Questions about children’s and adolescents’ tuberculosis

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Child tuberculosis

What are the symptoms of TB disease in a small child?

TB bacteria may cause the disease in the lungs of the child or elsewhere in the body such as lymph nodes, abdominal area or bones. The disease can also spread throughout the body and to the brain. The symptoms of TB disease depend on which part of the body is affected and the child’s age.

The symptoms of TB disease in infants and children below 5 years of age may be minor. The child may have cough, appear to be ill, have a fever and the child’s growth may slow down. The child may lose weight, or weight does not develop normally. The child may be tired and doesn’t have the energy to play and isn’t as active as usual.

TB disease can progress much faster in a small child than in a bigger child or an adult. A child can become severely ill within a few weeks, and the disease may be life-threatening.

Where are children (≤ 16-year-olds) examined for TB disease?

If a child has symptoms, the child will be taken to the health station. If the doctor suspects TB disease, the doctor will write a referral to the Pediatric Outpatient Clinic and investigations for TB will be done there.

How and where is TB disease of a child treated?

TB disease is treated with medicines. (read more about TB treatment here). Treatment is started at hospital in a children’s ward. If the child’s TB disease can spread to others, the child is first treated in an isolation room. When there is no more risk of infecting others and the child’s condition is good, medication continues at home.

The child will visit the hospital regularly so that the health staff can monitor the treatment and its effect on child’s health. Blood samples are collected every 1-2 months. X-rays are taken a few times during treatment and at the end of it. The child will also be checked by the doctor. If the child is older or an adolescent, sputum samples will be examined.

Taking medicines can sometimes feel hard or one may forget to take them. The child may also get adverse effects from the medicines. This is why a nurse will monitor how the child feels and will be present when the child takes the medicines in the hospital and also after the hospital period. It will be agreed with the nurse how the medicines are taken at home. Usually the child will meet the nurse 5-7 times a week. Depending on the situation, the child will go to take the medicines at a health station or, for example, in school health care. In some cases, a home care nurse can give the medicines at home. This is done to make sure that the child is cured. At the same time, this will prevent the bacteria from becoming resistant to medicines.

Can parents give the TB medicines to the child? Where can the parents get help if there are problems in taking the medicines?

If the child is shy of the nurse, parents can give the medicines to the child. However, to make sure that all medicines are taken regularly throughout the treatment and to support the family it is necessary that the nurse is present and observes when medicines are taken. If there are problems in taking the medicines, the nurse will inform the doctor who is responsible for treatment.

Can a child’s TB disease spread to other members of the family?

TB disease of a small child does not spread, but a school-aged child can have infectious TB disease (TB of the lungs or throat). Young people can easily develop a highly infectious disease.

TB bacteria are spread through the air from one person to another. When a person with infectious TB disease coughs, speaks, or sings TB bacteria spread into the air. Other people who are staying in the same room (flat, classroom, work space, car) may breathe in these bacteria and become infected. People with TB disease are most likely to spread it to people they spend time with every day e.g. people living in the same household.

Can a child with TB disease be at home/sleep with siblings in the same room?

A child with infectious TB disease cannot be at home.  TB medication is started at the hospital.  The child can go home from the hospital when the disease is no longer infectious. The child can then sleep in the same room as others. The child will continue to take medicines at home.

Can a child with TB go to a daycare center?

Usually a small child does not spread TB. When the child has been sent home from the hospital, he or she can return to daycare.

Should one tell others about the child’s illness and what should be told?

You can tell people who are important to your life and who you can get support from about the child’s illness. Explain that TB is cured with medicines. When the child gets medication, there is no reason to be afraid of transmission. Like any other sick leave, it is good to inform the day care staff about the child’s illness.

Adolescent tuberculosis

What are the symptoms of TB disease in a school-aged child and adolescents?

The most typical symptoms of TB disease in older children and adolescents are

  • a cough for several weeks, which does not improve (tuberculosis of the lungs)
  • fever which lasts over 2 weeks
  • lymph nodes get bigger
  • stomach and back pain
  • weight loss and loss of appetite
  • night sweats
  • fatigue

At first there might be no symptoms.

What can I do to pass time during hospital care in an isolation room?

You may have to stay in an isolation room for some weeks, sometimes for months. This way the disease is not spread to others. Think and plan what would help make this time easier for you.

Bring some of your personal things into the isolation room. Keep your own daily routine. Be active during the day time: read books and magazines, watch movies, keep yourself updated with the Internet, meditate.

When your condition improves, you can start exercising. Ask nurses and physiotherapists for equipment. Take a walk outdoors if it is possible. Ask for and eat your favorite food and drink.

Stay in touch with other family members and friends via phone and computer. Follow your studies and do your homework. The municipality arranges school education in the hospital for children who go to the primary school. Visits are allowed but visitors need to use respiratory protection. Big group visits are not recommended. Small children are usually not allowed to visit.

The hospital school teacher will support children who go to primary school in their studies during the time they are treated in the hospital.

What do I tell about TB to my friends and family?

