Tuberculosis. It is a very contagious disease that fortunately, when diagnosed properly, is treatable and containable. Of course if you are full blown TB, the signs are obvious. But if the disease is latent or has not advanced, it is important to be tested, especially if you work in the medical field, schools, or even zoos with primates. A TB outbreak can be quite serious, if not catastrophic.
TB is not much of a concern here in the United States, but as a free country, we have those who travel around the world. One such example of that travel, is to internationally adopt.
Both of my daughters are adopted internationally, and as part of their care prior to the adoption, was receiving a vaccine called “BCG”, specifically administered to prevent TB. Sounds like a good thing, prevention, and it is. But there is an unintended side effect.
Prior to both of my daughters arriving home in the US, my daughters went through physicals at the consulate clinic. Of course, both were healthy, happily. But upon returning home, we had our own well-baby visit to attend to. And a requirement by the adoption agency, our daughters needed to be TB tested.
Now, the issue that comes up from TB testing a child who has received the BCG vaccine, is something called “a false positive.”
And you can get these “false positive” reactions for any number of reasons. I get a seasonal oil based steroid shot for my allergies that produces a false positive. And in the case of my older daughter, and a clear majority of children vaccinated with BCG, she showed a false positive as well. Now there are immediate issues as well as long term issues that need to be dealt with. And as my daughters get older, now in their teen years, approaching adulthood, it is important that they understand their health, as limited as our knowledge is because of adoption.
At the time, with my older giving that “false positive”, and with others who have this result, a chest x-ray is done. And the only purpose of this chest x-ray, is to determine if you actually have TB. If the x-ray is clear, then it is assumed you do not have TB. Which is not completely true. The disease could be latent, or dormant, or as in the case of my daughter, just a “false positive” caused by the vaccine.
Depending on the protocols of your pediatrician, some may actually decide to treat your child as if they were infected with TB, even if no signs, just as a precaution. There are a number of drugs used, and the length of the treatments can last from weeks to several months. Side effects can range from minor to severe, mimicking flu like symptoms or even affecting the liver. I had heard nightmare stories about the treatments and their effects on their infants and toddlers, and it was decided that we would refuse treatment and look for a different pediatrician.
As for our younger daughter, we were ordered by the adoption agency to have her undergo the same test, but given what happened with our older daughter, we refused. For me, it was simple, once the x-ray ruled out TB, I was not exposing my daughters to any side effects from treatments that were precautionary. Dealing with side effects from my cancer treatments are harsh enough, and I had to go through those.
So, here is where it becomes important for my daughters, and others to realize how their bodies work, having received the BCG shot. There is a gold standard blood test that diagnoses TB, called Quantiferon. And this test leaves no doubt of a diagnosis, but also prevents the “false positive.” For someone exposed to the BCG vaccine, and as long as your medical professional knows this exposure, you should automatically pursue this testing if required for school or employment. Bottom line, this is where it will end up anyway, and, needless to say, the delays and worries you will face with having a “false positive” hanging over your head.
As I mentioned, that allergy shot I got, was always given around the time I had my annual health surveillance at work. I would hold out as long as I could so I could get the TB test done, but it never failed, I ended up with the allergy shot first. And then the threat would come from my employer, I would be prevented from working until I could be cleared, going through the Quantiferon testing. That would mean, no paycheck. For college or other schools, you could be prevented from participating in programs that involve health while you wait for official results.
“Paul’s Heart” is about awareness, not alarming. Know what you are dealing with, before you have a situation that has to be dealt with. I do not anticipate any problems for my daughters because of this BCG vaccine, but it is important that they know how to be tested when necessary.