STOP THE MEDICINE AND CALL YOUR DOCTOR IMMEDIATELY if your child has any of these symptoms:

• Nausea/vomiting
• Rash
• Stomach pain
• Lack of appetite
• Yellowing of the eyes
• Loss of energy/more tired than usual

Inform your doctor about any other medicines your child is taking

TB Disease in Children

A child with TB disease has active germs in the body. The child is sick and may pass the germs to others.

Children under five years of age often do not have TB signs and symptoms and are usually not infectious. Older children and adolescents usually have symptoms, such as fever, cough, night sweats, weight loss, pain, and/or swelling.

More detailed information about treating TB disease in children is available on our TB Treatment page.

Helping Children Take TB Medication

Tips to help you remember to give your child the medicine

• Keep the medicine in a place where you will see it, but out of reach of children.
• Use a pill organizer (dosette) if the TB medicine is in pill or capsule form.
• Give your child the medicine at the same time every day, such as before meals or before bedtime.
• Mark off your calendar every time your child takes a dose of the medicine

Tips to help your child swallow the medicine

• Crush pills or empty the capsule into a bowl and mix with a small amount of soft foods, such as applesauce, mashed bananas, yogurt, baby food or pudding
• Praise your children when they swallow the medicine
• Make it fun. Your child can mark the calendar with stickers

Prevent TB Disease in Children Pamphlet (Multiple Languages Available)

This information is also available in the following languages. To request a copy, email us at targettb@toronto.ca or call 416-338-7600 and ask for the TB program.