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Tuberculosis
Tuberculosis
is a disease which affects the lungs and pulmonary system. It is spread by
respiratory droplets. There is a high incidence of tuberculosis in almost all of the
countries of origin of adoptive children.
Much of the
tuberculosis the children come in to contact with is through the childcare workers
in the orphanage.
The
BCG vaccine given to the children in the first few weeks of life offers at best
60 to 70% protection against pulmonary tuberculosis. The BCG can, but does not
always, give a false positive skin test. If it yields a positive test, it tends to
wane over time.
All children
upon arrival to the United States, need to be screened for tuberculosis and
evaluated as though they have had an adult tuberculosis contact. A PPD skin test
should routinely be done each child. ALL tests should be read by a health care
practitioner. A chest x-ray should be taken when there is a 5mm or greater reaction
to the skin test. A 10mm reaction is considered a positive skin test.
Recommended
treatment for positive skin test without active disease (as evidenced by chest
x-ray) is nine months of a daily medication called Izoniazid. Children in whom
active disease is discovered should be cared for by a medical center specializing in
tuberculosis treatment.
All
adoptive children
should have skin testing redone within 6 to 9 months of arrival home.
Cindy Sundman, RN, BSN |
