Tuberculosis Doctor: Should Parents Worry?

"The single most important thing I think that we've all done is establish direct TB hotlines with live people," Keenan said. "We're committed to continuing that as long as there's a concern."

Keenan noted that for urgent concerns, a call could be answered outside of regular hours if patients called the desk and it was an emergency.

She noted that while only a relatively small percentage of the patients have been tested, many were unavailable because of the holiday weekend, but the families were assured that waiting would not be a problem.

McAuley confirmed that assessment.

"On some level, it's actually better when you wait, because the skin test is more reliable," he said.

At Evanston Hospital, the test is being offered to parents midweek this week, according to spokeswoman Amy Ferguson.

The hospital notified 71 parents by phone on Friday and sent mail to nine others for whom they did not have a phone number if the family had a child in their Infant Special Care Unit between February 11 and March 12.

Ferguson said about 35 calls about had come to their hospital over the weekend.

She noted however, that because of the air filter in the infant special care unit ward, precautions the hospital takes against infection and the fact that the resident's close friends and family have not been infected, the hospital sees the risk to the children as "minimal to non-existent."

Watchful Waiting

While infants and small children who come to the hospital can receive a skin test, parents should also be aware of possible symptoms of TB, since a test will not always be accurate.

"It's really all about the maturity of their immune system," said McAuley, since the reading of the immune test simply gauges the body's immune reaction to TB. This problem was once common for HIV patients whose TB would not show up on the test because of their weakened immune systems.

He noted that children may be less likely to inhale airborne TB bacteria than adults, but are more susceptible to the infection itself.

"Adults have a much more mature immune system and are able to handle that infection," he said.

He noted that weak bodily defenses were a particular concern for immunocompromised children who were being treated at the hospital. For them, McAuley said, a chest X-ray would also be prudent.

In many younger children, said Dr. Mark Metersky, a member of the American College of Chest Physicians Chest Infections Network, TB medications might be given right away to head off potential problems. The protocol, he noted, is "treat first and ask questions later."

Metersky noted that in young patients, TB will often show up as fever, weight loss, cough or lethargy, but the symptoms can also be less specific, so parents should be mindful.

"Especially in a [newborn], the infection can manifest itself just about anywhere in the body. The parents of an exposed infant should be looking for any signs of illness," he said.

But while concerns may remain, Gerber, like Metersky and McAuley said that in this case there is little reason to believe any children contracted TB.

"At this point, we have every reason to believe that the risk is minimal," she said.

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