As with any illness, tell the child’s family if you are concerned about their health. Contact 911 or your local emergency system if you think a child may be having a medical emergency.

Tuberculosis (TB) is a serious, contagious disease, caused by bacteria. It usually affects the lungs, but the disease can also affect other parts of the body. TB can make both adults and children sick.

There are two ways that TB can live in the body:

• Latent (inactive) TB: The bacteria live in the body but are inactive. The person has no symptoms and cannot spread the disease to others; however, latent TB can become active if not treated. Follow guidance to screen people who may be at risk so they can be treated early.
• Active TB: The bacteria cause symptoms that make it easy to spread the disease to others and should be treated right away. Active TB is typically seen in adults.

Knowing if TB is active or latent helps health care providers know how to treat it and prevent it spreading to others.

What are the symptoms of TB?

These symptoms are most often seen in adults with active TB:

• Fever
• Night sweats
• Chills
• Weakness
• Fatigue
• Chronic cough
• Heavy and fast breathing
• Swollen glands
• Weight loss

Children with TB may not show any symptoms.

TB is a notifiable disease. If a staff member or child is diagnosed with TB or has been around someone who is infected, contact and follow guidance from the public health department in your jurisdiction. Your local health authorities can help you notify parents/guardians about potential or confirmed exposures of their child to an infectious disease.

How does TB spread?

A person with active TB disease can spread it to others through the air when they cough, sneeze, or speak. People can only spread TB when they have active TB disease.

Other important things to know about the spread of TB include:

• Children usually get TB from being around adults with active TB disease.
• Not everyone who is exposed will become infected.
• It spreads more easily in crowded indoor spaces where people spend a lot of time close together.
• It is not spread by sharing clothing, dishes, or drinking glasses; shaking someone’s hand; or touching furniture and floors.

Who is at greatest risk?

People are at greatest risk of getting TB if they:

• Live with someone who has active TB.
• Have a weakened immune system.
• Live or work in crowded settings.
• Were born in a country that has high rates of TB.
• Visited an area where TB is common and had extended contact with people living there.

Young children and teenagers are at greater risk from TB because their immune system is not as developed as an adult’s immune system.

How can programs limit the spread of TB?

Health exams for staff and volunteers must follow the requirements of state, territorial, tribal, or local agencies. This may include documenting the results and appropriate follow-up of a TB screening using the Tuberculin Skin Test (TST) or interferon gamma release assay (IGRA) prior to working in early childhood settings.

Refer to Caring for Our Children (CFOC) 1.7.0.1: Pre-Employment and Ongoing Adult Health Appraisals, Including Immunization to learn more.

Subsequent TB screening may vary depending on the requirements in each jurisdiction and relevant history of an individual’s risk for TB. A person with a positive TB screen but without evidence of active TB may participate in program activities in consultation with their health care provider, health officials, the program, and child care licensing authority, if applicable.

For children, follow the recommended Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) schedule, including assessing the risk for TB. Also follow any additional recommendations from your Health Services Advisory Committee (HSAC) based on the prevalence of TB in the community. 

Refer to CFOC 7.3.10: Tuberculosis to learn more.

How can programs partner with families?

Here are some ways programs can partner with families:

• Share information about TB and other respiratory illnesses.
• Explain that adults with active TB are more likely than children to transmit TB infection.
• Help families find and use information about the signs and symptoms of TB.
• Encourage families to talk with their child’s health care provider about:
  • Recommended EPSDT guidelines, including assessing risk for TB
  • Vaccines they may have received in countries other than the United States
  • Importance of any additional evaluation and of completing treatment, even if the child or adult is symptom free
• Encourage families to share information with their Head Start program about any potential TB exposures, including close contacts and travel.
• For more information, see your state’s TB program.

« Go to Infectious Disease Fact Sheets

Last Updated: August 20, 2024