Tuberculosis, formerly called consumption, has been around for thousands of years infecting kings and poets and common men. Some famous people who had TB include King Tut, Ringo Starr, Pocahontas, Frederic Chopin, Eleanor Roosevelt, Andrew Jackson, Vivian Leigh and Nelson Mandela, to name a few.

Egyptian mummies dating back to 2400 B.C. showed bony deformities typical of tuberculosis, and Hippocrates described a fatal disease of young adults with the symptoms and tubercular lung cavities.

Nowadays, TB is still a major public health problem. In 2019, Texas had 1,250 reported cases. In 2015, more than 10 million new cases occurred worldwide. Up to 10 percent of asymptomatic people will develop active tuberculosis. The World Health Organization has purposed eradication of TB by 2050, which include diagnosis and effective treatment.

Tuberculosis is caused by a big germ called Mycobacterium tuberculosis. TB is spread when the bacteria is put in the air by a person with the disease in their lungs coughing, speaking or singing. This big germ falls on the surfaces around the infected person and may be breathed in or swallowed.

When a person breaths in the TB bacteria to their lungs, it can spread to the kidney or spine. TB in the lung or throat can be spread, but not when it’s in the kidney or spine.

Children do get TB as it is spread by people living closely together. This includes family members, friends and coworkers or schoolmates. Not everyone infected with TB becomes sick. As a result, two TB-related conditions exist: latent (hidden) TB infections and TB disease. If not treated properly, TB can be fatal.

In most people who breathe in the TB bacteria, the body is able to fight the bacteria to stop it from growing. They have no symptoms, feel good and don’t spread the disease. They usually do have a positive TB Skin Test (TST) or TB blood test. Later their body defenses may weaken, however, and they may develop the disease if not treated for this hidden infection.

A positive TST or TB blood test only tells that a person has been infected with the TB bacteria. To tell if the person has active disease other tests need to be done such as a chest X-ray and a sample of sputum. For children 2 years and older either a TST or TB blood test may be done. For children younger than 24 months, it’s recommended that a TST be done. If positive, a referral to an infectious disease expert is recommended.

Symptoms of active disease include a bad cough that lasts longer than three weeks, pain in the chest, coughing blood or sputum, weakness, weight loss, no appetite, chills, fever, sweating at night. There are medicines for treatment, but the treatment is very long, months long, and if not completed, resistance can develop to the anti-TB medicines.

Once again, an infectious disease expert should manage the medicines and the possible contacts of the infected person.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

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