Explain that TB is not easily transmitted. It can be cured with medicines. Those people who have inhaled the same air for a long period are at highest risk.

Tell your friends to read more about TB from the -website.

Can I visit a friend who has TB disease and is in an isolation room in the hospital?

Yes, you can. When you keep in touch with your friend it makes the isolation period easier for him. Visitors need to wear respirators when they go to the isolation room. Make sure that you put on the respirator in a correctly and it sits tightly on your face. Ask the staff to help you. Small children are not usually allowed to visit. They do not know how to use a respirator and may get infected. Read more about isolation here.

How can I support a friend who has got ill?

Keep in touch with your friend as usual. Ask if you can help your friend with anything. Do things together that makes your friend happy. Talk to your friend and find out what and to whom you can speak about your friend’s illness.

How soon can I return to school / study after the drug treatment has started?

Your doctor will decide when you can go home from the hospital. You will continue to take medicines at home. Before you go home, it is agreed where you go to take your medicines daily. In addition, you will regularly visit the outpatient clinic in the hospital, where your treatment and its effect on your health is monitored. This changes your normal daily schedule and requires adaptation and can make you tired.

It is good to rest at the start of treatment. When you get better you will little by little feel less tired. You can continue your school and study as soon as you are able to eat and be active. This also usually improves your mood and helps your recovery. Once you get home from the hospital, you will no longer infect or endanger your friends.

Will smoking hinder my recovery?

If you smoke, your lungs will be impaired and won’t work as well as usual. Your general immunity will weaken also.

If I drink alcohol, should I not take my medicines that day?

No. It is important that you take your TB medicines every day. Do not use so much alcohol that you cannot take care of yourself.

Can I go travelling to Asia or elsewhere during the period I am taking TB medicines?

It is better not to plan a longer trip during medication. Talk about shorter trips in advance with your nurse. That way your health staff can plan your medication in advance so that there will be no breaks.

Your TB treatment lasts for a limited time only. When you are healthy, you can travel again.

Is it possible to get infected when travelling abroad?

On a normal city or beach vacation and living in a hotel, the risk is small. During a backpack trip in countries where TB is common, the risk of getting infected is higher. During such travel one often sleeps and spends time with the locals in the same premises and inhales the same air.

Can TB be spread through a water pipe?

Using a water pipe for smoking is associated with the risk of TB transmission. Transmission of TB is not caused by contact with the waterpipe. TB is spread through the air from one person to other. When the sick person speaks, and especially when he coughs, TB bacteria are released into the air. Waterpipe smoking irritates the lungs and makes the person cough even more. Other people present, can then inhale the TB bacteria in their lungs and get infected.

How can I help my own recovery during the time I am taking TB medication?

TB disease and its treatment can bring tiredness, all kinds of feelings and a low mood. Open discussion and information on TB will give your family members and friends an opportunity to support you during treatment. Small activities and tasks which bring you happiness will also help you get well. People have their own ways and means to get better. Think about and write down those things and people that bring you strength and good feelings. Remember that TB treatment won’t last forever.

Take all medicines regularly. Do not skip doses, even if you feel well and you do not experience any symptoms of the disease. If you doubt or notice any side effects whatsoever from the medicines, always tell your nurse or doctor.

Normal versatile food helps you to recover. Take vitamin D daily, it is important for recovery. Fasting is not good when you are ill. Physical exercise and moving outdoors help you to get better and make your mood better.

Can TB be spread through kissing or having sex?

TB is not spread through sexual intercourse or kissing or other touch. TB bacteria are spread through the air from one person to another. When a person who has TB disease of the lungs or throat coughs, speaks, or sings, TB bacteria are spread in the air. Other people who spend time with the ill person may breathe in these bacteria and become infected. If the person who has TB (before he or she has started taking TB medicines) has stayed with their sexual partner indoors for long time, transmission is possible. You do not need to worry about kissing on the mouth or cheeks.

Taking TB medicines reduces the risk of transmission rapidly. You can have sex while you are treated for TB. At the beginning of the treatment, you may however, be so tired that sex does not interest you. It is good to tell your partner this.

Can a person who has TB disease have children?

Yes, a person who has TB can have children. Medication for TB does not affect the fertility of a man or a woman. If you are planning a pregnancy, it is better to wait until your TB treatment is finished. When you are healthy, you have more strength to take care of your baby.

If you are already pregnant when TB is diagnosed, medical treatment will be planned accordingly. TB medicines are not dangerous but untreated TB is a risk for both the mother and unborn baby. If TB treatment has gone well, the mother may take care of her child and breastfeed normally after delivery.

If the mother’s TB can spread during birth, the newborn will be given medication to prevent TB disease. The mother can take care of the baby if it has been confirmed that her TB is drug susceptible.

Why do young people get TB?

TB is caused by TB bacteria. The risk of getting sick with TB among those with TB infection depends on age. Small children are most vulnerable. After them, young and young adults have the greatest risk. They are active and move a lot in society, so infection also spreads among them more easily.

If you or your friend have symptoms of TB disease, go and get yourself checked and encourage your friend to do so as well.